12436 SW KING GEORGE DR --- ------- --- - - ____ - --
• CITY OF
BUILDING PERMIT APPLICATInN TIGARD DAT ��� --
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDI 6 TED
OR AS SHOWN AND PP 0 IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
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OWNER ! • I 1/T/ ADDRESS /P G
41in- --- ' , BUILDER PHONE
!!!! f ' i% ENGINEER ( � /
BUILDER / ' 1 ARCHITECT SIGNER
STRUCTURE ❑N•EW ❑ RE /DEL ❑ADDITION IUREPAIR ❑RENEWAL ❑FIRE DAMAGE ODEMOLITION •
'RESIDENCE 000MM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSDPATIO ❑CAR PORT. OGARAGE ❑ STORAGE OSLAB OFENCE
QBOND ❑ MOVING OCONDITIONAL USE ❑ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUP; NCY LAND USE ZONE BLDG. TYPE FIRE Z•NE. PLAN CHEC BY HEAT • , - /i % � ii 1/ ,
/.i&.I,. La ` - _ /I ..,-.4 � � -�. % .
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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
I Permit 7 G
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
f RESTRICTIVE COVENANTS. CONTRACTOR AN . JB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State , 34 LICENSE, • SEPARATE PERMITS REQUIRED FOR - .vER, PLUMBING • HEATING.
Total ..' // - i
By - / r .
■ . 1 N AGES . ,
Approved . I Receipt No.
ADDRESS PHONE
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