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City of T igard �
�fJNSPECTION REQUEST
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for
INSPECTION TIME I l PERMIT NO. :----
DATE:
O. :_-_DATE: - DATE ISSUED .^_L_Z_
OWNS S NAME : -
ADDRI-S3: .
CONTRACTOR : . 146. - - f
TEST : Air O, Water[] , Visuaip(l �--alioratory r,.i I
RESULT' Anpr.,%;nd pisr ,i ~v r-' Pe+,ding []
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City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME : - PERMIT NO.: --
DATE:
O.: __DATE: DATE ISSUED:—
OWNERS NAME : =—L'--------
ADDRESS : G.. z. -5 Su�h'_-'r t(%<<,
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CONTRACTOR :- -56`- iPLs .c
TEST: Air Cl, Water p , Vieu aboratory p
RESULT: Approved l7(, Disapproved ? , pending ❑
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SKETCH:
9
I INSPECTOR DATE
ICOTE : Attach supplemental test dato horot,
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City of Tigard
INSPEU "rIOIN REQiUE '
for
INSPECTION TIME :
r�. .,•.,•�..•�,my^•++^++eo,w•wr,N+m..w+h.�.xewr.«+s�.«„-..«wwwa.rwanwrkwwWw��11111��''t'V�Iti'TIM'+•+w5w•.�• :,`•yr++yls'�y'�1MMi•'91111�Y
CITY OF March A 76 g
BUILDING PERMIT APPLICATION TIGARD DATE 19 N� 0693
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIM. ..,QrNER PHONE
OWNER ',jiiiiilt1la(3raoi0'. Lu ADDRESS iUbjU ;9.L s Highland DX'• BUILDER PHQNE 639-3101
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ENGINEER same
BUILDER � _ r-1 ARCHITECT __DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR _❑RENEWAL ❑FIREOAMACE ❑DEMOLITION
STn
`J RESIDENCE ❑COMM ❑EDUCATIONAL ❑GO 'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
IROND ❑MOV ING ❑CONDIT1nNAL USE ❑DESIGN_REVIEW _❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE - FIRE ZONE—
PLAN CHECK BYE HEAT pati
--- jostruct 1,190 sq. ft. Frams dwralling with attached garagie.
No er!ngmunt. According to appy:+..,od pans.
a
---- ---- -- - r bedrooms
1491) 527 7 1
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA __ VALUE
BUILDING DEPARTMENT SET BACKS FRONT 01 REAR 14, LEFT SIDE RIGHT SIDE
Perini 1 410 ULL
--- — -.—_— —
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 APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRPt;TORS TO HAVE CURRENT CITY BUSINESS
State LICENSE. SIrARRAAT�EOPjE Mn�TS CFAU.IL Q FOR SEWER, PLUNBINO AND HEATING.
Total � $b j
By
APPLICAN' OR AGFNT
Approved Receipt No
ADORES5 PHONE
o
DATE INSP. TYPE: INSPECTION REMARKS PLUMBING DATE
Contractor
3 1 ''�(o �� Permit No.
Rough-in _
Fixture _
Fina;
tfl'�37G (" ��=sr�_
HEATING
Contractor + � 4617 6
! -]�••�� �An,�,� , Permit No.
P Gd�rat, p, .f/e! Due. Gas or Oil llo?6,2
Zif--
�— Hou h-in 1 Final _
/7 SEWER 3- •
Final
DRIVEWAYS-6:771
- _ Final = __
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
_ Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
��� CERTIFICATLOCCUPANCY ---
Landscaping
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