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BUILD;i'JG PERMIT APPLICATION TIGARD DATE ._ aril 5 --_ 19 4789
THE UNDERSIGNED HEREBY APDL IE; FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 620-74 16_
OR AS SI-I'OWN AND APPROVED IN i HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _— ——
OWNER rn= Mjl lar g JOB ADDRESS LOT NO.
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ARCHITECT
ENGINEER
BUILDER
S&L& ADDRESS W 18270 SW ;)gAUew fArry DESIGNER
STRUCTURE Qj NEW 11 REMODEL ❑ ADDITION—_❑ REPAIR ❑ RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
LI FIESIDENCE ❑ COMM U EDUCATIONAL ID GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY V_;13-3 LAND USE ZONE =A-4*�__BLDG.TYPE - 5Ir ._FIRE ZONE,__`—PLAN CHECK 8Y BC HEAT G
Construct single familyycLwellisi w Att.srht�d
-- --_•—__--- — ;#bedroorw 2 Esetl+ruor,
SEWERPERMITM �h:�+�"5 -- — G$XaQ.e
OCC.LOAD FLOOR LOAD 41) HEIGHT NO.STORIES I AREA 14U€1 NO.BEDROOMS 3` VALUE 6L ,000.
BUILDING DEPARTMENT SET BACKS FRONT - o — REAR _ LEFT SIDE RIGAT SIDE a
Peimlt — 331 QUO THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDINl1 CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGIEED THAT THE
Plan Check 215. 15 WORM; WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPI.ICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 5�ih. 15 _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUP CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State tax 13.24 LICENSE.SEDARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total 559.3'j SDC 44UU.W,
- -- PDCMPPLjd40dR ENT
By CH 1UU•U('P
Approved Receipt No.
y3l;k ADDRESS - -----—_. "---��---_
--—--- PHONE
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LATE INSP. TYPE INSPECTION REMARKS PL BIN DATE
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OLD&DEPT.FINAL TEMPORARY CERTIFICATE OCCUTANCY
�CBRTIPICATE OCCUPANCYT Final
L andsci.p ing
Zoning Final
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Bu i 1 d i ng Perm i t No
Location
Date TIZ
Certification of Registration
With the Builders Board
doing business as (dba) ,
l�� �i�� ���-� am registered under the provisions
of ORS Chapter 101 Oregon `( builders Law) .
My Builders Board Registration Number is
My registration is/ iin full force and effect and expires on
Signature/
TNF UNDERSIGNED HEREBY AP?LIES FOR APE HMIf FOFt IHE WORK HE it LIN INUIt.AlLL) uuILUL;htY?fC�fr
OrAS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. C1V/NEI?Tf!ONE __
LOT No
.'J_'.VIJEh��i""3rt•J /�(.�(/�' f�'� 'JOEi ADORr35 �/;7'i"7C� S/' ARCHITECT � r
��GAR1� ENGINEER
DF.SIG^J.-R _
STRU:.TIIPE YEW _ ElRF'S1f10El� ❑:OOITION _ ❑Rc.Ptln RENEYJAL ❑FIFIEOAUAGE QOE'AOL1'f ,
E1 nESILIE^ICE ❑COttRi ❑EDUCATIONAL ❑GOV-T ❑nCLIGIOUS OPAT10 ❑CAR PORT ❑ R
GAAGE CJ STORAGE[_]SL•10 ❑FE 1
CCC Q PAt;_Y LAND USE 20NEL`— OIUG TYPEa�i�!.afPIAN C'1ECl 0Y HEAT 3 a
1~ 4•_-//V 7�6 C 14 LL
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SEWER PERMIT T. �'' 6�/
Ys;C�lO_P_,J.417hii-040 __l h h1ELr,HT NO.SLORIFS _� Agea/-Val NO.OFOf100Aic VAwr,-, Q�
S�1ILOIN•�OEPAR I'M ENT SET RACKS FRONT G REAR /' LEFT SIDE MIGHT SIDE � (
THIS PERMIT IS ISSUED SU,f.IECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 2011
I �:an ChtCk ? REGULATIONS AND ALL AX ICABI' CODES AND ORDINANCES, AND IT IS HCREOY AGREED THAT
r----- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CGMPLIANCE'P
$:17•(acdl ,r !r tr? ' ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W/
�--- ---T- RESTRICTI4E COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIP
I'i(at+! Tax II LICENSE. SEPARATE PERMITS REOUIRED FCR SEWER, PLUMBING AND HEATING.
SCIS P014
APPLICANT OR AG@NT Y w
ApprovrA t Receipt Ni
SOC -
PDC - # _
SEWER CONNECTION S
SEWER INSPECTION S '
SEWER SURCHARGE $
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