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BUILDING PERMIT APPLICATION TIG�►�tD�
•�� � (� (� CITY
C ON �F DATE. '��' 7i -- 19 1s � f
4
THE UNDERSIGNED HEREBY APPLIES FOR APERN'IT FOR THE WORK HERE,N INDICATED 80ILDERPHON7
UR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO_
OWNER i Tc�anm�� H..�� JOB ADDRESS 1,133 561 Boxwood w t- HOME ADDRESS _
ARCHITECT
BUILDER (liimeENGINEER
ADDRESS DESIGNER
STRUCTURE_ ONEW ❑REMODEL ❑ADDITION ❑REPAIR OREN_WAL. ❑FIRE DAMAGE f EIDEMO..ITION
O RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNC:IL APPROVED ❑SIGNS
OCCUPANCYY —LAND USE ZONE__ --BLDG.TYPE '� FIRE ZONE PLAN CHECK BY HEAT
-
i:LE iJ1.cili i ail iaGl t.'ILja.rsw0c'f1 3 iy ;.;13droom :J UaLh
QCC,)<QAD ')____FLOOH_LQgQ_ 05 HEIGHT 16 __ No.STOR(E5a_—wi. —ARE A -;;t.`.a N_I.BEDROQMS+_.VALUE___.__ .__ _
BUILDING DEPARTMENT .
SET BACKS FRONT a.`l REAR LEFT SIDE RIGHT SIDE
Permit Ulf
T141S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check REGUI.AfIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES TNF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUf.RENT CITY BUSINESS
State Tax LICENSE. SEPARATE PEPIMITS RF.OU:aED FOR SEWER, PLUMBING AND HEATING,
Total 3?S.t�C rtgf'a (,, -_ :,11711 ' it-, Il::,i ^:i cWk_ IJP ..
By
— ----- APPLICANT Oq AGENT
Approved -°LI Receipt No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DAT
G Z y _ Contractor
Permit No.
Rough-in
�r3 Fixture
t ti �. Final
HEATING
' L
- o c!1"-"'l er "rap --dA') Contractor
/ z
L'C 6 .� .e7_ IA4 Permit No.
cX/ 'y'yi ` L——e— Gas or Oil
Rough-in
Final
6Lt _
r4 S-��o����Jf----=-5 T/� SEWER
Final
DRIVEWAY
Final — ---
_ Storm Drainage
Rain Drain) Final
rAroach
walk
&Street Final
BLDG DEPT. FINAL TEMPORARYCERTIFICATE OCCU?ANCV
CERTIFICATE OCCUPANCY i
I
Landscaping
Zoning Final
MRAIMIKm
�f SEWER PERMIT N? � 13407
Unified Sewerage Agency CITY OF Tigard DATE 6-10-77 __
of Washington County —
OWNER : Trademark' Homes PHONE ._ 643-6491
OWNER ' S ADDRESS: _—
TYPE OF INSTALLATION :
UILDING SEWER ❑BUILDING SEWER AND SIDE_ SEWER
XiaTYPE OF OCCUPANCY:
XGNEW XXO SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7- 1-70 ) ❑ MULT . RES. L iND'JSTRIAL
FIXTURE UNITS
DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
IdSPECTION , PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED ZHOULD EXPIRATION OCCUR .
FEES:
PERMIT FEE �5
CONNECTION CHARGE --
575.
h
SIDE SEWER INSTALLATION _
ISSUED BY
OTHER --
T T A L s_-6-0a,
=42 777
/ l'.PPL. I CANT DATE
SEWER PERMIT N° 13407
185
ADDRESS OF STRUCTURE--------- fa5W Box wood Ct. _
--
1AX LOT SYSTEM n90 creek
TAX MAP—
LOT - 180 BLOCK OF—
APPROVED BY DATE
I SSUEO BY DACE
REMARKS bldg. ;r 1511