10300 SW BROOKSIDE PLACE-1 A
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10300 SW BROOKSIDE PLACE
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BUILDING PERMIT APPLICATION TIGARD DATE..__-�? �1q L5
THE UNDERSIGNED HEREBY AP?LIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE41 -(''S�- 6;-
OR AS,;HOWN 77,4,1,j
APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
I (I I / LOTNO.
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OYJNER �' JOBADORESS / '( JC?o'-jt4 /L1/D�u'��`�— ARCHITECT
ENGINEER
BUILDER : / L(' _ADDRESS - DESK,.FR
STRUCTURE NEW REM('DEL L-1 ADDITION i11 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE, ❑ DEMO LITIOt+
❑ RESIDENCE ❑ COMN ❑ EOUCATIC NAL ❑ GOVT ❑ RELIGIOUS C] PATIO ❑ CAR PORT ❑ GARAGE G STORAGE ❑ SLABEI ENCI
OC'UPLAANNC"Y �_LAI IQ U� SES/Zp 11 1 BLOC.TYPE S--All FIRE ZZOON - PUN CHECK BY _[. i HEAT''
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V T'
SEWER PERMIT C .
CCC.L_O_AO FLOOR LOAD HEIGHT k,'*- yo.STORK AREA /4/4/ 1 O.BEDRC^OMS VALU- �C -
BUILDING DEPARTMENT 1 SET BACKS FRONT �h REAR LEFT SIDE &7 &'" RIGHT SIDEo r-1
PbrtnN THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWN;
Pta�Check -�� REGULATIONS AND ALL APPLICABLE CO ES AND ORDINANCES, AND IT IS HEREBY AGREED TY.AT TNI
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANC'
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV'
(rSu�lotal RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFS''
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUM QING AND HEATING.
Stats Tax
SDC-
Total
By
' POCA APPLICANT OR AGENT� _---
Receipt No.
APP� ADDRESS ---- i PHONE _
SC)C -
PGC -� —
SEWER CONNECTION S
SEWER INSPECTION S
SEWER SURCHARGE S yi
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L/01