12085 SW HALL BLVD-2 i
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LZOfiS SW HA:.L BOULEVARD �!
BUILDING PERMIT APPLICATION TIGARD DATE _ ,g�.� 38.E�.
TF'E UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUI_CER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
{ ` LOT NO.
OWNER J�
�.L� B ADDRESS / - C).� ) _} L•�`/��r! i�.-1 —
ARCHITECT _
;./I N j P.16 7',ENGINEER
V0019% "is I
BUILDER DRES SIGNER
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STRUCTURE Ll NEW 11REMOUEL L7 ADDITION_ ❑ EP�;9 O RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM F11 EDUCAi ONAL O GOV'T ❑ RELIGIOUS ❑ PATIO f_7 CR R PO I-z GARAGE ❑ STORAGE ❑ SLP 9❑ FENCE
OCCUPANCY _LAND USE ZO E BLDG.TYPE __FIRE ZONE _ PLAN CHE BY HEAT
'rte
SEWER PERMIT M
OCC.LOAD FL ROAD AHE HT — lk TORIES __ARE_ N0.BED OMS VALUE
Bl1iLDING DEPART t,v SET BAC FRONT REAR LE_ E ��_ RIGHT SIDE
Perrr!t THIS PERMItJS ISSUED S EJECT T6 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
GULATiONS,,AND ALL ePLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PlanChe.k WORk WILL BE DQNK_W ACCORDANCE WItH THF PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH AI.L 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
LIC'NgE SEPARATE PERMITS REQUIRED FOn SEWER,PLUMBG,G AND HE4,I ING,
State Tax
SDC �
S
Total _ y 111,
PDC# `/" :7,, APPLICA OR AGENT
BY /
11'Y lV!-7 Lki ri vL 3-_S2 � 7
Approved -- _ PHONE
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CITYOFTIGARD
vVASHi�1GTON COUNTY.OREGON
February 10, 1981
RE : 12085 SW Hall Blvd. , Tigard, Oregon 97223
Larry Bissett
2004 NW Irving Street.
Portlard, Oregon 97210
Dear Mr. Bissett:
The sow=r usage charge for the above addressed residence
shall be discontinued as of this date. Above residence
is not occupied due to fire damage.
If t-ouse is repaired and occupied within one (1) year of
this date owner agrees to pay all bacU sewer usage fees due.
After gee (1) year from above date, there shall be a $50. 00
re—instatement fee to owner of house when occupied.
If the house is demolished, a demolitior, permit is required,
and the selaer is to be capped at the property line.
Y rs t uly ,
E . T. Walden,
Tigard Building Official Uwner
�- ------- 12420 4.W. MAIN P O. BOX 23397 TIGARD, OREGON 97223 PH: o39-4171 ----�
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Address) D ✓���( I 14L Permit No. A
Name of OccupantA, t!�AV- Permit charge—_
Paid by
- —-- - -- Date connected
Type of Building Inspection feP
Service Rate �' G Paid by __ Dab
Contractor _— Assessmont Paid
Size of connection `
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