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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection _.� ,
Date Requested. :2 go Time A.M. P.M.
Address _ L. __ 1�tSdL_�-�J—LL4«-' _. Permit 8 _
Owner Lot #
Builder —._
The following Building Code deflciancies are required to be corrected:
-- -------- --
I
Presented to "proved
Inslrector L lJ ❑ Disapproved
Date
CALL FOR REINSPECTION
r1_1 YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection 12
Date Requested i !' Ll /Time�_ A.M. ✓ P.M.
Address :``�•� LZ� Lx-Z<-1 •Cy! j !-e-[ Permit
Owner Lot #_
Builder
The following Building Code deficiencies are required to be corrected:
--------------- -
Presented to
P�7ai
ApprovedInspector -AL. [_� Disapproved
Date 1 ---- — I
CALL FOR RYMPF,CTION
L..I YES FA ho
BUIL-DIi:G PERMIT APPI IGA.TION TIGARD DATE__— _ ?9____._ 5587
THE UIJDE,'iSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _,b42-3093
09 AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
Oa -- !y// C _L-OT-NO.
W1 1tuLFYrouerLies_JOBADDRESS--_ :. 4-S SW **ase-Crer.K Y'Imce . ?
ZU945 SW 'Tu Hwy. ARCHITECT
Haase /aloha UR 91UG6 ENGINEER
E�III ^CA ADDRESS _ DESIGNER — —
STRUCTURE ?W NEW CI REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
[A RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T CEJ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FE14CE
OCCUPANCY1fi ft-3LANDUSEZONE BLDG.TYPE —�N—_FIRE ZONE__ PLAN CHECK BY BLS HENT_IM
t;UNSTKUCT SINGLE FI.MILY OWELLING W/ATIACiUd,la Gravige
Re-isa,m of 5510 A 4842
--. 3 k1agroom 2 Dc C l roaran
SEWER PEFIMIT#
OCC.LOAD FLOOR LOA. 4U -HEIGHT 15-+ NO.STORIES AREA I NO.BEDROOMS 3 VALUE 62.000
BUILDING DEPARTMENT SETBACKS FRONT 201 REAR 213' LFFT SIDE 9 RIGHT SIDE till
Permit -I 19•UU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
4000 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
.
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
` `�"9.UU WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
S±ale T_ax
12 76 LICENSE.SP�11 E PERMITS REQUIRED FOP SEWER,PLUMBING AND HEATING.
371 16 SDC- OQWt >t y
Total - '.-m ft� t P?
- PDC# :511.i'i' APPLICANT OR AGENT
By 1 �__�✓ �,c.ZC
--- -- -
Receipt No,
ApprovRd 6TW ADDRESS PH( NF
DATIK, INSP. TYPE INSPECTION REMARKS PLUMBING DATE
~�` Contractor
Fix
io~yam g�T . �l�e�d7t, ---- —
_ Prrmlt No.
__-- Rough-in �j� 3 -----
�r-/
1 ` � � f S- -. -, Final - - - --
---- HEATING - —
l�Gt Contractor
Permit No.
Gas or Oil
Rough-in - �!
Final
SEWER- --
- — Final
DRIVEWAY
-Pinel
_- Storm Drainage
(Rain Drain)Final
Sidewalk
-- LVE—FT.
Curb&Street Final
Approach
BLDG. FINA- L—T TEMPORARY CERTIFICATE OCC7NCY —
CL•'RTIFICATEOCCUPANCY / Final
Ir 77
Landscaping -
'nning Final