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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE '9---N2 0 0 38
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS A JD SPECIFICATIONS, OWNER PHONE
281-1238OWNER _ ADDRESS _ i_ BUILDER PHONE
9L1 _ ER Clow Raori.tlq h �if�ll-ti, ENGINEER
IIRCHIICT _ _ DESIGNER
�S-TRUCTURE ❑NEW ❑REMODEL ❑_ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
URESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SL.AB ❑FENCE
❑Bl NG ❑MOVING ❑CONDITIONAL USE v- CIUESIGN REVIEW UCOUNCIL APPROVED ❑SIGNS
OCCUPANCY--_—.LAND USE ZONE....--BLDG,1YPE__ FIRE ZONE_ PLAN CHECK BY--_ HEAT,_
Firm Not ardent Hoot' c+jIverit, -- --- ---- —
QCC LOAD_._ FLOOR LOAD HEIGHT - NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET 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 SUB CONTRACTORS TO HAV' CURRENT CITY BUSINESS
19f,State _ - LICENSE. SEPARAIE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
- - - —
---- ----- ------ APPLICANT OR AGENT
Approved Receipt No.
tel
--------��-- AODR 55 PHUNG
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�o 74 '� - ,'- "'� -- `--------- ---- Contractor -�
Permit No.
Rough-in
Fixture
Final _
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Raiz Drain) Final
Sidewalk
Curb&Street Final
A roach
BLDG.DEPT,FINAL TEMPORARY CERTIFICATE OCCUPANCY Final y�
CFRTIFICATE OCCUPANCY
Landscaping
Zoning Final
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Address Permit No.
—` —_ T��/ �1� "�
Name of Occupant ,&--h f � Permit charge — — --
O`
Connection fee-----------
Paid
ee_ _ ----Paid --
Date connected...
'Type of Building _Sr
Inspection fee
Service Rate___
Paid by
Contractor __-___-
Assessment-
Size
ssessment_Size of connection -_ --
CITY OF TIGARD
APPLICATION FOR. E.G RMIT
PERMI T NO. 2(4 -C DATE
0 W N I 1 :0
I V_ALUE PERMIT FEE
I RT NO.
0
MANUFACTURER
*T,pl,"RT,S-S_-
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INSPECTIONS REQUIRED
ERECTOR SiTf
ADDRES
TEL 9
HEREBY:;RE'C'D MAKES AIPLICATIONTO SPECIAL INFORMATION
TYPE OF SIGNPLOT FLAN
G SHOW SIGN LOCATION
iOL.j
U_11C U-N_D MAR.,_'lUEE
---TEIIII-0 WRY—
liSIGHT-TOP FT.
R7-IT�H --3TTOM FT.
AREA d4- FT.
— FT,
PROJECTION
FINE
2
SIGN TO BE FASTL'oNED AND SECURED BY
-,E
Ap- jOVrD SUPIORTS AND IT IS HE! BY
XUR71. -F 'WHAT IF—T-HIS AIT—LicITT6WIS
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AND
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TT,E _DlNANCi�S_0F_PHZ_ CITZ OF TIUARD-
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BY
v""D CHIEF BUILDING OFFICIAL
GLASS
40