Permit F
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• BUILDING PERMIT APPLICATION TIGARD DATE_ 7 19_
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE•
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER rtscuip
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OWNER I j4.r
,R, . JOB ADDHE..5S .7 - v 6" ....S c -.5-5 64 7' ' 7" - • • 9j_
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BUILDIrCAMF 0 0 iRN IC me-ADDRESS dc=77-e--c, - 7.2.2 V DESIGNER
STRUCTURE 0 NEW 0 REMODEL 0 ADDITION >fiEPAIR . 0 RENEWAL 0 FIRE DAMAGE 0 DEMOLITII
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CI RESIDENCE 0 COMM :-. EDUCATIONAL 0 GOV'T 0 REUGIOUS 0 PATIO 0 CAR PORT 0 GARAGE 0 STORAGE 0 StABO FEN
OCCUPANCY 4 - / LAND USE ZONE BLDG. TYPE PLAN CHECK BY -------; HEAT?
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SEWER PERMIT I •
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA NO. BEDROOMS VALUt ---'
• BUILDING DEPARTMENT .. SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
P e i r u l l ' . . . . ( 5 9 - . , . - - - - - THIS PERMIT IS ISSUED SUBJECT T O THE REGULATIONS CONTAINED IN THE BIM LD1N6
REGULATIONS AND AU. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT 1
, imaiTCheck - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPUAt
, •, " --..,, . . WITH ALL APPUDABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA
I Sub-total . " " , ' ' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINi
' ' ...3 z LICENSE SEPARATE PERMITS REQUIRED FOR SV/EER, PLUMBING AND HEATING.
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POCI APPUCANT OR AGENT .
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• Approved --- . Receipt No. -- 9:4%- e- . ADDRESS PHONE
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