12520 SW MAIN STREET 12520 SW MAIN STREET
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CITY 0!I
BUILDING PERMIT APPLICATION TIGARD DATE 5-26- tg �� ra° 0362
!HE UNijERSIGNEG HERFDY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICA-rED
( RAS SHOWN AND APPROVED IN THI_ ACCOMPANYING PLANS ANIS SPFCIFICATION3. OWNER PHONE
OWNER A 90y Wast _ _ `— _ ADDRESS 121920 9*wo main 1116 _OUILOER PHONE _ --
t,`t rna)r d ENC:INEER
BUIL DER ARCHITECT DESIGNER
C1 STRUCTURE GNLy-�W 0RFMODEL ❑ADDITION LJREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEM00TION
U RESIDENCE ❑COb'M ❑EDUCATI?-- L.J
NAL 'JGOV'T ❑rEI-IG IOUS PATIO OCAR PORT� ❑CA,,,,,GE ❑STORAGE CIS--AB ❑FENCE
[
❑BOND QMCVING []CONDITIONAL USE ❑DESIGN REVIEW COUN(IL.APPROVED L751GN5
O(•CUPAN(. _LAN')USE ZOtIE-_ _BL_DG.TYPE__ FIRE ZONE— PLAN CHECK B"
--- —` �nttt.=->w .l els�e�>�SewY �+ii�tt�ci 1rttltu.l�i:i.l�l,—. _--_----------
.-!CPO cacd 3110
—
OI:C. LOAD FLOOR LOAD HEIGHT NO.STORIES _ _ AREA VALUE
BUILDING DEPARTMENT �— SET BACKS FRONT REAR ' LEFT SIDE � _RIGHT 31DE --�
Permit a.w"
THIS P PM1T IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUII DING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORr)I.NANCFS, p.ND IT IS HERER` AGREED THAT THE
WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICA-,IONS ANO IN COMPLIANCE WITH
Recording ALI. APPLICABLE r.OVES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRiCTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVL CURRENT CITY BUSINESS
1%State .Ub LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HFATING.
Total 1810p
3y
-- APPLICANT OR AGENI
Approved Receipt No
ADDRESS - NiONE
OP.Ik' IWP. TYPE INSPECTION REMARKS PLUMBING DAT[:
rw
`7- Contractor -- —
Permit Nu.
--- — -- — -� Roua'n-in
Fixture
Final
— —..---- - --------- ---- --•----_ HEATING
Contractor
Permit No.
Cas or Oil
Hough-in
Final
SEWER
Final
DRIVEWAY
Final
— -- — --�— _ Storm Drainage — --
(Rain Drain) Final--
Sidewalk
_--- ----- -- - —___�—_____ Curb&Street Final — ------
___ _
Approach
HtO(, DEPT, FINAL TEMPORARY CERTIFICATE Ot-CUPANC)' Final
CERTIFICATE OC(.')P.4NCY -- _
Landscaping
Zoning Final
1>
i
Address_1..ZJ .2 10 22Zadai Permit No.
Name of Occupant 71, 1, � �. Permit charge
---�_-.--_ - Connection fee____. ,
— — _ Paid by ------ — —— ---
__—____ Date connected
Type of Building Inspeciion fee--- - _
Service Rate "1-c
---�__—� _._... Paid by _. ._..._._-._ ._ Date_
Contractor Assessment Paid
Sine of connection ___.