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BUILDING PERM iTAPP'_ICATION TIGARD Dare - _ 19 x'89 T
1 HE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WO;-i1 HEREIN INDICATED BUILDER PHONE Vtl-R
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. 1 1 _
OWNER �.?�v .ail erJOBADDRESS :,;wi iwnJ_._ _„ __- ,uud parK--
ARCHITECT
ENGINEER
BUILDER bacwe ADDRESS P.O. FMx 2329!, _ � DESIGNER
STRUCTURE OXNEW ❑ REMODEL C1 ADDITION ❑ REPAIR 11 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
' RESIDENCE L.1 COMM El EDUCATIONAL G GOVT P RELIGIOUS C7 PANO ❑ CARPORT 0 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ n-3 _LAND USE ZONE !L-i 2 BLDG.TYPE _ 5N FIRE ZONE. - PLAN CHECK BY (%I` HEAT�_(_i1tL__
Construct rirg•le farmily dwelling, k/attached ara e. —_
kt:lesue of Prmit 94747
3 11athroom 3 Bedroom, _
SEWER PERMIT# 2791?. t,ar.�n e 487
OCC.LOAD FLOOR LOAD 40 - HEIGHT V ' I_ NO.STORIES 2- AREA 15:'. NO.BEDROOMS .3 VALUE bU.7 7y
EUILDIM':DEPARTMENT _ SET BACKS FRONT ZQ REAR LEFT S DE RIGHT SIDE
Permit '3 I6.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C('DE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREE ) THAT THE
Plan Check 4t)•�xl WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN Ck"MPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES I'OT WAIVE
Subtotal IS 00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 9USINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stat Tax 12.64
SDC- ")5110.(X)
Total 3b�>.i�ti ,[ ISU.(10
PDCIr -4000C-ANT OR XMIV
By _ Cf _ ssi)(: 25(1.00
Recelpt No.
Approved ---,[1CI4 - f ;�;�_, ADDRESS--- ----PHONE
DATE INSP. TYPE INlP[.CTION REMARKS PLUMBING DATE
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