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BUILDING PERMIT APPLICATION TIGARD DATE— Match �CITY OP � , 19 76N2 0735
TH= UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN IND,CA7F0
C i AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHWP E
ADDRESS --. _.— BUILDER PHONE
AWlIE�I ENGINEER
BUILDER ARCHITECT _— DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION _— ❑REPAIR ❑RENEWAL. — ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE []COMM ❑EDUCATIONAL ❑GOV'T ❑REUr;IOUS❑PATIO ❑CARPORT ❑GAr7AGE ❑STORAGE❑SLAB ❑FENCE
CBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED [:]SIGNS
OCCUPANCY—__G.AP,ID USL ZONE BI DG.TYFF. —FI3E ZONE_ PLAN CHECK BY
'.orssLrur:t 1„ 'x l64” fcumu add-ktiosl to dWAlll.ily
r�ancr ata floor — flat built up root
OCC, LOAD FLOOR LOAD HEIGHT _ NO.STORIES AREA VALUF _—
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE.
Permit — _.—.� --=—_ - _.--- —�_�._ ---------_------THIS PERMIT IS ISSUE 3 SUBJECT TO THE REGULA 'IONS 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 W.TH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
11%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEAToIG.
Total
BY _--
--..- APPLICANT OR AGENT
Approved Receipt IVa.
AC)ORE55
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Z)40)1'- Contractor
l(l-z6 Permit No.
Z-23-76 V Rough-in
Fixture
Final
HEATING
Contractor
Permit No,
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Filial
landscaping
Zoning Final