11965 SW SPRINGWOOD DRIVE 11965 SW SPRINGWOOD DRIVE
O
N
G
.o
O
O
3
cn
C
N
a
cn
Cn
Ln
rn
City of Tigard
S-INSPECTION REQUEST
for
h �..t tI`►
e-A-1f s ,f)*•GeYA
1148PECTION TIME PERMIT NO. :-.
DATE ' ' ' DATE ISSUED :_ I
OWNERS NAME :
ADDRESS: `
CONTRACTOR : � 7--.r—
TEST '
TEST : Air ❑ Water[] , Visual 'IN', Laboratory I-]
RESULT: Al,proved 14 , Disapproved C) Pending p
SKETCH,
INSPECTOR DATE
TOTE: Atte-h suPriernenlnl test data hereto
City of Tigard
INSPECTION REQUES"i
for
INSPECTION TIIVF- :4Te lom PEgml,.,- NO.,
DATE : Z-i ,76- DATE
OWNERS NAIVE '
CONTRA C;-r r)6-4 0!n�-lf=jf
TEST: Air D, Water visuai
' Z:SULT: Approved El Disapproved
K F "'H'
f {
INSPECTOR DATE
L.MOTE Attach supple,rent(Il t6li data hor.,
City of Tigard
7n
INSPECTION REOUES
d - f r
INSPECTION TIME :-!�'PItV PLRMIT NO. ' -
DATE: DATE ISSUED._ L1
OWNERS NAME :
ADDRESS :11?65_
CONTRACTOR
TEST*. Air 0, Water c; , Visual 0 , Labfratcry
RESULT: Approved Disapproved 0
SKETCH:
4L
jT
C LA fro,4
INSPECTOR DATE
NOTE . Attach suPPlametito, test date hRi
.._ - _.+:....mrn..,.-.-..n.w,v+�xx•m,.-....y,a«.q..^"y.nra,�RWI-.w.a11s�W.:A,::a{1tr:�a.,;..-.,,t'�.
CITY OF 0,739
BUILDING PERMIT APPLICATION TIGARD DATE— --_'THE UNDERSIGNED UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE —.
MNER ITS Lutz ro. --- -- ADDRESS 1;,96b Springuu06 BUILDER PHONE
ENGINEIR f>gp� yrry
BUILD ;R ��-yy — --__AHI T --- DESIGNER —.
STRUCTURE ONEW __- 0 REMODEL ❑ADDITION _—O_ REP_AI_RRENEWAL ❑FIRE DAMAGE []DEMOLITION
❑ RPSIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T r�,'.EI,JGIOUS❑PATIO ❑CAR Ppm OGARAGE [--]STORAGE CISL.AB ❑FENCE
_ ❑BOND []MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED []SIGNS
OCCUPANCY_ LAND USE ZONE,------BLDG., TYPE— FIRE ZONE—i LAN CHECK BY HEAT ___
reimu dwwl..ltriV with i t,techeo
basamunt accurdiny to aapprovi d i} Imes. -
?aauo . .W, runwoaJ Loop
S-SJ .2S_
QCC. LOAD FLOOR LOAD HEIGHT NO,STORIE1 AREA V LUE
DEPARTMENT Ij �Y i�(�)
BUILDING
SET BACKS FRONT _- _REAR LEFT SIDE RIGHT SIDE _
Permit
THIS PEPMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULA.IONS AND At 1. APPLICABLE CODES ANO QRDINANCES, ANC IT IS HEREBY AGREED THAT THE
-- WORK WILL BF DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
---- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CUnRFNT CITY BUSINESS
96 State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING.
Total
BV APPI IC'.ANT OR AGENT
Approved Receipt Nn
ADDRESS ---._PHHON-� —_.�_...
DATE INSP. TYPE INSPECTION dEMARKS PLUMBING DATE
f
ontractorermit No_ 0 3 J y3/6
6' e✓ e G 1tir' Rough in
Fixture ----
Final ---- — ---
BEATING
— _ _ — _--- -- Contractor ?rsr•
— —__-- -V- _ Permit No. 4 3
- Gas or Oil
-- -- 10uRh"n --- - -
Final
SEWER
Final
---- - - ---------
- —----- - --- - DRIVEWA -Z-7E'
Final
(Rain Drain) Final
_-- - - — Sidewalk -- ,� C G•7- 7G
_Curb&Street r inal _
--- — — A roach
BLDG.DEPT. FINAL TEMPORARY CER IFICATE OCCUPANCY Final �—
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
ADDRESS _.117.�'...,..✓�c PERMIT NO.
6
PERMIT CHARGE none
OWNER CONNECTION FEE
-------- ---_---______� PAID BY
TYPE OF BUILDING � DATE CONNECTED
SERVICE RATE INSPECTION FEE -„L.1„_"„�,
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
IN
:-71.7-L
ri
Fl
c�
r
qt.'.4E
i