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BUILDING PERMIT APPLICATION TIGARD DATE '_ -.1s %, 3770
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE _ 620-584095
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PI:- �8tb2U_5;�10
LOT NO 1
OWNER Wm, C. Derck JOBA_DDRES. 10305 SW Highland D:ivs _ 5 mmerfield f4
^p ARCHITECT -
ENGINEER
BUILDER p.S.Huf fman Canatr.CaoDRESS 12720 541 Bell Court.TiWIGrER Huffman _
STRUCTURE ❑ NEW f_] REMODEL El ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
IXRESIDENCE ❑ COMM_❑ EDUCATIONAL 0 GOVT ❑ RELIGIOUS [I PATIO ❑ CARPORT ❑ GARAGE F] STORAGE ❑ SLAB FENCE
OCCUPANCY R" LAND USE ZONE -1§pd BLDG.TYPE --?N FIRE ZONE . PLAN CHECK BY dwh HEAT___-���
Construct f6mily room addition to single family dwelling. ________
_ SCE C(IRRECTZON SHEE ATTACHCP.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 40 HEIGHT_ 11 NO.STORIES l AREA 164 NO.BEDROOMS VALUS 6,000.
BUILDING DEPARTMENT SETBACKS FRONT REAR _ 13 LEFT SIDE 17 RIGHT SIDE 27
Permit W 36.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, TONING
Plan Check 1H.(1Q 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
�4 pp WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total • RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4 1.44
Total %5b.44 SDC-
`�
PDC# APPLICANT OR AGEN7
By p 1 � •; � , sir
Receipt No.
Approved Bull ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit
Rough-in
,7- 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
Di-PT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
cEwrincATE OCCUPANCY Final
Landscaping
Zoning Final,,
........... ...................
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BUILDING PERMIT APPLICATION cQ Y TIGARD DATE «'''J r '
THE UNDERSIGNED HEREBY APPLIES FOR A PERINI f FOR THE WORK HEREIN INDICATED BUILDER PHONE_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
LOT NO.
OWNER berck _ JOB ADDRESS _V) lig,hlana ''x• HOME ADDRESS
ARCHIT19CT
ENGINEER
BUILDER ADDRESS
DESIGNER _
STRUCTURE [J
NEW ❑REMODEL 0�4DDITION ❑REPAIR
��11 ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑_RESIDENCE LJCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS OPATIO OCAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND _ ❑MOVING ❑r-%,—TIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE _BLDG.TYPE___ FIRE ZONE— PLAN CHECK BY HEAT
��orari_ .frame oatto cover I.'_ ' x I)l li—hor and brace a.gtructure per ec)(Jo, requirement
UGC.t<QAD __._. E14S2BJ.SAP_----.N ►�L----_______.NQ..$T_4L�LE�—_AREA --- _..—LQ_,_RUaQ.4M3—.___.VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit I — — ---- ---- _ _ -____ _
—� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS 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 AILD SPECI!"'.,.AT!ONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
—'— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRAC?ORS TO HAVE CURRENT CITY BUSINESS
State Tax .3o LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By -r
'-"-- APPI.ICAN`OR AGENT i
Approved_ / et,: Receipt No
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: _ PERMIT NC,-. :---
DATE.'
L-. :__DATE: A11f1'76. DATE ISSUED . __L Z
OWNERS NAME :
ADDRESS:
CONTRACTOR
TEST.' Air ❑, Woter ❑ , Visual ❑ , Laboratory ❑
RESULT' Approved Disapproved Cl Pending ❑
SKETCH:
tilt/ •G� ..t s� L (_E
IRI faECTOR DATE
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CITY
BUILDING P a r!
ERMIT APPLICATION TIGARD DATE Jeouw.'y 30, 6NI 0661
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 639-3101
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONFL.�fWyhjPH)NE
NER Tualatin 1-i)*VljOPIBt} ot �.,o*ADDRESS 10305 51L) }'irahlorld ars
BUILDER Ph7NE
011ly a ENGINEER
BUILDER _ ARCHITECT sofas
DESIGNER
STRUCTURE 6NEW ❑REMODEL CIA DDITION— Q REPAIR ❑RENEWAL [:]FIRE DAMAGE []DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL DGOV'T DRELIGIOUSDPATIO DCARPORT ❑GARAGE DSTORAGEDSLAB ❑FENCE
❑BOND ❑PAOVING ❑CONDITIONAL USE C1 DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY _LANA USE ZONE
BLDG.TYPE mmmmmo
FIRE ZONE PLAN CHECK BY HEAT GBS
..lr istruct 1.233 *4, Pt. rare* Wolli_n9 with Attached garaag
ucording To oppruve p anima K q. IielrooMen - -
roan e
G LQ A U F_ FLOOR LOAD HEIGHT NO.STORIES _ AREA VALLI
rBUILDING DEP T E —
-- SET BACKS FRONT
Permit • REARLEFT SIDE RIGHT SIDE
!an Check •jM— THIS PERMIT I5 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Recordin WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
9 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
1 -State e s - RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total - 125.00 :1401,1111)r mope tion
By
Approved PTA A Receipt No. APPLICANT OR AGENT --
,'."
AD
w.. .... .,.,a._w PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/3 Permit No.
�. �
Rough-in
Fixture
Final
HEATING
Contractor _
Permit No.
7 Gas or qi ,w.2'S-s
Rough-in
Final
SEWER.2/,f-;
Final
DRIVEWAY
Final
Storm Draina e
_ (Rain Drain) Final
�^ Sidewalk r�
-- €
Curb&Street Final
_ q roach �•
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final 41
CERTIFICATE OCCUPANCY
. 76 79 Lar►dscaping
Zoning Final
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