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0DRE55 5 �w�r � PER11IT NO.
PER1111IT CHA,'---' none
� '_!i�ER g ✓yt J CONNIECT ION FEE
PAID JY
v
TYPE OF BUILDING DATE DATE CONNECTED _
5CRVICi RATE �J,�1w %� INSPECTION FEE
CONTRACTOR / PAID BY DATE
SIZE OF CONNECTImv A,-SFS511ENT PAID
X? 2203
BUILDING PERMIT APPLICATION cOF TIGARD DAl"E.__—�
THE UNDERSIGNED HEREBY APPLIFS FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANP AND _?ECIFICATIONS. OWNERPHONE -
LOT NO.—
OWNER JOB ADDRESS HOME ADDRESS
-- _ ARCHITECT
ENGINEER
BUILDER _ ADDRESS _ r, [:]RENEWAL
STRUCTURE _ ❑NE_W ❑ U
Fit ^ _ADO
_DI FION rEPAIR RENEWAL ❑FIRE DAMAGE DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSLP 110 ❑CARPORT ❑GARAGE ❑STORAGEO� SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE -]DESIGN REVIEW UCDUNCIL APPROVED LJSIGNS
OCCUPANCY_____—L.AND USE ZONE_ .�'V BL,CG_rYPI.__._.-_ FIRE ZONE.— PLAN CHECK BY—J. HEAT
IJSLAEf�9SZS.3 VALV "
BUILDING DEPARTMENT r �'
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit -
-'—�� J 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
— —'—' ;NORK WILL BE DONE IN l CCORDANCE 1'YiTH THE PLANS AND SPECIFICATIOPIS AND IN COMPLIANCE WITH
Suh total ALL APPLICABLE CODE:', AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
—'-- RESTRIrTIVE COVENANT:, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax . LICENSE. SE?ARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
�1�' 0
Total - .- 100'u".
BY APPI iCANt tJf7 AGENT _—— ---- --
Ai wnu,,I I –� Receinr No
DATE INSP. TYPE Illi(SPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
I -ATING
Con(ract
rermi!No.
fiat
as or Oil
Roughain
Final
SEWER
Final
0
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Skkmik
Curb&Street Final
ILApp--+
ELDCL DEPT,FINAL TCMPORARY CERTIFICATE OCCUPANCY
C&WrIFICATE OCCUPlkNCY Final
Landwsping
Zoning Final