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INSPECTION NOTICE I
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection –
< '' • Time A.M. _P.M.
Date Requested_— A --
C�,- Permit # ---
Address — s2
Lot #_ --
Owner -------- ---
Builder - --^
The following Building Code deficiencies are required to be corrected:
--------------- ---
---- -- 1 Approve'
PresentrJ to
Inspector -
------ +t' Disapproved
Date _-.--
CALL FOR REINSPECTION
It YES ONO
INSPECTION NOTICE
City of Tigard building Department
12420 S.W. Main St.
T igard,Oregon 97223
Phone: 639-4171
Poll—
li
Tyne of inspection —. 111Z,
'Date 'Requested
s Time" A.M.. P.M.
Address S �� -•cGt�t,e ,- -r[.. Permit #—
Owner __ Lot #
Builder _._.
The following Building Code deficiencies are required to he corrected:
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I �
i -
I
Presented to —__ ---.-- — � Approved
Inspector __ _ ❑ Disapproved
Data
CALL FOR RFINSPF,CTION
❑ YES V7 NO
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BUILDING PERMIT APPLICATION TIGARD DATE__. ' t'r' ' t______,,e 4 34 t)
-THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR 1'HE WORK HEREIN INDICATED BUILD R PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PI -',.NS AND SPECIFICATIONS. OWN R P'04 '_n 9_
• _
OWNER J 9 113.rr ?L..x. T"'JOBADDRESS `,., 0, jr LOT 0.
ARCHITECT
'ox2323; 7'tretrd ENGINEER Jay '`filer
BUILDER ADDRESS DESIGNER
STRUCTURE- I$ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL U FIRE DAMAGE_ ❑_DEMOLITION_
(3 RESIDENCE ❑ COMM P EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 11 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
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OCCUPANCY — `LAND USE ZONE _ BLDG.TYPE - FIRE ZONE'__PLAN CHECK BY HE AT
Constrict einnle 13mily dwelling w/attnrl}ed jarn•;e
----- ^ems correction shect attaelmd. 3 lQdrramy
2 lotlis _
SEWER PERMIT M ? f 9 44
OCC.LOAD ;lam FLOPR LOAD NZ, 4,HEIGHT !' :IK NO.STORIES 'M4 AREA NO.BEDROOMS 3 VALUE 59 ,800
_ - BUILDING DEPARfMENT SET BACKS FRONT 1?' REAR `� L-EFT SIDE RIGHT SIDE S
Permit 3 r •lyJ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND 11' IS HEREBY AGREED THAT 111E
Plan Check 1 WORK WILL BE DONE IN ACCOP"ANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAkI)C
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal — 516.45 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINE!3S
State Tax
!`•fin LICENSE.SEPARATE PERMITS REQUIRED FOF'.';EWER,PLUMBING AND HEATING.
Total
123.3 r soc— . ,
By riW" PDCM 11 100•W.) AP�LI�ANT OR AOENfi
Receipt No.
Approved ddt, ADDRESS — - -~ PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
?- Permit No.
e-:'
Rough-in
Fixture
Final
HEATING
31'-(93 T;r I
Contractor
Permit No. TZ
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Main Drain)Final
Sidamik
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY GBS rIrICATE OCCUPANCY
CERTI�ICATE OCCUPAPICY Final
Landscaping
Zoning Final
BUILDING PERMIT APPLICATION TIG/ DATE4" 1903
THE UNDERSIGNED HEREBY A PPLIES FOR A PERIMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE'
OR AS SHOWN AND APPROVED IN THE ACCONIPANYING PbNS AND SPECIFICATIONS. OWNER PHONE .
Q p LOT NO _
i)'PJrtER..iA / f ilel �71�iI,J•gG�1013ADD_RESS V� JM��«L __— - - �
-" — Qp ^� ARCHITECT INEER 1
BUILDER �d �" ADDRESS(u�O�t �f29 t 1� DESIGNER_ -,J 0I 1 Qj.
STRUCTURE NEW ❑ REMODEL _ ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
HESIDF.NCE n COMM 0 EDUCATIONAL C? GOVT Q RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STOf1AGE ❑ SUkB❑ FENCE
-
OC UPANCY •3 LANDUSEZONE P BLDG.TYPE ��A!._FIREZOI4E ^/�FLAIJCIICCKl1Y HFAT �I
- CAtti �. � WFLII d W 0.Ldf�11 �7 �.
SEWER PERMIT M "
OCC.LOAD FLOOR LOAD �V HEIGHT �� NO..STORIES I AREA IA4#' NO.BEDROOMS 3 VALU.. BdO
6UILDING DEPARTMENT -~ SET BACKS FRONT Ip REAR LEFT SIDE ..1� RIGHT SIDE
Permit _���• �� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COv,ZONfN3
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ' WORK WILL BE DONE IN ACCORDANCE WITil THE PLANS AND SPECIFICATIONS AND IN COIAPLIA14CE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSU MOO E OF THIS PERMIT DOES NOT WAIVE
Su�tOta, 3��.'YS'- RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRAGI D 1S TO HAVE CURRENT CITY BUSINESS
(� •S,2 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Mata Tax
Total
SOC—
pp�y APPLICANT OR AGENT
By
- - --� —
(lecelpt No.
Approved ADDRESS PMONE
SOC - Q�- -
Pac -
SEWER CONNECTION S
SEWEfi INSPECTION S
SEWER SURCHARGE S
3 t�pl?
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