11515 SW 91ST AVENUE-1 'T A war M �!
11515 SW 91ST AVENUE.
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BUILDING PERMIT APPLICATION 10 Y TIGA,RD DATEMa"h 17• 1978 IP-72
T-IE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPhS?NF 639-2900
OR AS SHOWN ANC APPROVr-r' iN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE_
LOT NO
OWNER De Bal1JOB ADDPESS 1151 SW �!jyt Ave, HOME ADDRESS 11515 .:,L 91xtr Tigard
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE_ ED NEW C1 REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE GCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIC''S❑PATIO ❑CARPORT ❑GARAGE ❑ 'TORAGE❑SLAB ❑FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPAVCY__,— LAND USE ZONE —K-7 BLDG.TYPE _FIRE ZONE 3 PLAN CHECK BY '� - HEAT NOW
��a.cttirT► .:.Cc�r+a r� '-7 Sears Roebuck Metal Vsrden Storage Bldg. to be used to
s toxJ� rlecot4ln f 14m 13411 Ford - sold Junwary 3.1.1976 - LOOxl25 foot lot
'.:a11 tr►r I wipec i:rr , when complete. - -
OCC. LOAD _ __Y_L9QR LO.P1CL-- _----H€1SaElI-- --YL4 s_L��� _ AREA16�eyro��EDROQM5 vALue $374.95
BUILDING DEPARTMENT SETBACKS FRONT 309 fVOM N914MG LEFT SIDE 75' RIGHT SIDE 5#
Permit S.W — - — �— -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN rHE 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
Subtotal ALL APPLICABLE LODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVF!VANTS. CONTRACTOR AND SLIB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax .2o LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 5.20
By
ANT OR AGENT -
Approved 07 Receipt No./
AUURFSS PH NE-'-------._ --
CITY Tltii�q.RD N? �
BUILDING PERMIT APPLICATION OF
I4F UNDE RSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUVLDER PHONE
LF. AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE (1 J—" c)
LOT NO
� JOB ADDRESS �/5�.1 ��5 �"�IJir/ HO'�1E ADDRESS I/ /S~`�.S,(I1'�JST
ARCHITECT
ENGINEER
R _ _ ADDRESS _ DESIGNER
SEW__ ❑REMODEL ❑ADDITION '— O
❑r LPAIF _❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
DINCE EjCCIMM ❑EDUCATIONAL ❑GOV'T_❑RFLIGIOUSOPAT10 CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
i.. 'Nh OMOVING ❑CONDITIONAL USE QDLSIGN REVIEW ❑COUNCIL APPROVED'- / ❑SIGNS rte`
USE ZONE—6--n— _ _._FIRE ZONE._..? PLAN CHECK BY_ s�.�^ HEAT
L�)DQf LQAR-
BUILDING DEPARTMENT SET BACKS FF10NT REAR LEFT SIDE IT
- ---- --� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE III OG CODE, ZONING
'Ilan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERS AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SfiCIFICATIONS AND .N COMPLIANCE WI--H
I �tjbtotal — ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA,J£
. - - -- - -- -- --- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURREN) 71TY BUSINESS
Tait, Ta LICENSE SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING,
ii'v - —--- - _ ----
AD ,C XN't OD AGENT -
� , raved (f Recelpl No �' 1
PHONE
� t
Address f,) `� � � _ Permit No. i _ p
Name of Occupant Permit charge __._—_
— ------ --— Paid by
- -- _-_-------- Date connected J l- d � 7
Type of Building__ Inspection fee-__-
Service Rate---- � _ Paid by -----Date
Contract Assessment Paid
Size of connection f