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BUILDING PERMIT APPL.ICATiON "OF
TIGARD DAT[ _
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
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OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNUR PHONE
LOT NO._ �.
OWNER LUy Egix JOB ADDRESS 12630 W 1214k HOME ADDRESS _
ARCHITECT
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ENGINEER
BUILUER� & I Lonstrurtion ADDRE3151836 •If 82nd CESIGNEe'(,I,ttland --_
STRUCTURE ❑NEW ❑RFMO_D_EL C1 ADDITION OPEPAIR ❑RENEW'AL ❑FIRE DAMAGE []DEMOLITION
0 RESIDENCE ❑COMM ❑EDUCATIONAL_ CGOV'T 09ELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND ❑MOVING ❑CONnITIONALUSE 00F:AGN REVIEW_ ❑COUNCIL APPROVED _ ❑,IJNS
OCCUPANCV�?"'_`LAND USE ZONE BLDG, TYPE_—_—FINE ZONES PLAN CHECK BY..__k HEAT_"_—___..._
' �wdraam dryrut repair per plane.
.GG�lQ9fZ_—___._F.LS?�itiJ.QA�--_...____tiEJ_G►�S_—_—�9�;:TQHI ..__ _ ABEB.._--�10.RvQB44M�—�IAI.U �GU•[i;
BUILDING DEPARTMENT SET BACKS FRONT REAR Lr r T S:DF RIGHT SIDE
Permit 12b.UU
-- — — THIS PERMIT IS ISSUED SUBJECT TO THE RECULATIONS CONTAINED IN THE BUILDING CODE, ZONI1'G
Plan Check 14.()n REGULATIONS AND ALL APPLICABLE CODES AND OADINANCES AND IT IS HEREBY AGREED THAT T41
-- WORK W'LL BE DONE IN ACCORDANCE WITH TF•IE.PLANS AND SPE CIFILH r iij,'I i AND IN COMPLIANCE WI r
Sub-total 42.OL ALL APPLICABLE CODES AND ORDINANCES. TETE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tat 1.12 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total X43.12
By APPLICANT OR AGENT
Apprrived Receipt No.
1