Permit . ifiThr
� i
CITY
BUILDING PERMIT APPLICATION of TIGARD DATE t '� ' �7
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF -1620
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
LOT NO.
OWNER UQ1 Ux• t • k3.: JOB ADDRESS 14650 SW i ith HOME ADDRESS
ARCHITECT
ENGINEER
�
BUILDER "" ADDRESS 13137 SW Pacific Mu•' DESIGNER 8ob Greenwood
STRUCTURE ❑NEW ❑ REMODEL ❑ADDITION ❑REPAIR ORENEWAL ❑FIRE DAMAGE ❑DEMOLITION
El RESIDENCE 0 COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS ❑PATIO ❑ CAR PORT ❑GARAGE ❑ STORAGE ❑SLAB ❑FENCE
■ .nOND 0 MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY '-2 LAND USE ZONE BL TYPE FIRE ZONE_ P LAN CHECK B IrTW HEAT
,.instruct 12' X 36' ,, 10' Storage shed all per plan and U.B.C. Cody:
No Plumbing.
OCC. LOAD FLOOR LOAD HEIGHT 10 NO. STORIES 1 AREA 432 NO. BEDROOMS VALUES
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit $32.00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 154X1 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
Sub - total 48.00 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 1.28 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 449. 2IR
By I
IL APPLICANT OR AGENT
Approved Receipt No 3 3
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough -in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough -in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
BUILDING PERMIT APPLICATION coF TIGARD DATE -- . 10/ •i__. t 9-- - - 275
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE 4 _ ' — � / , -.._.-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF IC;. DONS IONS C''.'.NEF? ?HONJ 1(O .4.
SO I \ LOT NO----- ___ -- ... . ____ -
-[ S ADDRESS / l`— �_—
OWN_ :ARCHITECT {� -----
/ / ENGINEER ra
8 U I L D E R Q 1- -rr,■• Ii
a vlj. � 9•t td rt,. CA/ e
ADDRESS ?? `^� DCSIGNER
i��it —_. 7 Tt _ _ - - - -- -- -- — - -
STRUCTURE . NEW ❑ RE MODEL [_j%•DDITION DF ;EPAIR O'; •%AL AFIRE DAMAGE ❑DiM I. _
❑ RESIDENCE ❑COMM EDUCATIONAL DGOV T DRE_IGIOUSDPATIO DCAR PORT OGARAGE ❑ STORAGE ❑S_%-a UFLN_
Occ.:,PA -Jcv g 1.-- 7LAND USE ZONE 13%,-1. - B, DG TvPE_ . _ __: FIRE ?ONE P, an EF,
0 crNA.44-- 0_ Ni to ,)( to: gi..,..e.,_,. H
CHECK BY _ E - . _
SEDER PERMIT ; __ - .__....__. -
r, - - - _ —
- -
!JCC.I.OAO FLOOR H SIGHT / 0 NO STORIES) ..... AREA J Y - DR OOMS VALID =J00d
SUICDINi, DEPARTMENT_____ S f BACKS FRONT REAR LEI- : SIDE RIGHT SIDE -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE LC.)N;K
I Plan Check h REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY PGREEO THAT Ti
- — - rrOR WI LL DUN ACCORDANCE WITH THE PLANS A':D FICAT AND OE K PL I�N T l
S.;') - total 1 ALL APP LI CABLE CODES IN AND ORDINANCES THE ISSUANCE SPEC; OF THIS IG NSP PERMI FN DOES NOT Y it:! .�.I
-- - -- - -1 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINE
Ls..____ Z� . - ' I LICENSE SEPARATE PERMITS REQUIRED FOR SEWER PLUMBING AND HEATING
, te T I
ADC
Total - Q II
PY I / - �i. . —_. __. APPLICANT OP—AG—ENT .__ —. —.__.. . —_ —__
F i i ! .I.. No
L APPrOVf-e, - -- - _ A nr'•GF Sc --- - -. .. _ PHONE
SDC - $
PDC - $ i
SEWER ' rnt\!f CT ION $ ... ._
--
/
SEWER INSPECTION $
SEWER SURCHARGE $
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