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12115 SW KING RICHARD DR • -� -- r ._. _.._ .. _ . � - CITY OF BJILDING PERMIT APPLICATION TIGARD DATE g — 9, .19 77 N - - THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 6_/ �/ OR AS SHOWN A• 0 APPR ED I THE ACCOMPANYING PLANS AND SPECIFICAT ONS. OWNER PHONE OWNER f / ' a' ADDRESS S' `+ BUILDER PHONE ( (--/7 7 � j ENGINEER RUI LDER I •� l. f� ARCHITECT DESIGNER STRUCTURE ❑NEW D REMODEL ❑ADDITION ❑REPAIR L10RENEWAL ❑FIRE DAMAGE ❑DEMOLITION RESIDENCE DCOMM DEDUCATIONAL DGOV'T DRELIGIOUSDPATIO ❑CAR PORT• ❑GARAGE ❑ STORAGE DSLAB ['FENCE DBOND D MOVING ❑CONDITIONAL USE D DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY LAND USE ZONE . BLDG. TYPE FIRE ZONE_ PLAN CHECK BY HEAT . ( ��-- ..-7 a 3s4 — . I o n OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA VALUE BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit �j F' O • 1 © THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check 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 Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE 41) r RESTRICTIVE COVENANTS. CONTRACTOR Ar. JR CONTRACTORS TO HAVE CURRENT CITY BUSINESS State �� LICENSE. SEPARATE PERMITS REQUIRED FOk .vER, PLUMBING AND HEATING. Total Ij 9 3 Ip • By t 1 ' ? eX4'at-- I 1 AP I I AN / 1 'f Lit.* Lit.* EN, . `� . I Approved [ . I Receipt No. J e • � . r PHONE 6 5 2 7 ' . J