16134 SW KING CHARLES AVE �s
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I • n ' P D ATE CITY OF �_,19 � N BUILDING PERMIT APPLICATION TIGARD F -
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED / 3� 2— a 9 .
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
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OWNER v' ,. .-..t.--,.:- , = ' ADDRESS • • • --(1). eleS1 Jx-- -N BUILDER PHONE • .7+c c e ■
• e R/ 1 L ENGINEER
RLILOFR Y6TM J . HITECT DESIGNER
STRUCTURE ❑ N • EW ❑ REMO L " 'CO l :/f 0 ADDITION ,REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION •
RESIDENCE ❑COMM DEDUCATIONAL DGOV'T ❑ RELIGIOUS DPATIO ❑CAR PORT• ❑GARAGE ❑ STORAGEDSLAB ❑FENCE
❑BOND ❑ MOVING ❑CONDITIONAL USE ❑ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG. TYPE FIRE ZONE_ PLAN CHECK BY HEAT .
Mi AMY/ s O` - — • r j ' /i P • •
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OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA VALUE — -
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BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
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I 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
Recording I ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
MEM 3C RESTRICTIVE COVENANTS. CONTRACTOR Ar. JB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR .vER. PLUMBING AND HEATING:
Total .
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APPLIC l JR H _ - .
Approved I Receipt No. •
ADDRESS PHONE
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