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�¢ ECT ON NOTICE
City of Tigard Building Dopa
13125 SW Hall Blvd. Tigard, Oregon 22
Inspection Line (Rec-G-Phuns)(: 639-4175 Busines P n : 639-4171
Ineps.:tion: (mow AV
Footing Plbg. Underslab Koch. Rough-i:: Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
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Post/Beam Struct. Ban. Sewer Framing -Bldq�
post/Beam Mach. Rain Drain Insulation -Plumb. C
Plbg. Underfloor Nater Una Gyp. ad. -Koch.
Date Requested:_— _— Time: AK PK
Address: 4. �li_�_� �11?Lill�s`3rt Permit P: 600 el3-0.312
Builder: ��—
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THE FOLLOWING CORRECTL
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Inspector: —`�- natal--
APPROVED DISAPPROVED APPROVND SUBJECT TO ABOVE
Call For. Reinsp.
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CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT Y t F » • • • ''
13T2'S SW Hall Blvd.Tigard,Oregon 97223.6199 (503)639.4171
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iy'ar'd ftr2Cipal Cod@r Rase of Grit. "pecia t r 'C. es ar c,._ r.e 1.., L �: YT'+ (r-
rpp trabie laws. All work wail be done in amrcance
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:pprowed wt'k t5 r�. :,Q i.��n
it!"In i8l? days 0 issuance, or if work is r
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Residential Building Permit Application r
City.of Tigard
13125 SW Hall Blvd.
1 Tigard, OR 97223
(503) 639-4171
Jobsite Address:J. YY)
- Office use Ong
Subdivision:-41,
) Lot #
Planck/Rec
Valuation:—I 1 n U
(� Permit # o?, 3 - o 31 z- •
Owner: „w ,ten t n, IA x,
t Reissue of
S Address: I (¢ 0 S 1 cJ. _ VY)cruIrh
Approvals Required
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Planning
Phone:
Engineering
Contractor: N c, a,.n cn Q , ,�,� -I oth,�r
Address:
Items Required
Phone: ';i�! �� – Co(
Subcontractors
-1U
Contractor's License # VC) 7 OTruss Details� •e��• '-� � �� ' 7 `
(attach copy of current Oregon license) ,<t h¢r u
Subcontractors:
Plumbing: _
Me,:hanical:
(attach copy of current OR Contractor's License) I
ArchltectlEnglneer:
Address:
Phone:
COMMENTS: i % f 'r'yzj
Apolicant Signature & Phone number
Received by: _ _ Cate Received: ? °,
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Permit # Account Description Amount Amt. Pd. Bal. Due
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�w y3-U lai Bldg. Permit (BUILD) 2
Plumb. Permit (PLUMB)
_ Mech. Permit (MECH) _
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
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Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
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+ Parks Dev Charge (PKSDC) _
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) _ —
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Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
TOTALS:
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NOV-,02-'93 TUE 11:?4�I D:C I TY OF KING C 1 TY FAX NO:503 639-3771 1411?P02
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—_ NATURAL 11:25
I:25 I D:C I TY OF KING CITY FAX N0:503 63 Oct.7i 1 1993 @9 tt03 PM 03 PO4
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NOV-02-'93 TLE 1}•26 I U:CITY OF KING CITY FAX NO:503 63�X3'77 ____ _ #112 PO4 �5
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ra111L DIN113 PERM I ,I AN (A-WAX 11:% (6.
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INSPECTION 'S
KING CI'T'Y When work is completed ,
please notify Tigard Bldg .
15300 S.W. 116th Avenue,fling City,Oregon 972'4 Phone:639.082 Inspector at 639-4171 .
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DATES
1. NAME OF APPLICANT: ,TritA ni SttveRays GSho)t Phone No.�
ADDRESS: I L,C, Ie 0 5\A! M O N Tf-Y"P_u L,q N e
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ADDRESS OF PROPOSED DIx4EME NT cS rrr,�
2. 'TYPE OF aWGE, IMPROVE!eM OR CONSTRUCTION FCR WHIM PERMIT IS REQUESTED.
DESCRIBE BRIF17'LY - .ATTAC:i TWO COPIES OF PLANS OR DRAWINGS OF
PROPOSED PROJECT: 'f U to S",4 1'\d V S
3. NAME AND ADDRESS OF CONTRACTOR N at 1-
PHONE NO.ay 5'-1 U(o 9 L I CENSE NO. 4 b-7
4• NEIGHBORS WHO MAY BE AnECTED BY THIS PROJECT WILL BE NOTIFIED BX niT CITY.
5. APPLICANT OR HER/HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING CCHMISSION
MEETING NEXT HELD ON
REPRESENTATIVES NAME_ PHERE rl0. f710 -��EL
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Me ding City Planning Commission will consider only those applications received at least five (5) daps
prior to a ;teeting.)
SIGNATURE Darn o r
't*7k*71C7t***
APPLICATION RECEIVED BY-'1"1Y �L 2 DATE 2 7I�
APPLICABLE FEE REQ]VED $ TOTAL
PLANNING CC'I~4dISSION DECISION: Approved Denied
OONDITIONS I&
'ppr v a pplicat'ka&. z .Aalid for' i -months only
Signature .-�� Date
NOTE: t(goa Bai d
pbuers Lar-requires that all persons who contract f work �thmiL residence be
4-egistered with the Builders Board which meaas the contractor is bonded insured on the job site.
For your protection, be certain your contractor is registered by calling City Hall Ph: 639-4082,
NOTE: H permit must also be obtained ran the City of Tigard Department of
Ccmmnuty Developnvmt Ye_s No
CITY OF TIGARD INSPECTION REPORT If
Tle above listed project has been inspected and Approved Denied
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Date Cc mients j
Signature .
(&zitding .vL6po- ter,. pfzaz . AzbjA L ono. ( I) copy .to King cLty)
C3 2-37
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