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BUILDING PERMIT APPLICATION OF
y TIGARD DATE -
THE UNDERSIGNED HEREBY APP!;cS FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHOIA'"V�"'�OR AS SHOWN AND APPROVED IN THE ACCOMPANYINGhPLANS AND SPECIFI"ATIONS. OWNER PH°NE''_'f'—"�-�''--
OWN_R.}r rU11C EMCiC CCInatT !,)08 Al2DRESS"�" �"" ""� " HOME ADDRE887r(.10 SW E Vis)I"k P1
ARCHITECT
ENGINEER
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BUILDER ESS?700 SU Ey t I tf l• DESIGNER
'• ADDRrr---11 ,
STRUCTURE ONEW _ ❑REMODEL _L_ADDITION El REPAIR ❑RENEWAL _ ❑FIRE DAMAGE ❑DEMOLITION
❑°ATIO ❑CAR FORT L,3ARAGE ❑S'rOF.AGE❑SLAB ❑FENCi
❑ RES!DENCE L1COMM ❑EDUCATIONAL OGOV'T ❑RELIGIOUS
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑CO'UNCIL APPROVED ❑SIGNS
HEAT
OCCUPANCY.'_"`LAND USE ZONE----' BLDG. YPE__'—FIRE ZON PLAN CHECK BY��_ --_
011:�Lr.l , amily uuullini4 td/attached (jeraWe — 3 EitidrFjc'Itri, 2 uotf,.�---
`.:)uwoT Permit 1,;1737
--�Y
4 —HEIGHT
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—H.EIGHt � _.1V4�.SS4H1€q_"---B.RE9�'��
BUILDING DEPARTMENT SET BACKS FRONT 20 REAF. i LEFT SIDE RC1 r RIGHT SIDE _
Permit A. n
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED V4 THE BUILDING CODE, TONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 1'' !S HEREBY AGR -ED THAT THE
WORK WILL BE DONE IN ACL,'IROANCE WITH THE PLANS AND SPECIFIC'.'iONS AND IN COMPLIANCE WITH
Sub-total [.E t.• +f ALL APPLICABLE CODES AND ORDINANCES THF ISSUANCE OF THIS PERMIT DOES NOI WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR A1,10SUB t;'INTRACTORS TO H.41 E CURRENT CITY BUSINESS
State Tax �n fah LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER Pl'/MBING AND HE!TING.
Total :4 IL #4 10UsUU
ov -.. APv�ICANt OR AGENT
Approved ru Receipt No.
i
�DATE
INSP. TYPE INSPECTION REMARs.S PLUMBING i DATE
Contractors —
Permit No.
;!� 7 - J.�- 00
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�� Fj use
Final
c. _L �i�-� • LLQ /r __—HEATING
Contractor 1 1 T
Gas or(til
Rough-in
Final ---
/ -/iJ SEWER
f Final
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
_ Approach
BLDG. DEPT.FINAL TEMPORARY CE E OCCUPANPY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
6
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its _!�