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BUILDING PERMIT APPLICATION TIGARD DAZE _-- 3522-
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_ 61(3-0797
LOT NO.
OWNER J8Mt.'F,' logrVio JOBADDRESS 9920 SIj Rj,.T.. rt,,,00d Lane f)JcRs and--FI _I I
Bvtn. ARCHITECT
ENGINEER
BUILDER IJOY'J Thornton ADDRESS 8795 SW box i'erltu Rd. DESIGNER Piercy Barclay
STRUCTURE C NEW El REMODEL 0 ADDITION Q REPAIR IJ RENEWAL El FirDAMAGE 1-1 DEMOLITION
X RESIDENCE 0 Comm Fl EDUCATIONAL El GOV'T 0 RELIGIOUS [I PATIO [I CARPORT El GARAGE F1 STORAGE 1 1 SLABO FENCE
dw
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OCCUPANCY LAND USE ZONE LI —PDBLVG.TYPE 5N FIREZONE-d-8 PLANCHECKBY RUT)
HEAT
Construct p 4 Bedrooms 3
Lnu
duelling w/attached
LL COPRECTION SHLET ATTWit'j),
SEWERPERMIT# 1,3221_ $75 *00 Q raQ& 5.22. eg.f_t..
OCC.LOAD FLOOR LOAD 4() 2 __NO.STORIES 2 AREA 23b8NO.BE_DROOMS 4 VALUF676AQ0.
BUILDING-Dffp-AA-t-M NT - SETBACKS FRONT 20 REAR 34 LEFT SIDE 7 RIGHT SIDE 17
Pot init $241.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 1101 50 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATInNS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 361*50 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
9,64 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SlateTax4l% — SDC- 64UU.OU
Total 1371.14 PDC#II S100*00 APPLICANT 6FI AbEW
By I
Approved
KWh Receipt Nv. (4Y)
ADDRESS 1 PHONE
DAT9 INSP. TYPE INSPECTION REMARKS PLUMBING E --
Contractor _t—
Permit No. �
-7v" co��'`"> G4-s-•.. - -- _•mac L----
•/V'
Rough-in
Fixture
final
? ! i HEEAT�ING 1�
Contractor
iLf�—C_
-- Permit No.
Gas or Oil U
— --------- Rcughav —
---_ .— — — --_-_ � SEWER
Final
DRIVEWAY
- _-- -�—` Final
Storm Drainage
— (Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCC NCY Final
CERTIFICATE OCCUPANCY .y ----.— —
O�
I Landscaping
Zoning Final
i
BUILDING PERMIT APPLICATION TICAP. DATE.:JP.c. 23 1980
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT FOR THE:'ORK HEREIN INDICATED BUILDER PHONE �-J'680
OR AS SHOWN AND APPROVED IN THE ACCO IPANYtING PLANS ANv%SPECIFICATIONS. OWNER PHONE -
V 0
OANER JaI' es' - 4dr MO JOB ADDRESS 7, Q 1V ,t,p ^ '4 1 e► rLOTP10.IL
ARC,iITECT
4QnpALE2 - Dp� ENGIVEER
BUIL'OER t.!44eio—f � ADDRE5SD �{� �QyY�Rp/�/_80 8
STRUCTURE NEW ❑ REMOM21L ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DE►.SOLI T IO
C C0M:v1 Cl EDUCATIONAL_ ❑ GOWT Cl RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STOR GE ❑ SLAS❑ FENCf.
�CRESIOENCIE
ilPANCY- ` _LAND USE ZONE _ BLDG,TYPE .!_�,FIRE ZONE PIAN CHECIf BY HEAT
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SEW ERPEaMITM —.....__--_------ --_---_._...__._--- -��T't''w�iZI�•+ _ _ 1,
OCC.LOAC FLOOR LOAD _HEIGHTNO,STORIES Z AREA NO.BEDROOMS VALUE �f00
Lr
BUILDING DEPARTMENT SETBACKS FRONT FEAR -_-� ~
-1 .�O 3 LEFT SIDE RIGHTSIDE %�
1 Permit ,2 41. e o 1 ---- -- -- = — - -
I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EvjILDING CODE,Zati:'a
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY A3R£ED THAT THE
plenChack AI L2�. ✓� WORK WILL BE DONE IN .ACCORDANCE WITH THE PLAIDS AND SPECIFICATIONS AND IN COMPLIANCE
'Vat+tal WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT L'OES NOT WAIVE
cL � ''y 0 _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO "'"F CURRENI CITY 86SINEESS
G LICENSE SEPARATE PF9,M)T3 REQUIRED FOR SEWER,PLUMBING AND HL.tTING.
State Tax
- - -
SDC--•
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PDCN
BY APLIG_A PRA -ANT
1
Approved - '�- - Receipt No.
ADDRESS
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SOC - - - --- 4 0
SEWEP CONNECTION
=EWER INSPECTION S �5
.)EWER SURCHARGE S
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