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BUILDER VALUE FEE !^ L)AM
LOCATION ile'n OWNER
JOB # MAS' LOT
PLUMBER PERMIT FE''.
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,;EWER PERMIT - FEE WCHANI CAI. PMWT
EXCAVATION FILL - ALS CONDITIO..UNG
F00TI.GS FOUNDATION VENTLI.ATION
FORM;; SPRINKLER SXSTEM -SLABS _ MASONRY
REINFORC.INC STEEL FIR, DOOR;; EXITS _
STRtT-"rUP,AL_STEEL _y GARI',CE FLOOR
PL5ME3ING R.I. DRIVEWA.Y
�IFLA.SHIX JEWEF; Y -
FRAME __ STOW DRAIN
iATflfWALLBOARD--�---+ PARKING -- —_ -
HEATING N FE! CREEN
WATER HE.,AAmri A FI14AL
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CITY OF TIGARD
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APPLICATION FOR PUILDING PERMIT
ail
New Construction Demolish Addition F-1 Remodel Move
ZONING- A-2 _ DATE ISSUED BUILDING PERMIT
DATE RECEIVED BUILDI14G FEE $ 44.40• No.
,' BY PLAN CHECK � '�- --!23 24
�— - — OTHER $ .44 state VALUATION $42
TOTAL 3 RECEIPT No. TLZ-j-
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT 1 _ MAP 1 _ CENSUS TRACT _ JOB 1
Architect or Engineer _
Address Phone
Owner— yllli.■ .ra.oir
Address Phune
Builder____ iffith R.afing fa. ^_—
Address S815 a_u_ 11 r.rton o7nns _ Phone _
BUILDING USE Single Res. 0 Multi Res. 11 Comm. 1:1 Industrial L
OCCUPANCY GROUP No. of Stories Total Height Area of Lot
Type of Construction I II III IV V Floor Area B 1 2
i Set Backs: Front Back L.Side— R.Side (_
Private Sewer Pipe Size Sewer _ Septic Tank 0
J Water Service Pipe Size — Storm Sewer [- 1 Ditch 0 Drywell❑
Street and Curb Requirements
Driveway Width - —_No. of Park. nq Spaces—
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
- --- — -- Re-roofing only
ADDRESS ASSIGNED—
FIELD CI;ECK BY�-- --- — �- -- --- -- -- UATf_10-18-71
i
PERMIT APPROVED BY
It is understood that all wo►k will conform with applicable codes and inances
of. the State of Oregon and the "ity of Tigard, Oregon, and that the building wil
not be occupied until a Certificate of 0 p ncy has be _ ss /-by t City of
Tigard Building Inspectnr. �, !�
ature ofP is nt t
CITY OF TIGARD
12420 S. W. MeM SO oW
TIGARD, ORIGON 4f210
APFLICATION FOR BUILDING PERMIT
New Construction ❑ Demolish ❑ Addition ❑ Remodel [� Move❑
ZONING__ DATE ISSUED 8-16-73 BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ No +
PLAN CHECK $ � -x�
BY VALUATION $ 0
OTHER $ '-'
TOTAL $ 24.75 RECEIPT No. 91'?,;
_._. _ -.� �G• . �=,
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT M MAP N� _ CrNSUS TRACT _ JCB M_
Architect or Encineer _
Address _Phone
Owner William Graeper _- _--A -- -�
Address ,.._ lake ^a�WS _ PhoneGj� t�
Builder __-
Address _ - -Phonga_F
BUILDING USE Single Res. ❑ Multi Res. 1s1 Comm. ❑ Indus*rial❑
OCCUPANCY GRCUP No. of Stories Total 11eight-__ Area of Lot-
Type of. Construction I II III IV V\��loor Area B� 1_ 2
Set Backs: Front 'crack L.Side R.Side-
Private Sewar Pipe Si::e �� sewer Septic Tank El
Water Service ipe Size Storm Sewer ❑ \hitch ❑ Drywell❑
Street and Curb Requil-ements T� �M
t~
Driveway Aidth No. of ParkY`ng Spaces
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
_i Recreation facility_shower repair
I
ADDRESS ASSIGNED_ 10670 S.W. Canterbury Laos -
FIELD CHECK BY _ JB _ _ - (`DATE_)! a- -73
-I
PERMI'P APPROVED
It is understood that all work will cc:nform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the buiidinq will
not be occupied until a Certificate of Occup licy has been Issued by the City of
Tigard Building Inspector. 1
Signature of Applican=t �-