BUP1978-2392 BUILDING PERMIT APPLICATION 11T TIGARD DATE .7 2392
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE x_3487
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE -
LOT NO.
p
OWNER 'tilitY EqVXp*f I"kI0B ADDRESS SoS )W 77th Plc HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER Art Middleton
STRUCTURE El NEW ❑RFMODEL ❑ADDITION ❑REPAIR [:]RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE (]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY�_LAND USE ZONE R� BLDG.TYPE FIRE ZONE— PLAN CHECK BY [Tw HEAT
site Iwororewent permit. Gradins, Pawingiii, Store UraAn - All per plana
Code Aeyuirewente• Swet li 6 ao prepared by Agt,piddleton, AIA.
Approx. SOW CU Veedr.
—� t
OCC LOAD FLOOR LOAD HEIGHT NO.STORIES- AREA NO BEDROOMS VAL422 " 127-
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
wA
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 4040 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 136,01 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 3,84 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total $1311,#4
By Pl APPLICANT OR AGENT
Ann w—A I . AAM1,1 I RBCeint No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�. Contractor
Permit No.
Rough-in
ee c
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TCMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final