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INSPECTION NOTI,Ct
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
,Type of Inspection
Date Reques'ed Time
P.M.
Permit
Lot
Builder
The fuliowing Building Code deficiencies are required to be corrected:
A
Presented to
'vApproved
!Inspector
D Disapproved
Data
CALL FOR REINSPECTION
YES
INSPECTION NOTICE
City of Tigard Building Department.
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A.M._ _P.M.
Address . ��} Permit #_
Owner --- __ _____—�_ Lot
Builder
The following Building Code deficiencies are required to he corrected:
— i
I
i
Presented tor� proved
Inspector — — �__ — ❑ Disapproved
� Date
CALI, FOR REINSPECTION
❑ YES kS NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
�- y-7G
Date Requested A-� T / Time A.M. �= P.M.
Address ' �/ .rs i' ZL 2� P rmit A`-_—
Owner _ -- - -~— -- Lot
Builder
The fol!owing Building Code deficiencies are required to be corrected:
o
i " 1
Presented to ❑ Approved
Inspector
r� Disapproved
Date _ t
CALL FOR REINSPECTION
j2"YEa 0 NO
Building Permit Pio.
Location
Uatr
Certification of Registration
With the Builders Board
doing business as (dba), '
�y � � ----- am registered under the provisions
of
OR., Chapter 701 (Oregon Homebui lders Law) .
try Builders Board Registration Nvwber is
My registration is in full force and effect and expires on
f �`
Signature-
BUILDING PERMIT APPLICATION TIGARD DATE_v- r _I�-___ __—_.,�s-_ <+__ 4815
'THE IJ14DERSIGNED HEREBY APPLIES FOR A PERMfI'FOR THE WORK HEREIN INDICATED BUILDER PHONE 63
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHON%
LOT N0. b
OWNE'A mh mot , k JOB ADDRESS It Ay nus -- --- - - — l,neeland hstntF-S
ARCHITECT
ENGINEER
BUILDER -- — ADDRESS 154)(Ki SW Serena_._--_-- !DESIGNER ----`-- —__
STRL',:I'URE U NEW ❑ REMODEL U ADDITION ❑ REPAIR 1:7 RENEWAL 0 FIRE DAMAGE ❑ DEMOLITION
Q RESIDENCE ❑ COMM C_l EDUCATIONAL 0 GOVT ❑ RELIGIOUS ❑ PATIO ❑ CAF1 POR"[ V GARAGE [I STORAGE_❑ SLABO FENCE
O'CCUPANCY _ — --LAND USE ZONE M-j L) BLDG.TYPE Se+ FIRE ZONE---PLAN CHECK BY _Kn�-- HEAT —_ Gays
Construct siinirle tami,l�*
3 fl edroom 2 K athroom
SEWER PERMIT# _ 26534 (aara4c 450
OCC.
--
OCC.LOAD FLOOR LOAD 4t) HEIGHT Ib+ NO.STORIES I u_ AREA—1475 NO.BEuROOMS 5—_VALUE b4,tl J(j.
gIJILDING DEPARTMENT GFT RACKS FRONT REAR LEFT SIDE— RIGHT SIDE
Permit — 3251u() THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORnINANCES, AND IT IS HEREBY AGREED [HAT THE
Plan Check 211.25 WORK WILT BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIrICATIONS AND IN COMPLigNCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
SUb•lotal !04.25 �RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED-OR SEWER.PLUMBING AND HEATING.
State Tax 13•()U
SDC—I 15U•`
Total -
----- pp •UO APPLI A T OR ACiENI '"�
By Uill - SsiX 25('I.(N) 1 r e'� `.+ I 'N( rt ov.. 1 II ►l 1 _�:> r1tJt1 61
Recelpt No., —__ -...
Approved FiTw rtADDR 89 PHONE —
h"i
_T
DATE INSP. TYPE INSPECTION REMARKS '__PLUMBING DAY
i—----- Con
Par, I t4
0
Perf'oltNo. P/1,7,
Rough-;n
Final
HEATING
Contractor
LhWd,_
Permit N
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage_
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
f_4AL ! —TEMPORARY CERTIFICATE OCCL)P)%NCY F!Mal
.f-'ERTIFICATE OCCUPANCY
Landscaping
ZoningPinal
THE UNDERSIGNED HEREBY APPLIES FOR APE WIT FOR THF 'WORK HEREIN INDICATED LIUILOLRP40NFrQ��
Grp A $HOWPJ A D APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNEPPHOrl
Loy rlo
_�'.VtJEF� , 7ll08 ADDRESS �`� ��SyL. �� L<,(c"yes / , 41
-1HITECT
° ENGINEER
r `J �6b `x(1/14.►�B DESIGNER
$Tgl!CT�IRE kJ`IEW
0Rt1.1110EL_ DADDITIO^I CIRCPAIR_ EIRENE41AL DFIREDA?RAGE ODE.',IOLITI
RESIDE^ICE '�CO►fti1 ❑EDUCATIONAL CJGOy'T ❑RELIGIQUSCJ 4TI0 QCARPORT ❑GARAGE IJ STORAGE SLAB— `JFEn
CC.CU >r:•.r ._LAN JSE 2ONc't-7 `ti—CLOG,TYPE A) _FIRE LONE PLAN CHECK BY _ HEAT _
2 �`
:SEWER P E R M T.T
WC-LOAF FLOOri LOAD HEISiL NO.5IORIES AREA /y7-) NO.BEDROOMS— VALUEO4V
SaiILr,ING DEPARTMENT SETBACKS FFICNT AV REAR LEFT SIDE c7 RIGHT SIDE
I-- THIS PERMIT Ii ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON
REGULATIONS AND AL1. APPLICABLE CODES AND ORDINANCES, AND IT IS HE REBY AGREED THAT i
I-------- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS ANO IN COAIPLIA.NCE W
S.1'?•CD(dl S 3 �_ ALL APPLICABLE COTES AND ORDINANCES. THE 1'_'.SU4NCE OF THIS PERMIT DOES NOT WA
i RESTRICTIVE COVENANTS, CONTRACTOR AND SUB COPITR:CTORS TO HAVE CU?PENT CITE° BUSIN
`:;eta Tax I �J�J LICENSE. SEPARATE PERMITS REQUIRED FCR SEWFR• PLUMBIN: AND HEATING.
Tutsi SOC IL " POC#
_ APPLgCANT OF AGENT
LAppruvcrl — Receipt Nu.
AnnAFSS
q �• CfS�
Poc
(o o
SEWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE_
� 25' ls�
/ 0 -5-4 q,
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