15748 SW 87th Ave Tigard High School Area Parking Permit Application
Permit Period: September 2016-June 2018
1. Applicant name: �u
Address: �z „ S� "
Tigard, OR 97224 Phone # 52S 3=!�C,
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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.
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Each household will receive 1 guest-parking permit. If you would like more than 1 guest-
parking permit, how many would you like?L--")-
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.
Tigard, OR 97223
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PLATE iuMBER TITLE NUMBER FUEL TYPE
7FARMfJO. NEW EXPIRATION DATE
2:X` 752 0822822006 GASOLINE _ NOV 30 , 2017
YEAR MAKE STYLE MODEL VEHICLE IDENTIFICATION NUMBERHVUT DATE
2004 FORD UT PL 1FMZU73KO4ZA19713 FEE
EQUIPMENT NO, WEIGHT/LENGTH TITLE BRANDS
— NONE — $86 . 00
ODOMETER READING T07DOMETE7RDAT�E ODOMETER MESSAGE
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*MORAN, PHILIP HENRY stir OF r11k
15748 SW 87TH AVE COUNTY OF RESIDENCE COUNTY OF USE
TIGARD OR 97224-5628 WASHINGTON