Permit BUILDING PERMIT APPLICATION TIGARD DATE 4/23/ ,19 8'1 • . 371: , ' :'.:.x , ,
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 62O 175'.
OR AS SHAWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNE 4II .T R1{�OB ADDRESS MOO SW Caeca& LOT NO.
ARCHITECT
ENGINEER
BUILDER Milne Johnson ADDRESS DESIGNER
STRUCTURE ❑ NEW 7,1 REMODEL O ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE Cl STORAGE Cl SLAB 0 FENCE
OCCUPANCY _13.• ? LAND USE ZONE BLDG. TYPE 5N FIRE ZONE "'— PLAN CHECK BY Sty HEAT
Construct tenant modification all per plans and code requirements.
1
SEWER PERMIT # I
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA NO. BEDROOMS VALU$2S =QQO•
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit $112.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check r . fir WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
4-4, 80 1 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub -total Z,IZa p RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
State Tax 4.48
SDC —
Total $217.28
PDC# APPLICANT OR AGENT
By P
Receipt No. 4
Approved Ott. ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
7 / g t � R f , ,p Contractor
G/6 (1-42' /Y Permit No.
Q Wf .sc -r Rough -in
S //��•/ ��� .�t�.r.�� 01,404 ■p Fixture
;57 4---r--Le Final
6eQ / HEATING
� � � ��i D'Dt -iI�
: 244 Contractor
Permit No.
Get or Oil
Rough -in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
GERTIF'ICAT6 OC PANCY ` — _ n(7
d.31 (/ /�JS/J�
I Landscaping
Zoning Final
•
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL
INSPECTION NOTICE
OWNER DATE
OCCUPANT OCCUPANCY
LOCATION
YOUR ATTENTION IS CALLED TO THE FOLLOWING FIRE SAFETY DEFICIENCIES:
. - . _ . •
U
L■r
0
cU fufti r, /1 f Lrp x' - 4l
•
:la (u r71lis 175 16 , <
-
FAILURE TO CORRECT THE ABOVE CONDITIONS WITHIN DAYS WILL MAKE YOU LIABLE TO PROSECUTION. SHOULD FIRE
RESULT FROM SUCH CONDITIONS YOU MAY BE LIABLE FOR DAMAGES TO PERSONS OR PROPERTY UNDER PROVISIONS OF
ORS 479.190 By
WASHINGTON COUNTY FIRE DISTRICT #1 FIRE MARSHAL
20665 S.W. BLANTON STREET P.O. BOX Y
ALOHA, OREGON 97006 649-8577 PRESENTED TO
FORM 900 - 40