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City of Tigard
INSPECTION REGUES
for
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INSPECTION TIME : PERMI t' NO. : .. .._
DATE; 1 ' 6 DATE
OWNERS NAME ' 1-�) C
ADDRESS . S;5 — --/ a
CONTRACTOR :—____.
TEST. Air O, Water p , Visual Ll , Luborator�
RESULT : Approv ' Disapproved ❑ Pet�G; �y
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City of Tigard
NSPECTION REQL,'E,9,,. "1-
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INSPECTION TIME: PERMIT NO.
DATE.* DATE ISSUE'D . — I Z
OWNERS NAME
ADDRESS. 4?
CONTRACTOR
TEST : Air Fj, Water El , Vislial X, Laboratory [3
RESULT* Approved Disapproved U Peidinq rj •
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SKETCH.
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city ty 9 of Tigard
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INSPECTION REQUES
for
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INSPECTION TIMI` • PERMI
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i DATE7 DATE ISSUED.
f OWNERS NAME ! _ _ .��L �• �' ---- _ _w_ _._...
ADDRESS :
CONTRACTOR :--- --
TEST'.
ONTRACTOR :_-- --TEST'. Ait ❑, Woter p , 'Visual A(, Laboratory ,,
RESULT: Approved , Disapproved CJ f'�+ .-
~SKETCH:
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INSPECTO OF DATE
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME :��r
+' DATE: I ') DA1 ISSUED _ I
f OWNERS NAME : .
ADDRESS :
CONTRACTOR :__..
TEST. Air ❑, Watfir [j , Visual`[^. , Laboratorw v
RESULT. Approved 0 , Disapproved ❑ , Pending ❑
i SKETCH.'
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13pEt�TOR DATE
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CITY QIP
BUILDING PERMIT APPLICATION TIC ARD DATE----- 720 Q r 21
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN lNr ICAT D
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING P'-ANS AND SPECIFICATIONS. OWNER PHONE:— —_
'uaLattn Development C€: 4W S IS4 1ie, mpisgrpield
OWN E' ADDRESS - i f� � Ii1� Ura r! I ER PH�)NE
same ENGINEER
F.UlLUER ARCHITECT UESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION nREPAIR ❑RENEW��AIlL_ DFIHELAMAGE ❑DEMOLIT.JN
❑ RESICENCE ❑COMM ❑EDUCATIONAL_ ❑GOV'T EIRE LIGIOUS❑PATIO ❑CAR PORT L_,1GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ODESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LANU USE ZONE_ –U BLDG.TYPE---"L—FIRE ZONE— PLAN CHECK BY r�a _ HEAT 4—
canetruct 1490 ey. Pt. frame Idwsllin,„ with attached garage
no, basement according to approved plane
--- -- }}�� r 2 bedroom*
CC LQAD –A_'FLOOR LOAD A�_�">=IEIGHT NO.STORIES AREA _t –VALL:E
9UILDING DEFARTMENT SET BACKS FRONT 10 REAR 14 LEFT SIDE RIGHT SIDE
{] v��1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL AFPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTPI–iOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State 3,54 LICENSE. SEPARATE PERMITS REOUIREE. FOR SEWER, PLUMBING AND HEATING.
Total 160.54 1.25.00 f car newer g.nepaction
By f
---- ------ - APPLICANT UR AGENT
Approved Receipt Na.
ADDRESS � qF'�
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DATE INS?. TYPE INSPECTION REMARKS PLUMBING DATE
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�'/J'�'•/ ski, ,M l�J _ Permit No. 0,2s
Rough-in — —
'�-/5'7>''� Via,% �Cr'( •�f fJ �cr Fixture_ —
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HEATINC
Contractor
It 7 _EVA kt'L- w �— Permit No.
Gas or Oil-L C7
-Rough -y
Final _
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SEWER �7SJ •L
Final
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Final
Storm Drainage T
(Rain Drain) Fin,l
Sidewalk
Curb&SUeet Final
Appmach
8L.DG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning F'nal
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