11610 SW HAZELWOOD LOOP }
11610 SW HAZELWOOD LOOP
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City 0f Tigurd
INSPECTION REQUEST
for
INSPECTION TI r - PO PERMIT NO. :--
DA-, F-
O. :_—DA, E ISSU'�D :_._LL
OWNERS NAME --
ADDRESS: m 35 4"/!Lw�4t, vow
C 0 N T R A CT 0 R :
TF ST . Air r_,, Writer ❑ r Yfesal ,, Laborolory ❑
9ESUL.T* ",r)rrVOd ,�. , Diem, privr!d ❑ Pending E]
r
SKETCH,
1. E
City of T-igurd
INSPECTION REOUS- !�' '."
for
INSPECTION TIME le fil, PERMIT NO.
DATE :, .3 DATE ISSUED'.---L'-.L'-.
OWNERP NAME * i-�227 — '/ .
ADDRESS :
CONTRACTOR :—
TFST*. Air0 , Water r Visual 17-1 , Laboratory LJ
RESULT*. Approved Disapproved 0 PeadmL]
I -- J
SKET"'$H:
I � P
I N s TOR DATE
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE— a 19 N° ' 0743
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPPOVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
NEH_ _ ADDRESS J.xlZ 1} — "'fit UVB _ -JILDER PHONE
ENGINEER --
BUILDER — ARCHIECT
� yt ff----11 DESIGNER _
SIRUQ
CTUHE NEWQREMODEL—` Qt�--J
ADD11ION LREPAIR _`JRENEWAL _ ❑FIRE. DAMAGE ODEMOLIrION
RESIDENCE QCOMM (]EDUCATIONAL QGOV'T QRELIGIUUSQpAT10 QCAnPORT QGARAGE QSTnaAGEQSLAB QFENCE
QBUNU -QMOVING ❑CONDITIONAL USE GDESIGN REVIEW 000UNCIL APPROVED _ QSIGNS
OCCUPANCY-_.-._.--LANr,USE ZONEBLDCa_TYPE_ FIFE ZONE_ PLAN CHECK BY rim HEAT
-- L. r-7,I,t 14ki$ ft, f'�imd 6ww1l.iny w,;th attachiRd �jaysgea No bassmu
76 01.1dinq fo spproved pll�ns. "61710 as 1 31 S.W. Ironwood Loop. �—
3 bo rUutils
.............. }
OCG, LOAI; FLOOR LOAD T HEIG.,HTN0.STORIES AREA ul.
��u
BUILDING DEPARTMENT I �...,� 14
-
--- SET BACKS FRONT — REAR LEFT SIDE RIGHT SIDE
Permit
. - THIS PERMIT IS ISSUED SURJECT 70 THE hEGULATIONS CONTAINED IN THF BUILDING CODE, ZONING
Flan Check REGULATIONS AND AL1 APPL,CARLE CODES AND ORDINANCES, ARID IT 1S HEREBY AGREED THAT THE
WORK WILL BE DOP12 IN ACCORDANCE Wil THE PLANS AND SPECIFIC.ATIGNS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODEcz AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUa CONT'nACTORS TO HAVE nURRENI CITY BUSINESS
1%Slate — i �— LICENSE. SEIARATE PERMITS REOUIRED FOR SEWER, PLUMBIAG AND HEATING.
Total
By
----------__. - APPLICANT ON AGENT — _—"'------------.
Approved Receipt No.
a
DATE I NSP. TYPE INSPECTION REMARKS PLUMBING DATE
ContractorV_,�,. ,
04,
TPermit No.
I_�ou2h in
It,4
I 1, Fixture
�,A6 Je .. zA*-d Final
HEATING
Contra..;toif
"Urmit Nom
CasorOil
Rough-in
Fipial
SEWER
Final
DRIVEWAY
Fin;;
5_fRrm ILraina t,
(Ra*,-, Drain) Final
Sidewalk vie
Curb&Street Final_
Approach
BLDG, DEPT. FINAL! TEMPORARY CERTIF ICATu OCCUPANCY
0 CERTIFICATE OCCUP\NCY Final
_1_ 3 Landscaping
1Coning Final
ADPR15S,��� PERMIT NO n 1`7 .-.-
PERMIT CHARGE none,,____„.„_
OWNER /�7s � ....,*._� CONNECTION FEE
PAID BY
TYPE OF BUILDING DATE CONNF_CTEO
c�
SERVICE RATE INSPF" TI0N FEES
CONTRACTOR __ �r PAID BY _r.._ ,._ DATE
SIZE OF CONNECTION ._.,...�.^�.
ASSESSMENT PAI,) . ...___
i
JAY HARBIs
646-0166
�21ta 2nd
BEAVENT03, OA 97005
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