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BUILDING PERMIT APF LICATION Co FY TIGARD GATE 19
THE UNDERSIGNED HEREBY APPLIES FOR APFRMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNERPHONE__
LOT NO. —
OWNER JOB ADDRESS __ _HOME ADDRESS
ARCHITEC f
ENGINEER
BUILDER ��1t ADDRESS DESIGNER
STRUCTURE JNEW. ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL— ❑FIRE DAMAGE —1t ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE'EE—JSLAB ❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY _LAND USE ZONE__-- BLDG. TYPE_ FIRE ZONE— PLAN CHECK BY--- HEAT----
OCC,
EAT— _OCG. LOAD FLOOR LOAD HEIGHL ___AQ.JTQRI€5 AREA __NQy@EDROOMS VALUE _
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
'-- -- THIS PERMIT IS ISSUED SUBJE::I TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGUI-ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— - — WORK WILL BE DONE IN ACC!'ROAI"CE WITH THE PLANS AND SPFr:FICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES ',kND ORDINANCES. THE ISSUANCE OF THIS PERMIT DUES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
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APPLICANT OR AGENT
ved l Receipt No.
— - —� ADDnESS — — PHONE ---- ---
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DATE INSP. TYPE INSPECTION —� REMARKS PLIJMBIN%3 _ DATE
_ Permit No. _.
_ Rough-in
Fixture _
— Final
Contractor —
Permit No.
Gas or Oil
Rough-in
-- ---- Final _
SEWER
Final
—� DRIVEWAY
------• --- ----_— .—__ Final —---- — —
--•-�--- --+-- --_ _ Storm Drainage
(Rain Drain) Final
Sidewalk _.__
_ — Curb&Street Final
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BLDG DEPT. FINAL_ TEMPORARY CERTIFICATE uCCUPANCY Final
CERTIFICATE OCCUPANCY -- ---
Landscaping
Zoni,ig Final
3UILDING PERMIT APPLICATION CI Y TIC,'k.RD DATE- - ---• Yq- C -� Np lecI7
HE UNDE HSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BL.LDER PHI
A� SHOWN11) APPROVFD IN THE ACCOMPANYIN,3 PIANS AND SPECIFICATIONS. owNERPHONELOT NO
" 7CTK.�/1 JOB ADDRESS rC 7. / l ADDRESS
- /V/ ARCHIT6GT
ENGINEER
ADDRESS _ __DESIGNER
_C7URE _❑_%EW FMODEL ❑ADDITION _❑RLPAIR_-_ ORENFVIIAL ❑FIRE DAMAGE ❑DEMOLITION
F'�,OFNCE IJOOMM_OEDUCA_TIONAL OGOV'T ORELJGIOUSOPATIO ❑CAR PORT ❑GARAGE OSTORAGEOSL, 8 ❑FENCE
7PON0n MOVING /OCONDITIONAL USE q. 1'ODLSIGN-REVIEW_—OCOUNCIL APPROVED OSIGNS
LTANCY_ !F-I!TAND U5E ZONE _BLDG.TYPE �I _LIQ __FIRE ZONE=4- PIAN CHECK BY_�Z HEAL
H.EIQH-L --INS--il4pl ---�P_ _ �4.@El?P!OOMS (VALUE �Q
BUILDING UEPARTMENT SET BACKS FRONT REAR LFFT SIDE RIGHT SIDE
_..�. _
r r'rIT
- ---It--- THIS PERMIT I5 ISSL'4D 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 COMPLIANCE WITH
Sub Yolal ALL APPLICABLE 3DES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- RLSTRICTIVF COVENANTS. CONTRACTOR AND SUN CONTRACTORS TO HAVE CURRENT CITY BUSINESS
18Y lax LICENSE SEPARATE PF RMITS REOUIRED FOR SEWER, PLUMBING .AND HEATING.
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Total
APPL ICANI OR AGENT
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