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12449 SW MAIN STREET
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CITY OP It)Ta:� �1 N2 0752
BUILDING PERMIT APPLICATION TI GARD )ATE -. 19-
THF
, 19THF UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE -----
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND oPFCIFICATIONS.
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OWNER _�.._ ADDRESS
ENGINEER
oi,on e ARCHITECT DESIGNER _
BUILDER-- r--tt
STRUCTURE ❑NEW ❑REMODEL ❑ADDIT ❑
ION ❑REPAIR RENEWAL r,JFIREDAMAGE ❑DEMOLITION
RELIGIOUS❑PATIO []CARPORT ❑GP.RAGE uSTORACE❑SLAB ❑FENCE
❑ RESIDENCE []COMM ❑EDUCATIONAL ❑GOV'T ❑
❑BOND CJ MOVING ❑CONDITIONAL USE — rJDESIGN REVIEW ❑COUNCIL APPROVED — ❑SIGNS
OCCUPANCY ANP USE ZONE BLDG.TYPE _EIRE ZONE PLAN CHECK BY —
HEAT===== _
(,0f)St.TLfCt, 43pProx. 1111111XIIIIIIIIIIIIIIE11 yxl►G•.stwtvAby. non bUrlrlm� partitit)(1
I)rtnW1 wall#� approx 16Weq. pani l ng
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SUBaq.� ..Ft._ gypf,'raGr"—r_
HEIGHT N0.STORIES AREA VALUE
OCC.LOAp FLOUR LOAD
BUILDING DEPARTtrEPdTSET BACKS FRONT REAR L_FF T SIDE
RIGHT SIDE
Permit �$•
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF RUILD.NG CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, :.ND IT IS HFREB\ 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 SUB CONTRACTORS TO HAVF CURRENT CITY PUSINES,
%state LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND "EAIING.
1.
Total
By
_ APPLICANT 7R AGENT m �---- ---_--_—J-~—
Approved Receipt No.
ADDRESS
INC
)ATE SNSP. TYPE INFPECTION� NEMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final _
HEATING
Contractor ate-;
Permit No. 4,14f 6 //
Gas or Oil co b
Ho_9 h-in_—
Final _
SEWER
Final _
DRIVEWAY
Final
Storm DrainalM
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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CITY Of d 7g N2 0225
BUILDING PERMIT APPLICATION TIGARD DATE - l9 l� G
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE —__—_-
1�!1111Lem t
OWNER ADDRESS 1?449 —
S.W. Main Street BIJILDERPHONE
_
ENGINEER
BUILDER ______ -__ kFFjQHIT QT DESIGNER
STRUCTURE ❑NEW _❑REMODEL ❑ADDITION 4J REPAIR ❑RENE'WAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE []COMM ❑EDUCATIONAL. ❑GOV'T ❑REL.IGIOUSLJPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB )FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCIIPANCY_____LAND USE ZONE_- —BLDG.TYPE-- —FIREZONE-- PLAM CHECK BY_ ___ HEAT_____`=
i x 4 double faked illum1r)At1,1" : grl
OCC. LOAD - FLOOR LOAD HEIGHT NO.STORIES _ AREA VALUF
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 10.00
"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
WORN WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL,ANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACT17R AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 10.ou
BY v m —
APPLICANT OR AG:FN1
Approved Receipt No.
ApORE55 � - —�— PHONE
JATE INSP. TYPE INSPI=CTION REMARKSPLUMBING DATE
Contractor _._.
ti 7
Permit No.
Rouh•in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
�— SEWER
Final _
�r DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
.� Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
-- _..............._._._............. .
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Address Permit Na.
Name of Occupant t,, _l it,,-I d _ Permit charge
Connection
- Paid by ----- - - ---
Date connected
1.2
Type of Building
o, -L — - Inspection fee
Service Rate _ Paid by Date
Contractor_,;1 A r .LL'�.rt .lam'._. Assessment_____.__ _)laid --- .-----_--
Size of connection
Address..f.Z SG V �.�� 289-t-y1 Permit No.
Name of Occupant Permit charge
Connection fee
Paid by
Date connected 7"
Type of Building _� Inspection fee.---
Service
ee._—Service Rate__, d� Paid by Date
Contractor, �� c Jy=,ns � _ Assessment---_-----------Paid---__-
Size of connection