11452 SW TIGARD STREET -11452 SW TIGARD STREEgt DK-
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CITY OF ounSe 30 76 W 0900
BUILDING PERMIT APPLICA i ION TIGARD DATE 19
THE W)E:RSIGNED HEREBY APPLIES FOR 4PFRMIT FOR THE WO' IEREIN INDICATED 6:?0-2079
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE__ _
"AmsUWNER ADDRESS BU,-DER PHONE —
?N�WEcR
BUILDER --_.— AfICHITECT _ _ DESIGNER —
STRUCTURE _ ❑NEW —❑REMODEL ❑ADDITION � ❑REPAIR ❑RENEWAL LJFIRE DAMAGE ❑FEMOLITION
C1RRES�IDE14CE 000MP,1 ❑EDUCATIONAL. ❑C,!�V'T ❑RELIGIOUS OPATIO ❑CA"PORT ❑GARAGE C1 STORAGE❑SLAB ❑FFNCE
� �wOND MOV!NG 0CONDI,r'ONAL USE ❑DESIGN REVIEW Y❑COUNCIL APPROVED �E]SIGNS
OCCUPANCY --LAND USE ZONE BLDG.TYPE FIRE :UNE PLAN CHECK BY HEAT__
Tax Lot 9900 Tax Map 151-1.36 CD
--- --
To conletrict lUwxlzlPetiu covet, as pflr approve pans ___---------
_CC.LOAD FLOOR LOAD --_----HEIGHT _ NO.STORIES AREA VAI UE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SID':
Permit -
- HIS PERwT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- -- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COPIPLIANCE VIIIH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOFS NOT WAIVE
-- v RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
196 State LICFNSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By --
---- _ ----.. APPI ,N: UR AGENT '-
— — - --—. —
Approved Receipt No
_—_ _--- ADDRESS -- --------- PF40NE--- -- -
DATZ: INSP. TYOE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rouqh-i,n
Fixture
Final
HEATING
Contractor
PermitNo.
Gas or Oil
Final
Final
A" DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
4-
Approach
BLDG,DEPT.FINAL TEMPORARY CERTIFICATE OCCLIP!.NdCY
CERTIFICATE UUPANCY Final
:O
Landscaping
Z,)ning Final
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PERMIT TO CONNECT
Tigard Sanitary District
PERM .T N9 1404 DATE
PFRMIT 15 GIVEN TO
OF
TO CONN:ECT A--- -- ---- - _ —--- .._-.��- --TO TILE E'RSTEM OF TIGARD SANITARY DISTRICT
AT JZ
THIS PF. tMIT MUST BE POSTED ON THE DF.4CRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $_. ...... .....................TIGARD SANITARY DIS'T'RICT
By
.w owoh. .tea ,�.� nnM.i nwMMI
CONNEC PION INSPECTED AND APPROVED
Date Supertntendent y
Address //5i�':�.._S tom;,o s�(l �
Permit No a
r/
Permit charge
Owner `f�Z4 �L, -� � j�l� ��>� Connection fee °
�S "
Paid by
Type of buildinDate connected
Service rate Inspection fee- es
Contractor _ Paid by _Date
S i Z e of connection `�I' _ Assessment Paid_____.,
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