11835 SW LINCOLN AVENUE 11835 SW LINCOLN AVENUE
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-ATY OF — _ V 19 ►V� u u '3
BUILDING, PERMIT APPLICATION TIGARD DATE- +
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN
THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER ir A�C�! �''�`•P/1 ADDRESS /r4 '� • BUILDER PHONE
-�aY
Atljel
ENGINEER
t.•• ARCHITECTg�ul nca ��y(( - —
STRUCTURE XJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL IRF. DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DLSIGN REVIEW [--]COUNCIL APPROVED ❑SIGNS
OCC�IPANCY— ND USE ZONE / BLDG.TYPE FIRFIREE ZONE_— � PLAN CHECK BY r_ t— NEAT _--
r 7-
00
_ or
APE�A JALU
OCC.LOAD __FLUOR LOAD HEIGHT _ NO,STORI
BUILDING PART ENT SET BACKS FRONT REAR LEFT SIDE � RIGHT SIDE
Permits ��''�
--- 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 ANO SPECIFICATIONS,AND IN COMPLIANCE WITH
Recording ALL APPLICARI F CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTROCTORS TO HAVE CURRENT CITY BUSINESS
1%State �� LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Total
By 7 _ _ —
_ APPLICANT OR QG'NT,
Approved ;9 .�'rf Rerc w No.
-- -- -
HON
ADDRFSS
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
01- /Z ,-" Contractor
Permit No.
--- _ Rough-in _ —
Fixture
Final
�— HEATING
Coy-tractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
-- ------------- Final
DRIVEWAY
Final
—_ Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final j
_ Approach
BLDG. DEPT. FINAL TEMPORARY TCERTIF'CATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Finic!
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�?�t= L�I�ICT Or,) .J OLD �C�U. 3Jfi—T �pN Wi~1t��
Awl
P.ddress V��_ L"y►'t- Permit No.
Name of Occupant--__W_ Permit charge _
Paid by
Date connected
Type of Building_ Inspection fee --
Service Rate Paid by
-_� ' G Date
----�... ---------
Contractor. ___ Assessment_ Paid
Size of connection_ (M -._-