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CITY TIGARD DATE
BUILDING PERMIT APPLICATION OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE -
LOT NO,---.—
OWNER Tuaalatio 1..°8111• '90B ADDRESS �' •'n I F1ijhjLjE `)t.j �)IkOMEADDRF_SS
'ARCHITECT
ENGINEER
BUILDER __ ADDRF`SS nESIGNFRr'
SERUCTURE ONEW ORF' 10DEL _ ❑ADDITION -�OREP!'.IR ORENEWAL OFIREDAMAGE ❑DEMOLITION
0 1iESIDENCE ❑COMM LIEDUCATIONAL OGOV'T C.IRELIuIO,:C r�oATIO ❑CAR PORT ❑GARAGE [I STORAGE OSLAH []FENCE
`❑BOND ❑MOVING OCONDITIONALsUSE �ODESIGN REVIEW ❑COUNCIL APPROVED OSIGNS
k-3 ' —
OCCUPANCY— SAND USE ZONE �^r -BLDG.TYPE.— FIRE ZONE—� PLAN CHECK BV��t�L HEAT _
(JI)c� E tl(.l_°I_ingl l fatgily d1jelli,,1 {d ut tw;:h>lld_.usiago* :1 gpdrt gm,
rile—jamus some as 1:)'Al 541 Summerfiald Lane Mark 1A
Jewer PRI.-mi
1.8869 ;,680,UO ,F It�'�a•LIC r 70b•OC)...__
N4.uQ-fil5�—A___AEP. . �A1i�}NSL..�.f�HQSLM�_._x_-YALE! "�`�et �� •
h BUILDING DEPARTMENTSET BACKS FRONT -- REAR ` _T i l F t sIDE RIGH'r SIDE �—
Permit �11liW 00
TH1� PERMIT IS ISSUED SUBJECT TO THE REGULATIONS, CONTAINED IN THE BUILDING CODE, ZONING
Plan Check J O.017 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH 1 HE PI ANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 17U*X10 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— — RESTRICT I'JE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax �i 6*64 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tr.tal $3 6' .b4 `AUC $400.00
POC #2 Slan.00 ;
By P1 ---- - - --�--- ..
grnF( (CPNT i,i ALiFNI
Approved �. Receipt No 1713 f
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor -- — t
r,42r,alc dat"PArie'"' pr[ So" r:orpf't_ Permit No. It, 7"�J
Rough-in — ----- —
Yom-/�'i ��JatcIt tL - - - Fixture _
Final
7 - {�y//Re v ..,.! -----__ — - HEATING --
Contractor
— — -- --- Permit No. S 9� 7-A-1-71 _Ad
Gas or Oil
Final --
----- -- --- SEWER
—I- — -------- �.—__ Final
DRIVEWAY
Fin,!
—� Stor'Mt Dralnspe
(Rain Drain)Final.
— Sidewalk
Curb R Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCI NCY —p
CERTIFICATE OCCUPANCY `L/ 7(� Final -�
Landscaping
Zoning Final
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