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12675 SW 111TH DRIVE r M 12675 SW 111TH DRIVE , a) U M --1 t1 L •-1 '-1 '-1 3 Ln U7 N SCI N I CI1 Y OF TIGARD BLDG. DEPT. 12420 S.W. MAIN STREET TIGARD, OREGON 97223 PHONE 639.4171 CONTRACTOR: Pursuant to Section(s) of 'ie Uniform Building Code, the following it,•m(s) require correcting: -- /7.S �; --111--- -- —�- zz� Date:- Y--3`�' � Permit No. -___-- Inspector CALL FOR REINSPECTION r it ADDRESS �-- „ PERMIT N 0. �oZ��T•-� Q PERMIT CHARGE none _ [►USER CONNECTION FEE PAID BY TYPE OF BUILDING � _ DATE CONINECTED SERVICE RATE INSPECTION FEE CONTRACTOR PAID B Y DATE SIZE OF CKCTI0N ASSESSMENT PAID f w i O ryh05 BUILDING PERMIT APPLICATION Coy TIGARD I)A,E__ 11 19 THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE- DR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHON' 1-01'NO.--- OWNER Con GUtf'trio JOB ADDRESS 12675 �' 111tt1 Pje`ICE,HOME ADDRESS _ ARCHITECT +� ENGINEER BUILDEFi3ftM 60ttjaT AODRESS.I_263'�. 'of Liend lid. DESIGNER STRUCTURE ©NEW 0RFMf1DEL _ ❑ADDITION El REPAIR [:]RENEWAL []FIRE DAMAGE ❑DEMOLITION ® RESIDENCE [:]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE 013OND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY_-`�.LANO USE ZONE_ 7 —BLDG.TYPE _ FIRE 20NE._ PLAN CHECK BY_ HEA1 o']yitrupL sifluYe feelilY duallinj 1, at,t.schs.d garai46. " 3 oUdrOOM21— 2ti5. Q-U-LQAD FLOOR LOAD__..________HLCJHTN_Q'STQRIE AREA-LI•®�I--�4�@�DROOMS �__VALjb1 BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit 211,()() THIS PERMIT IS ISSI!FO SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check ltI ,� aG REGULATIONS ANC AL'. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DON- IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Sub-total 1;: (� ALL APPLICARLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Taxa CENSE. SEPARATEPER , lS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total $324. 9A IL);. 1 - 4iloo.aU APPLICANT OR AGENT Approved Receipt No - 7 REMARKS PLUMBING DATE DATE INSP. TYPE INSPECTION - - e pia _ - Contractor I�P Permit No. Rough-in Fixture zz Final _ � HEATING Contractor Permit No. Gas or Oil Rough-in --- - - --- Final - - ---- ---- SEWER -- ---- - v Final -- -- DRIVE'YAY _- -- —_- --- Final -� --------_��- StonhDrainage (Rain Drain)Final -� — ---_- -- Sidewalk - A Curb&Street Final ---------- ---- --- -- Approach _ BLDG. DEPT.FINAL TEMPORARY - CERTIF"KATE OCCUPANCY Final CERTIFICATE OCCUPANCY r Landscaping Zoning Final