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BUILDING PERMIT APPLICATION T11GARD DATE_ av 31 is �_ 4454
UNDERSIGNED HEREBY APPLIES FOk A PERMIT FORTH WORK HEREIN INDICATED BUILDER PHONE
OR A13 SHOWN AND APPROVED IN THE ACCOMPANYING PL �N i AND SPEGIF:GATIONS. OWNERPHO
LOT N0.
OWNER l)C'+.t) ''c l! 1c+'� �.. t%C GOB ADDRE S� 12 95 '14l:a c.—Trine± St.�
--� — � � P,RCHITECT
;$ 10 I K I `.,I RaTbur 51vd. ENGINEER Dwmonic
A BUILDER ADDRESS DESIGNER
STRUCTURE C NEW ❑ REMODEL ❑ ADC111014 ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
Ll RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GO_V'T ❑ ri£'__II;:IOUS ❑ PATIO_❑_CARPORT U GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCU;'ANC', I't" _LAND USE ZONE R" ' BL.DG.TY"k--�'4 FIRE ZONF — PLAN CHE^.K BY
-- Construct mje Family 0,,v1'J.n,r w/attached psr0�pe
`;rk? correction sheet attaclaeel. 3 beada;oomi
^— y iF• ���i!) 'fia7;1'C ,r.r,1',vood ! .�Jso `.iubj. to Leron P .6. 1
SEWER PERMITM 7', }t' !e 12
OCC.LOAD FLOOR LOAD tali HEIGHT NO.STORIES AREA 1930 NO.BEDRJOMS 1 VALUE
_ BUILDING DEPARTMENT SI=T BHCKS FRONT ?t) REAR '' LEFT SIDE 17• ' RIGHT SIDE 1 •`�
Permit 36/"})aJ THIS PERMIT 11-4 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 11IIILDING CODE,ZONING
r RE,311LATION6 ANO ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check a3 " WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WI'-H ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RE'3TRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 1'O HAVE CURRENT CITY BUSINESS
ire F, LIC ENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SC1C—
4(10 a(h)
Total
'pDC;M 1 1 X) 110 APPLhGAN7 OR AGENT
gy d:a j
Approved
il1h Recelpt No. AGURESS - -- -- PHONE
DATE INSP. TYPE INSPECTION — REMARKS PLUMBING DATE
Contractor Cla+'hCl✓1�
r
—_ ��. . ���1��-LPermit No.
--3Y�D _ 13 f7AO (p.�.'�j.t/f--
122 Rough-in
Fixture —-- -- - —
?�
Filial - --
HEATING —
8��7-gJ Contractor
Permit No
Gas or Oil
--- — ----_----- ----- Rough-In f
Fin
— seweR
--- —---------------------------— Final
DRIVEWAY
-------_T. Final
Stvrm Drainage —
(Rain Diain)Final
Sidewalk
Curb&Street Final `--
_ Approach
BLDG. DEPT. FINAL TEMPORARY CERTWICATF OCCUPANCY
CERTIFICATE 7CCUPANCY [Final — - — -
Landscaping
Zoning Final
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BUILDING PERMIT APPLICATION TIGARD DATE tt,,'---44
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE•��A� 70 011
QQ AS SHOWN Mt Nr,APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIIO•NS. OWNER PH E
qr- # 11% QAe� lANQ
OWNER �q � . ' BADDRESS (PRJ [
.
II 61�
ARCHITECT
ENGINEER
BUILDER ADDRESS VIN S�tZU►r !S DESIGNER ON'IkH c,
STRUCTY u �' NEW ❑ REMODEL ❑ ADDITION ❑,REPAIn ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMQLM04
Fm RESIDENCE J COMM 15 EDUCATIONAL ❑ GOVT ❑ RELIGIOUS ❑ PAT0 ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCe
OCCUPANCY, LAND USE ZONE ]ft�- BLDG.TY1,1E -FIRE ZONE.._=-PL..AN CHECK SY HEAT•
G 'J+1
314e 3 _
SEWER PERMIT I
OCC.LOAD FLOOR LOAD #Q. HEIGHT��NO.STORIES 2, AREA 0 N.O..BEDROOMS VALU ��
BUILDING DEPARTMENT SETBACKS FRONT .20 REAR LEFT SIDE IZ•- RIGHT SIDE 12-$-
2;13
Z.$
Permit THIS Pf'AMIT IS'ISSUED SUBJECT TO THE REGUUTION&CONTAINED IN THE QUILLING CODE,ZONIN
Plan Check ,Z 3 e. REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,'AND IT IS HEREBY A15REED THAT THE
WORK WILL BE DCNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS l,ND IN COMPLIA14CE
f WITH ALL APPLICABLE CODES AND ORDINANCES.THE ISSUANCE OF THIS PERMIT DIE:NOT WAIVE
Sutrtota �/b' ` RESTRICTIVE COVENANTS.CON,RACTOR A.ND SUB CONTRACTORS TO HAVE CURRENT ATY BUSINESS
• , LICENSE SEPARATE PERWTS REQUIRED FOR REWER,PLUMBING AND HEATING'
State Tax ry t
Total F 0..2 3 $�_ •-��i� K �' t L s. _�_
PDCA APPUGAN.o OR AGENT
By
Receipt No. _ _
Approved Aor,aEs3 PHONE.
SDC qvo -
PDC - S +- / 00
SEWER CONNECTION $ 2
SEWER INSPECTION $ '�
SEWER SURCHARGE $ ice= ,t«,.. r„ ektovaQ N$10 41. `1R le00% Vik)
17-20
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