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CITY OF TIGARD 6�9- 171
BUILDING PFF,MI DATE _�—� '!_I��� /t'!.✓1+�'�
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1'.i1. Box 21197, figard OR 91223 TAXMAP LOTNO. S�U,9�UfIVi^iv'h1�/��_�.�_�Y
OWNER JOB ADDRESS
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BUILDER . __ ST.I;c REG.NO. _ 1_,�_—EXP.OATS _
OUIL^ER'S PH6NE
07
A RCHI i ECT �1L4�—�._
PHONE
STRUCTURE MEW U REMODEL U ADDITION U REPAIR Cl MOVE U OTHER L7 DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATION ❑ i'40 0 RELIGIOUS U ACCESSORY Q GARAGE L OTHER ❑ FENCE
OCCUPANCY UNI)USE ZONE y' BLDG.TYPE Y_�FIRE ZONE--.e.PLAN CHECK BY HEAT
.-Toe Sys_�� -- ----- --- ���.—.5__ 2...
SEWER PERMIT 1 2_
_OCC.LOAD
FU-X,9 LOAD Y40 4 HEIGHT /57" NO.STORIES ANEAj NO, 9EDROOMS_ VALUE
— BUILDING aE ARTMEN 7 — SETBACKS FRONT Z IJ REAR I.EFT Sluc RIGHT SIDE
P*fMAI — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING;
REGULATIONS AAD ALL APPLICABLE CODES AILD ORDINANCE'S,AND IT IS HEREBY AGREED THAT Tm"
Plan Check Z Vt) WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPi.IANCF
WITH ALL APPLICABLE CODE .AND ORDINANCES. THE ISSUANCE OF THF! PERMIT DCE;,' NOT WAIVE.
Pt.CILFim " '" RESTRICTIVE COVENANTS.CON TRACTOR AND SUB CONTRACTORS TO HAVE CURRENT ;ITY BVSIIIE :S
TAX PERMITS.SEPARATE P,EITNItT�4 REQUIRED FAR SEWER,PLUMBING AND HEATING.
Slate Tax A. 1
/ SDC--
Total Gp !7 +� AP AN PI'A � )- -
P.epd. of o `OCA 7 �6` G _ G i'
rweelpt No. ADDRESS — PHONt
1001.Due
Issued By—_ —_..APProvW BY — —.
..SDC ---- $
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iEWER CONNECTION � #
EWER INSCECTiON
EWER 3UhCHARCE S /5"0
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