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7225 SW BONITA ROAD
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BUILDING PERMIT APPLICATION 1 FY TIGARD DATE -9-6Y G 77 _ 16"1 1
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE___
OR AS SHOWN AND APPROVED IN TH& ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER
Q, LOT NO.—
OWNER L1Uwi' L_,;i,,:L1U+,L.._J06j8MRESS (225 W Qgnit,.S Pd. HOMEADDRESS _
L ARr"17 FCT
ENGINEER
BUILDER f�--yf ADDRESS
DESIGNER
STRUCTURE ❑NEW ��-TTO REMODEL DADDITION_—_ C1 REPAIR ❑RENEWAL [:]FIRE DAMAGE - []DEMOLITION
C3RESIDENCE /000MM OEDUCATIONAL ❑GGV'T ❑RELIGIOUS❑PATIO ❑CAP PORT ❑GARAGE ❑STORAGE OSLAB ❑FENCE
❑SOND
]MOVING ❑CONDITIONAL USE ❑DESIGN P.EVIEW ❑COUNCIL APPROVED OSIGNS
_CCCUPANCY1—w—LAND USE ZONE 1� BLDG.TYPE - FIRE ZONES PLAN CHECK BY L1 _ HEAT
fidmodal I,,If exturiar wincl: :r rated dtaar sec. and adding bla :k wall.. - —
--- ------------ ---
BUILDING DEPARTMENT SET BAC,:S FRONT - REAR _ LEFTSIDE RIGHT SIDE
Permrk
-_
THIS PEPMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan REGULATIONS AND ALL APPLICABLE CODES i ND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL IANCE WITH
Sub- ALL APPLICABLF CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
StateLICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tota
By --- —------- --- - . .. -- - -
AP 1 SCANT nRNi
AppI Hrrrinl No
ADDRESS GI�iiN�
r
DATE NSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No,
/21112S. Rough-in
Fixture
Final _
— HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
_ Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk _
Curb&Street Final-- _
Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
t. Landscaping
V Zoning Fir it
i
Address
o Permit
,J Permit charge e>--o
Owner �a �� Connection fee
Paid by
Type of Building ( Date connected
i
Service kate Inspection fee
Contractor �.C//Y�/ ��` �'` ' _ Paid by Dater yC�
Size of connection L� — Assessment Paid
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 ti 59 DATE
PFUMIT 1S GIVEN TO `
OF
TO CONNECT ATO T11 SYSTEM OF TIGARD SANITI,AY DISTRICT
AT
THIS PrStMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NEMON IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID t . ...........................TIGARD SANITARY DISTRICT
By
J-3s7
CONNECTION INSPECTED AND APPROVED
Pate Superintendent