7875 SW HUNZIKER ROAD-1 7875 SW HUNZIKER STREET
Q
O
a
c.:
w
a
H
N
z
;D
3
U)
un
r-
00
00
DAT � � Z•- 19_
BUILDING PERMIT APPLICATION TIGAP� �--� ��,C/3���
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TFIE WORK HEREIN INDICATED BUILDER PHONE +�'.1
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHO :E
� Lt)1'210.
1
OL'l2aE /14dttQ_ ADDRESS ���,? � ARCHITECT
�+r �- r" ENGINEER
BUILDER aODRESSt10 Q ,/1 :�J DESIGNER
�-�
STRUCTURE ❑ NE ❑ REMODEL ADDITION REPAIR (OLJ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITIO
❑ RESIDENCE ❑`EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE C3 S�LAS❑ FENCE
�/—�-��
0CCUPANCY S rL- LANO USE ZO`E �yc__BLDG.TYPE ,�L� FIRE ZONE =PLAN CHECK BY — HEAT�T„
SEWER PERMIT M --
c
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.SEOPOOMS VA!Uc _
HUILDINGDEPARTMENT SETBACKS FRONT REAR LEF'TSIDE RIGHT SIDE
Permit 0 O THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWN
REGULATIONS AND ALL APPLICABLE CODES AND GRDINANCES, AND IT IS HERE3Y AGPEED THAT Tx
�C:IanCheck V I WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER` IT DOES NOT WAIV
Su rt.ta) RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUr-!Z!:1G AND HEATING.
S:a:3 Tax + �`•
('�'� :IOC--
Total I L ��127 P,DC# APPUGANT OR AGENT _
ey
- �- Receipt No. ADDRESS PHONE
Approved
.IOC
);,D C --
-EWER CLININECTION 5
:EWER INSPECTION S _
SE'�!tR SUnCHA"nGE _5 _
BUILDING DEPARTMENT, TIGARD Tn �� �' 7
1n� PLUMBING PERMIT CC _
wl
oldeeof a'4 pfumb�,fr'tractors license is hereby
authoriz�o us, lumbing work as herein noted to be installed in accomatice with the plumbing c P
p g cd. of
Tig,d. Such inst,lllations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard rusiness License required
for all contractors and sub-contractor;.
Address %Nj iC _ i t� /
_ Date_
NUMBER OF TOTAL PERMIr NO.'S
TYPE OF PERMIT e ITEMS FEE ON EACHAMOUNT (Office Use Only)
Sin la Famil 1 bath each ---
�_�.__Y_..`_.- —___--_ --------- ------ 29,00 _ —
Uuulax-Eac:fr i iwth unit 25.00
Additional bathrooms-each _ 10,00
Mobile Homa Space-each _15.00
INDIVIDUAL FIXTURE_FEES
1 to 50 Fixtures in!buildin -each 3.00
5110 100 Fixtures in 1 building-each 2.50 �-
101 tri 200 Fixtures in 1 building-each 2.00 -"
201 or more Fixtures in 1-building-each 1,50 '-
b1 I S CEL L A!:5 O Lr s — ------- --
Building Sewer=1st 50 It, _ 10.00
Sewer•-each additional 100 ft. 10.00 T
Water Service to building
Priv:,te Water Systems--each 100 It, 10,00 r! -
r Other (Specify): - -----
PLRMIT_ _a�-!, J,�_ for Plumbing Inspection Phone 639.4171
.v Statr. Plumbing Ctmtractor By I
TOTAL_ RECEIPT NO. Issued By