11845 SW 79TH AVENUE-1 11845 SW 79TH AVENUE
c
0
ro
n
E
U
ro
4.)
c.
m
J7
0
I
r
1?
r Jt
I
J
W
I '
Itnuts
WNWNTAF
i
++pw e�c^nt..'nw"�P^ryirPwloomIMI;R"-mwF*z"-'"9�M�!!0.'U"" �ew'�"'"�+sr.�+gir�. r..«ys7nw�y,..�va�•!+�rwR�•►grw.�.n...,..,._.v..p,.._^ I (�6
j I�
CITY of , ,, f�
BUILDING PERMIT APPLICATION TIGARD DATE + . 19 N° 0003
�
THE UNDERSIGNED HEREBY APPLIES FOR A PEn, !IT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE AC(.OMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
WNER �G �' -- r S00DRESS Jr ---- ----BUILDER PHONE
( { ENGINEER
9LLLDER '/ I ARCHITECT _ DESIGNER
STRUCTURF 13NEW Ci REMODFL OADDITION_ ❑REPAIR ❑RENEW.IL- _ ❑FIRE DAMAGE []DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE (:]STORAGE❑SLAB ❑FENCE
_uBOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_ LAND USE ZONE BLDG.TYPE, F;RE ZONE— PLAN CHECK i;YHEAT
OCC, LOAD FLOOR LOAD HEIGHT NO,STORIES AREA VALUES 4 J
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit ; , ---- FRONT
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULAT;uNS AND AL L APPLICABL F CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE KITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT NAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BU�ANESS
I%Ftate �.►+ ✓ LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
--
�' APPLICANT OR AGENT
Approved ,./ ( Receipt No.
ADDRESS PHONE —�
i
I
W DATE TINS?. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
'7 31- er Fixture
2 Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainagp.
(Rain Drain) Fin--11
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Finai
Landscaping
Zoning Final
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N�,' 1221 DATE
PERMIT IS GIVEN TCS
OF : :..
TO CONNECT A .,
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISE!{UNTIL CON-
NEC'TION IS MADE AND INSPECTION OF CONNECTION HA.:' BEEN COM-
PLETED.
PERMIT FEE PAID s.... _......:...............-...TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
__—_�_ Date -- Superintendent- — —
,
Address -,--/ 7 Y Permit No. /2 Z ( _
Permit charge E'-`,
Owner ���_ ,f' , Connection fee
Paid by
Type of Building IL.'� Date connected1� G
Service Rate Inspection fee /14 o .v
Contractor Pz,id by Dace
Size of connection Assessment Paid
__ 1