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DRAWING IS LESS CLEAR THAN '"'— ----��r.
THIS NOTICk; IT IS DUE TO
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THF QUALITY OF THE ORIGINAL
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : � --4 PERMIT NO.:
DATE: G 1-fY1,74 DATE ISSUED:�.L�
OWNERS NAME : T 0C
ADDRESS : _� _.
CONTRACTOR :
TEST' Ai;❑, Water ❑ , Visual , Laboratory ❑
RESULT: Approved) , Disapproved ❑ , Pending ❑
SKETCH:
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INSPECTOR DATE
CNOTE : Attach supplemental test data hsretj
JOHN E. PEINIVOT P11>a+BS,1RUILDING DLI AK f MLN 1 , f IGAHL) tS C�
No. a �P. 0. 03X 119 PI_umw,%,G PERMIT
NEP1sERG, OREGON 91131 _ holder of a valid piumhing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in ac:curdance with the plumbinrl code of
Tigard. Such installations require inspection by the City Inspe:tor who shall be not.ifierl not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
"74 Zp
0 w n 2 r 2a-kiLL,_:
NO HER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS w r-1 E ON LACH AMOUNT (Office Use Only)
Single Family-1 bath.-each _ ✓ 25.00 �� �• LaD _ _
Du lex-Ench 1 bath unit 25.000
Additional both roorns_each 10.00
Mobile Home Space-each 15.00
` ifYU!VIDUAt._FIXTURE FEES ^'
1 io 50 Fktures in 1 buildin -oath 3.00 _
51 to 00 Fixtures in 1 building ,Poch —22.50
101 to 2(10 Fixtures in 1 building-each _ 2.00
241 or Tetra Fixtures in 1 building-. ach_ 1.50
MISCELLANEOUS
Bulldinc�Sewer-1st 50 it. _ 10.00
Sew—each xtditional 100 ft. 10.00 _
Water Servico t_o_building _ 5.00 _
Private Water Systems-ea.n 100 ft. _ 10.00 _
Other (Specify,L
PERMIT 00 For Plumbing lnspecdon Phone 6394191
9G State /• 0 _ Plumbing Cuntracior By
TOTAL . D 5 RECEIPT NO. Issued By Y ,
City of Tigard
INSPECTION REQUEST
for
19;
0(/
INSPECTION PERMIT No. ' ----
DATE: .Sj_1_1L7_4_. DATE I
OWNERS
ADDRESS :
r ONTRA C TO R
TEST*. Air 0 , water Fj Visual 0 La borator% U
Disapproved 0 Fleivd:ri;
RESULT'. Approved
SKETCH'.
INS TOR DATE
N(17 1 1. 1t7rt
"+r ,..-nn.�a,:..,.,ro,+r•n. '!••i4��eau+�...•win+,e.•ti.nur^:rw.•-+..w!.+•...-.wrz.+.�.tra-xs,w�v+^.+w+7mn+•ug..,'�..••.+'a-.mr'Ar'......,,•-r.......,..,�...,;E,+.., ....,,
BUILDING PERM►T APPLICATION TIGARD DATE `Wiry � 19 N" 0781
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPHUw'ED IN THE ACCOMPANYING PLANS AND S,7ECIFr4 jIO"t'1 OWNER PHONE
QWNER Tualatin l.)euolupment LOADDRESS 10."25 ""' Highland or, 639-3101
-- — — - Bul DL ER PH,QNE
Sam*, ENGINEER
flUILUER ryry�� ARCHITECT DESIGNER
SI HUCTURE L'JNEW ❑REMODEL _— ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
O RESIDENCE ❑COMM ❑EDUCATIONAL 0130V'T ORELIGIOUSOPATIO ❑CAR PORT ❑GARAGE f ' iTORAGE OSLAB ❑FENCE
_O90ND OMOVING ❑CONDITIONAL USE ODESIGN REVIEW OCOUNCIL APPROVED OSIGNS
G
UC(:UPANCY__ LAND USF_20NE s._BLUG.TYPE t,l FIRE ZONE— pLAN CHECK BY HEAT
onastruct 1 ,: 60 sq. ft, . Promo dwAa inn with att.aChod guragn.
I:�fafi�T�lllral It.
bec:!I'aum
(?CC•- OAD __FLOOR LOAD` HEIGHT NO.STORIES AREA 1348 VALUE90Q
___BUILDING DEPARTMENT ��' i ^..': o f 7 1
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit — 1 `L1
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINEr IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANO IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECT►(CATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
T State r ` YX LICE(!4SI!(, EPAAPxS�°R40
PfOR SEWER, PLUMBING AND HEATING.
Total � d F
Bv
APPLICANT OR AGENT
Approved — Receipt No. ,'
DATE II�'SP- TYPE INSPECTION REMARKS PLUMBING DATE
5 v ✓ `� Contractor
Permit No. ySD
d
Rough-;n
— !x*'t.1r� �.{' IG�G Fixture
!1(/td-Ct. Final
HEATING
Contractor
76 '
Permit No. /*
Rough-in
Final
SEWER
Final rUy
DRIVEWAT,yy?y7
Final
Storm Draina e
(Rain Drain) Final
Sidewalk _ ,( G v�?, •. ;�
Curb&Street Filial _
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
C►� 1' / Landscaping
J Zoning Final