11920 SW KING GEORGE DR CITY OF p � • _
• RJILDINC PERMIT APPLICATION TIGARD DATE , 19 M
•
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN. AND APPROVE IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER / 4(7)A-6/ / ADDRESS //!/ SW/ f /r ', BUILDER PHONE
: Cap loo' -- ARecaek g SLR _ i//
... ,/„.., - tierfiarz ,
STRUCTURE ❑N ❑ REMODEL ❑ADDITION %REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION •
rRES■DENCE 000MM DEDUCATIONAL l_GOV'T ❑ RELIGIOUS DPATIO ❑CARPORT. ❑GARAGE ❑ STORAGE QSLAB ❑FENCE
DBOND ❑ MOVING ❑CONDITIONAL USE ❑ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCC PANCY LAND USE ZONE BLDG. TYPE FIRE ZONE_ PLAN CHECK : Y HEAT
r / /'
6,40,... l ./. / `aJ .� 1 .i! %/ _. / -� .. / (/ �—!f i-mwrL %`
.1 01 eJ . "� /�/ t•_ _ -, #,�i, / ■
•
or.s
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA VALU
I
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE /
Permit l 3 °°- .
• I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check II 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
RESTRICTIVE COVENANTS. CONTRACTOR Ar. JB CONTRACTORS TO -HAVE CURRENT CITY BUSINESS
, ' State 1 - 3 LICENSE. SEPARATE PERMITS REQUIRED FOR .vER, PLUMBING AND HEATING.
Total I, �S 3
By 7 c,
, t II APPLICANT Jf1 AGE4.
I Approved 1 I Receipt No.
ADDRESS • PHONE