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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone: 639-4171
Type of Inspection r
OU
Date Requested Z Time A.M. P.M.
Address Permit
Owner Lot
Builder-7 L L CC A ai 0,f -
The following Building Code deficiencies are required to be corrected:
Presented to Approved
,inspector Disapproved
r2
Date
CALL FOR REINSPECTION
O YES IV No
CRY (alf Nled',ianlcal Permit
-1 1 DA7
14,10w fil-locatioll Addition Alteration
HEATING
CONTRAVJ ' OWN r 11
00A
JOH ADDHESSA10L
WA_
Flat input 113tingia,ru per i-icuo Villit Size_
r.Uft 011-F Flua Size_.
GAS 0 FLFCT LJ ul"E-ll
Y.-
ITEM NO. FEE ffOVI TA). H:E
r,issuancnaiTl—er r";.I-t-- _k,E_BELOW Fach Air
Naw-ue
to & incl. 100,000 BTU RE Commor'coil H podXc
- tein
L,kc��j 1U9000 BUT's & over 7.60 Otllqr�LqLji me - Each4.W0
Woodburning Stove 4.50 r'l p 1011
R,a(-Lett
MtL ELP6.00 Air rciro , �.ompressur - up to& incl,3 1 I.P.
-Tr-S_1-�-!p —
Vent Swtem wlFan 4.50 J.I to t6.N.P.incl.
fdcpoir !a_a!_(L0_9 11 r-fL 6.00
CITY BU31NE5S LICENSE RE616 OR SUB-CONTRACTF'FORS
0. ..
FIRIF ISSUANCE 10. 0 ------
SULI TOTAL
r4
'I* % STAT E Issued By
BUILDING PERM ITAPPLICATION TIGARD DATE �T'sllr 1? 19 `.32 4125
THE UNDEE;SIGNED HE HEFT APPLIES FOA F PERMIT FOR THE WORK HEREIN INDICATED 8U'LDER PHONE
OR AS SHOWN AND APPROVED IN THE,ACCOMPANYING PLANS AND SPF_CII-1GATIONS. OWNER PHONE iI
iipp LOT NO. 31 V)L X la''stl
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OWNER :r4U �illOt`3i1i1.!erj j AbDRFSS 16315 Sylvan r,rt,
M.-'e 'tifood ARCHITECT
Raw 23550 S.W. Graflama Var IIyy IGNER
BUILDER ADDRESS �Y �E.91G,JER ',Tiller
STRUCTURE_ EFNEW ❑ REMODEL ❑ ADDITION ❑ RE:'AIR ❑ RENEWAL ❑ °IRE DA_MAGF ❑ DEMOLITION i
1� RESIDENCE EJ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE. C7 STORAGc ❑ SLAB❑ FENCE
OCCUPANCY' T��TLAND USE ZONE _-._BLDG. TYPE FIRE ZONE.—PLAN CHECK BY —_ : HEAT 0 -v
Construct Single Famil,v fAmllin.%- .;/attached Carowe
correction :st,ce t .at t me"had Y —' 3 3e d rncr;saa
2rwths
SEWERPERMITM 23943
OCC.LOAD FLOOR LOAD h'-.) HEIGHT ' _ N0,STORIES ' AREA 1-11MI NO.BEG 400ME .I VALUE 60}200
BUILDING DEPARTMENT SETBACKS FRONT �� ' REAR LEFT SIDE RIGHT SIDE l,{)
Permit 316100 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
205.40 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
521.4f) WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERM6TS REQUIRED FOR SEWER,PLUMBING AND H'7ATING.
State Tax
SDC— dQta
J3Ct
Total «(lr► TT 100
pDCp APPLICANT OR AGENT �,^ y •
By
Receipt No. C-
Approved i / ADDRESS PHONE
r_
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
v — _— Contractor -2/-fz
7- / 1,2 mon /
--,- Permit No.--3
7-z -,LZ ' f _ Rough-in -- - -
�rA Fixture
o Final
HEATING
Contractor
y �eF Permit No..
Gas or Oil
Rough-in -- —.�—
Finol —
_ SEWER --
Final
i
Final
Storm Drainage
(Pain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIxICATE OCCUPANCY Final
f CERTIFICATE OCCUPANCY _ —
r
Landscaping
Zoning Final
r
BUILDING PERMIT APPLICATION TIGARD DATE14._. �2' --_, 19-e�
THE UNDERSIGNF_D HEREBY APPLIES FOR A PERM IIT,FOR THE WORK HEREIN INDICATED BUILD F,FHONE6,9!_7 i�
OR.AS MOWN AND APPROVFD IN THE,. .COt�"f3 IG PLANS AND SPECIFICATIONS. OWNER.PHaNE�
F_ LOT Nc, _ � _
r:Ef'�b���dll Gly kTJOB ADDRESS�� � iT, _ -A ARCHITECT ESIGNGIN NER ��BUILGER JAN ADDRESS ESIGNER J :�704
�-__
STRUCTURE NEW ❑ REMODEL ❑ ADDITION :] P'cPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑�GpOWT ❑ RELIGIOUS•'❑ PATIO ❑ CARPORT E GARAGE ❑ STORAGE ❑ SLAE/❑ FENCE
G%GiirANCY3_.LAND USE ZONE -L•_.�LOG.TYPE --FIRE ZONE-.---FLAN CHECK Bl�^_t`f—HEAT
- � �,�-fes.,;
P. a,. s4� at .
SEINER PERMIT M -_..__.----
OCC.LOAD FLOOR LOAC460 HEIGHT /J NU.STORIES AnEA15 S40 NO.BtDROOMS 3 VELD d
BUILDING DEPARTMENT SET BACKS FRONT �9 REAR T? LEFT SI CE RIGHT SIDE
Pnrrnit �b O� THIS PERF 1-i IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE, ZON"WG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TPAT TV..
--
OS,O'��� ORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN C01 PLIAN
1 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE. OF THIS PERMIT DOES NOT WAIV
I Sub-total �• �0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 1.0 HAVE CURRENT CITY BUSIIQES:
�- LICENSE.SEPARATE PERMITS R'_OUIRED FOR SEWER,PLUMBING AND HEATING.
"tato Tax At It&19,
- - - SDG-
Total PD(JA APPLICANTORAGENT --...—
By
-- Receipt No. —
Approved — r•nORESS PHONE
S U C
PBC
SEWER CONNECTION $
SEWER INSPECTION $_ 3
_SEWER SURCHARGE $
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