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INSPECTION NOTICE
City o' Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phcn`e: 33`d-41?F
Type of Inspection r-1 r +_�r! ._ _ 7- i � ,
Date Requested ..z 9-.3-7 Time/ p A.M.___—P.M.
Address ssc' �` Permit
Owner Lot #
BuilderThe following Building Code deficiencies are -squired to be corrected:
i
Presented to Approved
Inspector .• -- _— Disapproved
IS,
CALL FOR REINSPECTION
0 YES L! NO
Address
�5r% �,�1 �� ��' Permit No.
Permit charge—
Owner—
hargeOwner '
Connection fee—
Paid by
Type of Building_ date connected
Service Rate _ Inspection fee
Contractor Paid by Deter ` -�9
Size of connection
Assessment` Paid
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