16210 SW KING CHARLES AVE /
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1
BUILDING PERMIT APPLICATION CoF 1 41=1— � DATE Oct.31 , 19 78 NA •
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE281 1238
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF 6043
LOT NO
ERMT'S Bertha Haller JOB ADDRESS 16210 S.W. King Chankodm ADDRESS
ARCHITECT
=RClow Roofing & SidinsoacEss 434 N. Tillamook.Portlaor
ENGINEER IGNER
UCTURE NEW 12 REMODEL ❑ADDITION 10 REPAIR ❑RENEWAL DFIREDAMAGE ODEMOLITION
- !DFNCE COMM DEDUCATIONAL DGOV'T DRELIGIOUSDPATIO ❑CARPORT ❑GARAGE ❑STORAGE ❑SLAB ❑FENCE
'JBOND Cl MOVING DCONDITIONALUSE DDESIGNREVIEW DCOUNCILAPPROVED ❑SIGNS
UP ANDY__ L AND USE ZONE BLDG. TYPE _FIRE ZONE— PLAN CHECK BY HEAT
Reroof house with Certainteed 240# three -tab composition
shingles.
- — Cost $1,350.00 ,
- ' ;C :LAD FLOOR LOAD HEIGHT NO STORIES AREA NO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
—'— 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
I Sub-total 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 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total Clow H / & Siding Co
By Office Mgr
-^ APPL ICA TOR AGENT
Approved Receipt No.
4 N. Tillramook,Portland PHONE
1238
- - -- A URESS
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