Permit p _"711rr_.-1. ' GI As **wow . P. CITY •-,'. � . -, 1•/"1•/"1, w w• . .1.1-i � Z
BUILDING PERMIT APPLICATION of TIGARD DATE 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
dMENT CO. i 2 Coo f i'y Row LOT NO.
OWNER ' }r ,a1-- +ANre JOB ADDRESS SW Scrlvlla/ HOME ADDRESS
` r �/� ARCHITECT u—tai.44,.e
?`c-!
fr c,r •t :! I",�r�e •`` 1y �Gi. of ENGINEER It,,,E;
BUILDER - &Li ADDRESS (105" l ,J�. Din el t DESIGNER _
STRUCTURE DNEW 0 REMODEL ❑ADDITION ❑REPAIR DRENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM DEDUCATIONAL ❑GOV'T DRELIGIOUSDPATIO ❑CAR PORT ❑GARAGE ❑ STORAGE ❑SLAB ['FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
a ' 5'
OCCUPANCY LAND USE ZONE BLDG- TYPE �` FIRE ZONE _ PLAN CHECK BY HEAT
.. iLLA , O u�i.t + ..rRINKLEREL.
- trust commercial building all par plane 4 r:;,pwca it ...4.6 Coda .
ever Permit for Building C
OCC. LOAD FLOOR LOADronc!e`s1EIGHT 20 NO. STORIES A REA ' 1 ' NO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
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
Sub - total 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 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 6 0 4 1 1 / 0 &`/ pca ,
By
.7-773 APPLICANT OR AGENT
Approved Receipt No.
•
•
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
• /S' ? ? e.... • . .. 0 e. Contractor
I< -c-4_ Ot /P4/L - , Permit No. C_..cp 9d.,, P14;; / .
�� / 2 ��Rough -in
/2 IP/ 2. iAt• Fixture I
le 15 -?? sa.— Mt 01.1 �i G A.+ 6-v 9AI�• em- •
•c nal
+�_ � ti v Y N'� /a°J- roc, — Q ty, / J co O f. HEATING
7 -g0 YY A Co,- - ( n/ .v. Ph. W A C r r! O k. I Contractor
4. 4Z- Cc." 4i4, Aka 2.1 - • Permit No.
3 / / / y& / / - C � � 1004 � ` + Gas or Oil
/r_/ , r� Rough -in
�f = S' - � �/ / � W � j� � � Final
�LCAs /C
/� QA. SEWER
/ /- ' i
C +++(((�// /�. .41k N' Final
DRIVEWAY
"r9i6 f Final
Stonh Drainage
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final