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BUILDING PERMIT APPLICATION TIGARD DATE_,__ 2 3 '1981 3576
THf. UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK I FREIN INDICATED BUILDERPHONE 639-40:,C
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICATIONS. OWNER PHONE_ 639-5i466
LOT NO. r
OWNER _Phil E&,n JOBADDRESSI3110 SIJ Ash Drive.
James Brien 0.8.A. — ARCHITECT
ENGINEER
BUILDER Ti_Qard rence Co. ADDRESS 1211tJ SIJ Lincoln _ DESIGNER_ F'teval1l s DEiBJ 1 _
STRUCTURE_ F1 NEW ❑ REMODEL _ CX ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE _❑ DEMOLITION
ED(RESIDENCE 0 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO Cl CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R-3 LAND USE ZONE R'7__BLDG.TYPE L' FIRE 20NE___-PLAN CHECK BY 8 tW NEAT
Construct -_fnmily room addition to existing single family swelling.
SEWERPERMITq - ---- - --
--..._ --
OCC.LOAD FLOOR LOAD 40 HEIGHT lb NO STORIES 1 AREA 66 NO.BEDROOMS - 'VALUI11.39 5OU.
BUILDING DEPARTMENT - j SET BACKS FRONT REAR Sq LEFT SIDE RIGHT SIDE
Permit _ 3t bap OU I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINFJ IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AC7EED THAT THE
Plan Check 34.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOE:; NOT WAIVE
Sub•tota 10 .UQ RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4';
SDC—
Total ` ' n 4.7 L - «-
PDCM nPRI-icn.NT ori ACErvr
By p1
Receipt No.
Approved _ �iwh ADDRESS PHONE
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
t-13-ill a -_ ---- ----- Contractor
C.
-- -
Permit No.
Rou(sh-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
--- - - SEWER --
Finch a
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Flnal
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATEOCC NCY Final
CERTIFICATE OCCUPANCY -- --
3-16-&t
Landscaping
II Zoning Final
ij
Address /3i/ 0•%r Permit No.
Permit charge , 1fi0
Owner'���P.�o � �_� Connection fee `A-e-)
Paid by
a
Type of Building _ Date connected
Service Rate Inspection fee 129 elm)
Contractor Paid by Date
Size of connection `�� Assessment Paid
PERMIT TO CONNECT '`
Tigard Sanitary District
PERMIT N9 1213 DATE}_
PFR311T IS GIVEN T07—L.,,
OF — --- ---- -----
TO CONNECT A 4— - ----.--- ----------
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT a71
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID TIOARD SAD`ITARY DISTRICT
1. �• 2
----- - - --- -- - - - - - - ----- -------- - --- - - - -
CONNECTION INSPECTED AND APPROVED
Date -- - -- --8uperintendent
L _