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16855 SVI 124th Ave KING CITY
ME.'C 1-4 ANI CAI PIEPMIT
CITY' OF TIGA RD EPMIT NO . MF(39061. 1
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COMMUNITY DEVELOPMENT DEPARTMENT MOON
13125 5 W.Holl Blvd.,P J.0, ::,LZ)7 .?/I/13 9
Tigard.Oregon ST223.(503)639-4175 DATE ULD .
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FUYT AL el,*3
This permit Is issued subject to the regulations cr- itained in Title 14 NE?ICE:T P T NO /03
of the TIVIC. State of Oregon Specialty Coces zoning regulations ................
and all other applicable codes and vrdl,isnses, and It is hp-pby
agreed that the work will bir done in accordance with th i plans and GW;5 I.A 1`41-'-
specifications and In compliance with oil applicable codes and 1::1(:)!;�i F NE16M
ordinances The issuance of this permit does not v aive restrictive
co4ements Contractor and subcontractors shall have current city FMI.Wol-1 IN
business lax permits This permit will expire and become null and TNAI.
void if work is not started within 180 days.or if work is suspended or
ab9r.donF'1 for a period of 180 days any time after work has
cummenL)d It shall be the responsihllity of the permittee to assure
all required inspections are requerled and approved
Permittee Signature
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
_.. ___ .._. _._. -........._ .. _-.. ...... ... .f+:t`:'.,,. .r.•_.,'...•..ar..r...... ....`..... ,. .,..». .... w1�.AYM....r�-.-��i/VI'•Y..,.
BUILDING PERMIT APPLICATr!nN KING CITY DATE___-__.�___, 19____
THE UNDERSIGNED HEREBY APPLIFS FOR APE RMIT FOR THE WORK HEREIN INDICATED SUILDERPHONE
OR A. SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONF-- —
;:1 E��J 4 • LOT NO.
OWNER ----JOB ADDRESS SW 126boh HOME ADDRESS
ARCHITECT
` i lwauki a ENGINEER
_BUILDER ADDRLSS DESIGNER
STRUCTURE_ ❑NFW ORFM(1DEL UIADDITION_ REPAIR ❑RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑ RESI7FNCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PAIIO ❑CARPORT Cl(-,ARAGF ❑STORAGE❑SLAB [:]FENCE
❑80ND - ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNC.IL APPROVED []SIGNS
CQCUPANCY--__LAND USF ZONL _BLDG.TYPE FIRE ZONE- PLAN CHECK BY HEAT
vw.I ld dock pox cuntYfACt ayx�atnrrl�tlL.
Q C,LOAD ._ FL,QS2B_L4AD__�
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE FIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT Tn THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
i Plan Check REGULATIONS AND ALL APPLICABI 'ODES AND ORDINANCES. AND IT IS HEREBY AGP.EED THAT THE
-" WORK WILL BE DONE IN ACCORDAN(.,r WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
ib-total ALL APPLSCABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- - RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 'O HAVE CURRENT CITY RUSINFSS
State Tax LICENSE. SEPARA fE PERMITS REOUIRED OR SEWER. PLUMBING Ar1D HEATING.
Total _-
By
____... APPLICANT OR AGENT
1
DATE SP. VPr, INSPECTION REMAR PLUMBING - - DATE —
Contractor
Perriit No.
— v Fixture -----
---- ----- _----- ----- Fina! - --- ---
-------- -----------
HEATING
Contractor
_ — Permit No.
—— — Gas or Oil — —
Final
— ------- — SEWER `�-----
.—_. — ----- — ---- -- Final
DRIVEWAY -- - — _
--------_
Final —
Storm Drainage
(nein Draln)Final
Side milk
Curh&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CPinel
ERTIFICATE OCCUPANCY
Landscaping
7.oning Final