12010 SW KING GEORGE DR E • OPZINO'O
BUILDING PE APPLICATION : *:L�t .B...ay .19 Ng. _
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED •
OR AS SHOWN AND APPROV D IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
' OWNER . �
_Q . ADDRESS / J K ;) BUILDER PHONE
ENGINEER
•
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW ❑ EMODE ❑ADDITION ZBEPAIR ❑RENEWAL OFIRE DAMAGE ❑DEMOLITION
lg.-R ESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS ❑PATIO OCAR PORT. ❑GARAGE ❑ STORAGE ❑SLAB ❑FENCE
ONO ❑MOVING OCONDITIONAL USE El DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG. TYPE FIRE ZONE_ PLAN CHECK BY HEAT
4 !.0-4 •/ 1 ' ° ^ ...„
•
OCC. LOAD FLOOR LOAD HEIGHT • NO. STORIES AREA VALUE / / gyp ° ' — '
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit / .., OD • •
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
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
3% State 3,G LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total /g--_ 3(
By ' (21 LC-e- , 2 aZ.,P1..../Lit.,,-,...j .
APPLCANI...O.R .AG IL _ 9
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Approved Receipt No. Alice Canham 3 9 ^ / - c'�
. ADD 120 IOSWKingGeorgeDr . PHONE
'Tigard, OR 97223 •
•