11369 SW LAKEWOOD COURT -AL�
11.359 SW LAKEWgOD COURT
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City of Tlc,ard
INO"PECTION REQUEST
for
INSPECTION TIME: h PERMIT NO. :-
DATE: DATE ISSJ17D :.__.1 L i
OWNERS NAME :
ADDRESS'
CONTRACTOR
M
TEST : Air ❑, Water[] , V►sual 11, Lobo-story ❑
RESULT: Approved d Disapproved O , Pending ❑
SKETCH,
� I
INSPECTOR DATE
CPIOYE: Attoch supplementol telt Jr, r
-Wiwi=
City of Tigard
INSPECTION REQUE $
for
c LL)
INSPECTION TI ME : PERMI".'
DATE: DATE ISSUED.—IL-11 -
OWNERS NAME ' -
ADDRESS : /1.3
CONTRACTOR .'- Z-2 LL
TES"r' AirO, Water Luhorai.).,; L
RE SU► T. Approve 6A, Disupproved 0 -i
SKETCH.'
1A
41
IN E C TO R DATE
COTE . A t I
'I
CITY OP
BUILDING PERMIT APPLICATION TIGARD DATE— t2.1 19
"` N° 0608
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND ^PPROVED IN THE ACCOMPANYING PLANS AND SPEgf(JS�TIFWW . �NER PHONE road
F;rt Lut: X I.u. 113UV ;,.w.XKi Xditil,s> N'A tY
OWNER ADDRESS BUILDER PHONE
>tia�+d ENGINEER
BUILDER _ ,t-1 ARCHITECT DESIGNER
STRUCTURE ❑; O
.EW O REMODEL ADDITI(N ❑REPAIR CIRENEWAL AFIRE DAMAGE r- ODEMOLITION
O RESIDENCE ❑COMM ❑EDUCATION OGOV'T ORELIGIC!'SOPATIO UCAR PORT OGARAGE O STORAGE OSLAB ❑FENCE
I ISOND EIMOVING OCONDITIONAL USE ❑DESIGN HEVIEYV OCOUNCIL APPROV' ❑SIGNS
OCCUPANT; —1-AND USE ZONE____="'~ ' .BLDG.TYPS .a FIRE ZONE--L PLAN CHECK BY rra HEAL_
" ,'strut 1429 eq. Pt.* frame dwelling wib attaches A r�aL'e a
r,,:1 basement scoording to approved plana
Og,C• LOAD FLOOR LOAD HEIGHT NO.STORIES 1 AREA 1922� VALUE 3 1111000
BUILDING DEPARTMENT SET BACKS FRONT I I REAR 'SIG LEFT SIDE Ull RIGHT SIDE La e
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUIL DING CODE, ZONING
Platt Check .LOS Sul REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND I r IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AVD IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 461010 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, Pt UMBING AND HEATING.
Total
BY -- — _ ---- -- -
_ APPI ICANI )R ni;FNr
Approved Receipt No.
ADDnESS -- --- --- -- r OHNE ---- -
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor JAIV
�� ! / 1/ Permit No.
��� U
�juLtr l_" _ Hough-in
Fixture
3'z 7�' P� - Final _
— HEATING
PermitNo.
Gas or Oil.'
-- ------ - _Dqqkh n �- -
_ Final
— --- SEWER -?3-;�6
Final
- -------- --- ---- -- ---- - DRIVEWAY
Final
Storm Drainage
)Rain Dr in) Final
_ - - — Sidewalk
I'urb&Street Final
-- -----—�— — - _
Approach
BLDG.UEPT. FINAL TEMPORARY - ^.ERTIFICATE OC:UPANCY F.nal
S- -�/(o CERTIFICATE OCCUPANCY
Landscaping
Zonir,7 Final
C
ADDRESS ..�`S.�J - `-y- s•�� / z ( C PERMIT NO. '?
PERMIT COARGE _ none
OWNER
�
CONNECTION EE SJ
P A 10 BY
TYF" OF BUILDING DATE CONNECTED
:;ERVICE RATE 9 INSPECTION FEE
PAID BY DATE
CONTRACTOR w
�;�S
SIZE OF CONNECTION ASSESSMENT _ PAID
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