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13070 SW ASH AVENUE
BUILDING PERMIT APPLICATION 1o' TICARD DATE-__--____.._�—_,
THE UNDERSIGNED i'EREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BIhLDER PHONE
OF AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. O`.n'NERPHONEV
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OWNER yJ. . —`_—_--JOB ADDRESS I P',10 Sw A•;{I'1 _st,. HO 1E ADDRESS
r ARCHITE�
BUILDI'RII }t;u;, ENGINEER
ADDRE-1,9 _ DESIGNER
STRUCTURE ❑NEW ❑REMODEL DADDITION ❑REPAIR ❑RENEWAL ❑FIREhIAMAGE _❑_DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑ .
GOV'T 1.IRELIGIOUrC1PArlo []CARPORT ❑GARAGE 0STOR46EGSLAB ❑FENCE
OBCND UMOVING ❑CONDITIONAL USE. ❑DESIGN REV-EW ❑COUNCIL APPROVED ❑SIGNS
QQCU AN Y�' LAND USE ZONE -,`�--IjLDG.TYPE_ FIRE ZONE—'_PLAN CHECK BY_ HEAT _ —
ofbr rite d61ottce Lr. - ,IIJI. wj eplal.,.,mu,ir, u1 _ul1cl)'I —
M1.7 f : ; L! .L.L - U eRfOty raquiLemsfiv. J. Smoke deter,turs r�Lquii alll. --u--
HF1G�iL---.---�dQ.�SIS?B!€�S_ r: AREA NIS.eEpj30 S �11.�� •
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit —
�'--- THIS PERMIT IS ISSUED SUBJECT TO THE RI:GUI.ATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND O'1LINANCES, AND IT IS HEREBY AGREED THAT THE
"'--'—" - WORK WILL BE DONE IN ACCORDANCE. WITH THE PLANS AND SPECIFICATION';AND IN COMA';IANCE WITH
sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOFS NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY nt1SINES!i
State Tax LICENSE. SEPARA!E PERMITS REQUIRED FOR SEWER, PLUMBING ANn HEATING.
�Total
By
--'-- ---------- APPLICANT OR AGf NT
Approved Receipt No.
- ----- ADDRESS
DATE INSP.N TYPE INSPECTION REMARKS PLUMBING DATE
—
1 1 1 p f- =: c—,`;v C--I? LQDIC-f <iool) Contrnor
Permit No.
v I
&-�Q /I-S :Ah2j,,QA) 152,t) r7'— �h-in_
-4_/ Zj,.J
Fixture
t-T Final
IIEATING
Pei mi t No.
Gas orOil
R 9�uqt-_in_
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainag?
___[(Rain Dram) Final
Sidewalk
Curu Z,Street Final
Approach
BLDG DEPT.FINAL TEMPORARY uERTIFTC4TE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
Address ;7,:2 4C;2Y� Zt,�2�I Permit No.. Alki
Permit charge
Owner `Q, Connection
Paid by
Type of building_ Z. Date connected
Service rate Inspection fee
Contractor Paid by Da-Le
Size of connection Assessment —Paid
PERMIT TO CGNNECT A%
Tigard Sanitary District
PERMIT N9 1263 DATZ 9
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN Com-
PLETED. .3 46 -� kq(k
PJCRMIT FRII PAIL' TIGARD SANITARY DISTRICT
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CONNF(M, ON INSPECTED AND APPROVED
Superintendent