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INSPECTION NOTICE
City of Tigard Buiiding Department
12420 S.W.Main St.
Tigard,Oregon 9/223
Phone: 639-4171
Type of Inspection
Date Requested__-_-*j6- A.M. P.M.
Address
A
L I --t Permit
Ow"P't Lot
Builder
The following Building Code deficiencies are required to be corrected:
Por--
71Z
Presented to Approved
InspectorPrDlupproved
Date
CALL FOR REINSPECTION
YEa F-1 No
INSPECTION NO' ICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639 4171
Type of Inspectior __
3 '..f
Date Requefted _� — 2- � Time _ A.M.--K.—P.M.
Permit #
Address .e
Owner ___ __ __ Lot
I
Builder ---
Tho following Building Code deficiencies are Mequired to be corrected: i
Presented to ---_/Approved
Inspector L -- C I Disapproved
Date
CALL I OR P EINSPECTION
❑ YES leNO
BUILDING PERMIT APPLICATION TIGARD DATE `t�r� ':' -I''� 19 64 4776
THE UNDE SIGNED HEREBY AIIIILIe_S FOR A PF RMT POR I HE WORK HEREIN INDICATED BUILDER PHVNE -Q0---7Ajfi
OR AS SHOWN AND APPROVEC IN I HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
OWNER
LOTNo. __._ 40 4a _
:.11er JOI3ADDRELl8 I Hiller Drive_ _ I NO,_lerlxd I L
-- Ss_ O.RCHiTECT—
BUILDER _ ADDRESS ? 1270 Sig' ttcrvner ENGINEER
PL. DESIGNER
STRUCTURE —Q NEW ❑ REMODEL ❑ ADDITfnN C] REPAIRC RENEWAL 11FIRE DAMAGE_ _ ElDEMOLITION
ljj7 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT U GARAGE ❑ STORAGE Y❑ SLAB ❑ FENCE
OCCUPANCY ;J�n3L.LAND USE ZONE R-4.5 BLDG.TYPE --5N —FIRE ZONE PLAN CHECK BY ±(.K—.HEAT_ ""L'�—
��_ construct, miitKle family ttwelling w/mita shed %-a,: ge.
SEWER PERMIT# a'Ij�t Garage 49/
OCC.LOAD FLOOR LOAD i.(p HEIGHT —14 NO.STORIES _I AREA 16O_' NO.BEDROOMS VALUE 75 tJUU.
BUILDING DEPARTMENT SET SET BACKS FRONT 2( _
' _REAR 1 — LEFTSIDE raj _RIGHT SIDE
Permit °.56UU i PERMIT 15 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED i HAT THE
Plan Check __?32.70 _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORWNANCES. THE ISSUANCE Of THIS PERMIT DOES NOT WAIVE
Subtotal 59!1.70 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 14.32
LICENSE,SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
—._
Total ShC- $4U11.f1l1 _
(►05.02 � u
By - Cti PDC#,, 100.()() APP'_!GGE
A TORAN7
A roved Receipt No. _
PP _ -_ tl(y AUDRE88-
DATE INSR TYPE INSPECTION REMARK; PLUM ING PATE
A r, � Contracts
Permit No. �—
�/ r — Rough4n
AP, Fixture
final._—.
HEATING
Contractor
Permit No, � 1.10
r
� Gas or Oil
Rnugh in
Final
-- -----_— -- E6WFCR � .—
DRIVEWAY—
ar— .�~ --- - ---
Final
Storm2rainnge
(Rain Drain)Final
Sidevval k
Curb d Street Final
Approach
BLDG. DEFT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
II Inning Final —
#4,' y77,l
TFAE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE vVORK HEREIN INDICATED 13UILCER1`:i0fIG641320
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. QVMEp101t,, (D
LOT
JOB ADDRESS �'/� ')(J-J �l[/ ✓/ "�LL t /: fj J R; r� -
ARCHITECT �'
ENGINEER
ADURES� 220 E
7 Z n �,d'LA�' �51' r�r--�1 r DESIGNER
STRUCTURE 0NEW URE'linCEL Cl AUDInw, CJRcP„IR LJREWE4/hL ❑FIREDAMAGE ❑DE.'.IOLITI
RtSILIE^ICE ❑COr!m ❑EDUCATIONAL ❑ LJ
GOV•T RELIGIOUSOPATIO ❑ 7R
CARP. r ❑GARAGE CISTORAGECISLAB ❑FEr,
CCCUP•Vr__Y�LAND USE ZONE� ` 'l CLOG.TYPE..,. L L.FIRE ZONE PLAN CHECK BY
._ L ��? ''•r ��-�w�—.Lr�i__��-� �11'L.�A j.�it.��'i_�w Y� _ -
SEWER PERr,]IT # f"151 7
QL'� LO 19 _FLriVJHJ.QAD. �`�, r�1Ci�L ��/� �SL�4IS�` ALEA/l�_i NO BEDRQS�RIS VALq�s.��l4
97)'IL OIti a OEPr.R rMENT SET BACKS FRONT - �� REAr1 I<e LEFT SIDE RICHT S16E�_
r
�,� -� THIS PERMIT IS ISSUED SUBJECT TO THF REGULATIONS CONTAINED IN THE BUILDING CODE. ION
I F:Tn Check 2- v REGULATIONS AND AL! APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT 1
r- -" - WORK WILL BE DONE IK ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AN0'N COMPLIANCE W
•7 ALL APPLICABLE CODES AND ORDINANCES. mr- ISSUANCE OF THIS PERN11DOES NOT WA
-'')- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CO iTRACTORS TO HAVE CIIRgENT CITY BUSIN
;ata Tax Z LICENSE. SEPARATE PERMITS REQUIRED FCR SEWER. PLUMBING AND HEATING,
SDC --
FDC#
y1� APPLICANT OR AGENT
e
�Approv4 I ` =,�- Receipt No. -
L—.�— annr7F55 MON .
SDC --
PDC - 'r #
SEWER CONNECTION $
SEWER INSPECTION
SEWER SURCHARGE $
Comments : � � / �1 �Eq —
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Building Permit No.
Location
Cert.ification of Registration
With the Builders Board
ILL.,--, :joing business as (dba) ,
I
__ am registered under the provisions
o`f ORS Chapter 701 Oregon ikxuebuilders Law) .
My Builders Board Registration Number is :6
Ply registration is in full force and effect and expires on
's
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