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Tigard High School Area Parking Permit Application
Permit Period: September 2016—June 2018
1. Applicant name: IIUCI IA10 A 4 , <: i a
Address: 6 &35-- 'f�t_j 93 0 &oe
Tigard, OR 97224 Phone AgyS) -- 0'5- ''P4-
2. For proof of residency, attach a copy of a utility bill, real estate title or rental contract
including name & address.
3. Attach a copy of the vehicle registration for each parking permit requested.
Each household will receive 1 guest-parking permit. If you would like more than 1 guest-
parking permit, how many would you like?
I agree to use any parking permit(s) assigned to my vehicle(s) only on the specific vehicle it is
assigned by the City of Tigard Police Department, for the purpose, it was issued. Any
parking permit(s) remain the property of the City of Tigard and may be revoked if improper
use is demonstrated. I agree to assign guest parking permit(s) to people only while visiting my
home and surrender any rights if I move. Violation of any of these understandings may result
in cancellation of the parking permit(s). After cancellation, any vehicle(s) found parked in the
permit area bearing said parking permit(s) shall be cited.
Signature Date
Mail this application with proof of residency and vehicle registration(s) to:
Tigard Police Department
THS Area Parking Permits
13125 SW Hall Blvd. j
Tigard, OR 97223
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638CDK 0733794083 GASOLINE OCT 22, 2017
YEAR .SAKE STYLE �11ODEL ICLE Ih1DETltIf FIFCA,TUO"IHIutameR E
2005 =0RD I UT PL IFMZU73K55ZA17229 PEE
EQUIPMENT NO. EIGHT/LENGTH TITLE BRA14DS
- NONE - $E6.00
ODOMETER READING ODOMETER DATE ODOMETER MESSAGE
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*SMITH, RICHARD ALEN ,'••' "
SMITH, BARBARA MARIE
16435 SW 93RD AVE CONI MY OF RESIID E COUNTY OF USE
TIGARD OR 97224-5597 WASHINGTON
E\N ADDRESS(HOUSE NUMBER,STREET,CITY,STATE,ZIP CODE) VA,,
NEW PLATE NUMBER
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