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CITY OF TIGARD
Approved ( ):
Conditionally Approved ( ):
For only the work as described in
PERMIT NO. 'Y►S f„ No L — 00 3
See Letter to: Follow ( ):
Attach fa/ J . - ( ):
Job Address: /.3635 ''`h
By:. Q r Date: .5 - G -- G
•
LIABILITY
The City of Tigard and its
employees shall not be
responsible for discrepancies
which may appear herein.
J
�� ) �Or rtr : 1°4