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SHKARME
INSPECTION NOTICE
City of'Tigard Building Department
12420 S.W.Main St.
7'igardr Oregon 97223
Photic- 639-4171
Type of Inspection
-27 Ln
Date R64uested " 'MOB. A. P7e
Address Permit
Owner Lot
Builder--
The following Ruilding Code de9cienciet,are requited to be conected:
-lt-4 el gl�
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPFCTION
El YES �16 Mn
BUILDING PERMIT APPLICATION TIGARD LATE.__ ''c`�"`'`�„r `-' �,19 4 563
THE UNDERS GNED HEREBY APPLIES FOR A PERMI I FOR I HF.WORK HEIRF!N INDICATED HUILDER PHONE __ �[-11►93
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPF(;IFICATIONS. OWNER PHONE
3:4 LOT NO,
OWN[R - U_71 !juga) J013 ADDRESS Luruln►1 fit. - -- or; quarr____.�.
ARCHITECT
ame Job 2ENGINEER
BUILDER ` 1'� ADDRESS 1j�12 W fialV. Hill }T+„ry. DESIGNER •JAS t`013I'•
STRUCTURE_ F..➢+•NEW_—_❑ REMODEL ❑ ADDITION ' ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
E RESIDENCE O COMM f-] EDUCATIONAL ❑ GOV'T ❑ RELI310U8 L PATIO F-1 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABO FENCE
OCCUPANCY LAND USE ZONE --L-tL--L—t2BLDG.TYPE ` FIRE ZONE — PLAN CHECK BY HEAT_'
_`—,------____ Cartstructsingle. ramlly TkfelliTtg W/Att4CIlec!
Ru-]�� •reue of Petit 14562
SEWER PERMI"'N 2fAfl(� 17(ti sq. Et,
OCC.LOAD_ FLOOR LOAD 40 HEIGHT _NO.STORIES AREA 11711 NO.BEDROOMS �Y' VALUE 46,000
BUILDING DEPARTMENT SETBACKS FRONT 2.0 REAR LEFT SIDE >� RIGHTSIDI
-- _ -- - -
Permit 205.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HERESN'AGREFO THAT THE
Plan Check 40,0U7XXTZ3 WORK WILL. BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AIJD IN COMPLIANCE
WITH ALL APPL'(.ABLE CODES AND ORDINANCES. THE ISSUANCE OFTHIS PFRM0 DOES NOT WAIVE
Subtotal_ .�Ug.l)118CS1� RESTRICTIVE COVE NANT3. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Slate Tax
I C1 ((1 LICENSE'.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HIFATiNG
_
Total 315 Coal -XSBy SDC 19400.Q()
PDCN 110.(N.) APPLICANTORAkGENT -- -'
I. <r Receipt No.
Approved x . !j, ADDRESS _ PHONE W --- -
DA +INSP. _ TYPE INSPECTION _ REMARKS Pr,UMBING DATE
„ ✓ _ Contractor /✓) d ♦��
I ► .� __..------ Permit No.
Plough-In
Fixture
Final _
—�
-tile
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
T Final —
SEWER -
--
—Final --
DRIVEWAY
—'^ Final
Storm Drainage
(Rein Drain)Final
Sidawelk
Curb&Street Final
_ f- ____
Approach ---_—
9:6-6.SEPT. 'NA'_ TEMPORARY T CERTIFICATE OCCtIPAIVCY
CERTIFICATC OCCUPANCY Final
Landscaping
Zoning Final
j
t�
`i
i
BUILDING PERMIT•APPLICATION TIGAHD DATE—_._..
THE UNDF_RSIGNED HERLDY APPLIES FOR A PERMIT FOR TIME WORK HEREIN INDICATED BUILDER PHONE,���L�L�j
OR 1S SNOWN A APPROV .DIN THE ACCOM ANYING PLANS AND SPECIFICATIONS. OWNER PHONE
1 c1 LorNo. �-
OWNER JOBADDf ESS
11 LP T 1,. ARCHITECT—
ENGINEER T
BUILDERV � ADDRESS ��' �QLDESIGNER V nt. SLA-k _
STRUCTURE_XNEW ❑ REMOO-'y ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRI:DA MAGE UJ DEMOLITIOt
�I REstrENCE ❑ COMM ❑ EDUCATIf'AAL iJ GOV'T G RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE ❑ SLAB❑ FENCI
OCCUPANCY LAND USE z,,NE ���_BLDG.TYPE _.rA/FIREZONE ""'PLANCHECKBY !F,t4je—HEAT ____--.
SEWER PERMIT M
OCC_LOAD FLOOR LOAD (J HEIGHT NO.STORIES 1�' AREA NO.BEDROOMS _ VP.LV4�z&v
BUILDII,G DEPARTMENT 1-tl REAR LEFT SICE )l RIGHT SIDE !> J
_. SET BACKS FRONT
Permit _V•/ .�U THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIO14S CONTAINED IN THE 3U1LDING CGDE,ZOt1!N:
REGULATIONS ANE'. ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TKAT TP..,
an Check V-�
, !.j" WORK WILL BE DUNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL1ANC'
IPl _ WITH AL1. APPLICABLE CODES .AND ORDINANCES. THE ISSUANCE OF TH15 P£RPAI'i DOES NOT WAIV
�Suh-total 341 It _ ESTRICTIVS COVENAXIS.CONTRACTOR AND SUJ CONTRACTORS T°J HAVE CURRENT CITY BUSINES:
1060 Q O LICENSE,SEPARATr PERMITS REOUIRcD FOR SEWER,PLUMBING AND HEATING.
State Tau
-- —_ SDC —
Total _ -WP-F) - ------.----�.___. _��_----_
CANTOAAGENT
By
Receipt No. ------
Approved ADDRESSPHONE
3006
Sol - `{ D 40 I a-4 I l,! .1-1
Par -
SOWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE
C n m m o G t