12430 SW MAIN STREET 12430 SW MAIN STREET
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BUILDING PERMIT APPLICATION TIGARD DATE ,19 N° 0591
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
WNER ' ADDRESS _ BUILDER PHONE
ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW �I❑REMODEL ff�11 ❑ADDITION ❑REPAIR [:]RENEWAL ❑FIRE DAMAGE L�DEMOLiTION
❑ RESIDENCE ❑COMM DEDUCATIONAL uGOV'T ❑RELIGIOUSDPATIO `.CARPORT ❑GARAGE ❑STOPAGELJSL.Ab LIFENC[
❑BOND ❑MOVING ❑CONDITIONAL USE GDESIGNREVIEW ❑COUNCIL APPROVED SIGNS
OCCUPANCY - LAND USE ZONE Bl G.TYP�._FIRE ZONE—PLAN CHECK 9Y_ HEAT___---.
OCC,LOAD FLOOR LOAD _ HEIGHT NO.STORIES — AREA VALUE
BUILDING Dllf�'ARTM NTSET BACKS
�,..�._._ _FRONT REAR LEFT SIDE RIGHT SIDE
Permit
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 AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
—' RESTRICTIVE COVENANTS. CONTRACTOR AND S±IJB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SFPAR••IF PERMITS REQUIRED FOR SFWFR, PLUMBING AND HEAIING.
Total
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APPI ICANT OR AGENT
Approved ;� <1 Receipt No.
ADpRESS 'r+iiivE
OATS INSP. TYPE INSPECTION —_ REMARKS PLUMBING
DATE
-- Contractor
Permit No.
Rou h-in
- -- Fixture
---• F i nal
HEATING -
-— Contractor
Permit No.
-- --- Gas or Oil
Rou h-in _
Final
— -----__—__ S E W;-'R
-- Final
DRIVEWAY
Final
— -- — �_ Storm Drainage(Rain Drain) hinal
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY —'-
CERTIFICATE OCCUPANCY Final _
3- Landscaping
Zoning Final
I
CITY OF 8-20 74 N° 0043
BUILDING PERMIT APPLICATION TIC ARD OAT E__._.
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_ _—
OWNER fob Voy `ADDRESS 112430 Sow, Main Sheet BU-DER PHONE
ENGINF..ER
BUILDER _ AR H17 .Sct_. DESIGNER _
STRUCTURE _ CINEW _ ❑REMODEL CADDITION ❑REPAIR ❑RENEWAL ❑FIR-1E DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM_❑EDUCATIONAL OGOV'T ORELIGIOUSUPATIO ❑CARPORT ❑GARAGE ❑STORAGEOSLAB ❑FENCE
�OBOND ❑MOVING OCONDITIONAL USE ❑DESIGN RCVIEW ❑COUNCIL APPROVED SIGNS
OCCUPANCY LAND USE ZONE._.__ BLDG.TYPE __FIRE ZONE_ PLAN CHECK BY_ _ HEAT_
_ Fres standing sign — cRkmpsign sign _
OCC, LOAD FLOOR LOAD _ HEIGHT _ NO.STORIES AREA VALUE
BUILDING DEPARTMENTSET
SE7 BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit +�
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN TNF BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICARI E CODES AND ORD"NANCES, AND IT IS HEREBY ,AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL. APPLICARLF CODES AND ORDINANCES. THE IS;>UANCE OF THIS PERMIT DOES NOT WAIVE
——�` RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
A PP L I t.A N T OR AGENT
Apptoved Receipt No
HON
-7—
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
R 2a[L'--
Fixture
Final
HEATING
Contf actor
Permit No.
Gas or Oil,
Rough-in
Final
SEWER
Final
DRIVEWAY
Finpl
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Ao roach
SLOG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
s ■ �j /
Irl��t
Address , 24" Permit No.
Name of Occupant ,�'�� s� Permit charge
c
Paid by
Date connected
Type of Building�--5,, / 13� Inspection fee
Service Rate.JZ�s �,D U Paid by Date__
S
Contractor ..7..�,�v s„rr-d ��. -�.�-.
�. Assessment_-_ Paid
Size of connection___ _T___
I
Address 1Permit No.
Name of Occupant Permit charge
Connection fee-----
Paid
ee __Paid by�_. _-- ----- -- -
Date connected
Type of Building if� ►-- Inspection fee
U
Service Rate .�i � Paid by --___ _ _ _ Daie_ _
Contractor Assessment---------..- .-Paid
Size of connection__