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BUILDING PERMIT APPLICATION TIGARD DATE Or-tc',.,mr �� ,to `''1 _ 4211
s THF UNDERSIGNED HERE APPLIES FOR A PERM I IF FOR I HE WORK HEREIN INDICATED BUILDER PHONE 64'`�-_2208
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEC'FICATIONS. OVVNER PHONE
OWNER ,r�i..:'t.: �: ': . . LOTNO.__ l0,
I r1V- _JOB ADDRESS 1 r` 0 .;. �c3t iA:�CC�d L� tlit ZC�adi ° Fat t
Pt:)rtlanrl, Ore, 9 "225 ARCHITECT
r.7. aox 255 1 ENGINEERStudio 5
BUILDER 4���'�'� � T ADDR_:SS 1'.
_ DESIGNER,
_
STRUCTURE NEW l] REMODEL `11 ADDITION FJ REPAIR ❑ RENEWAL —_❑ FIRE DAMAGE _❑ DEMOLITION
C� RESIDENCE ❑ COMM _D EDUCATIONAL 11 GOVT ❑ RELIGIOUS O "ATIO 0 CARPORT ❑ GARAGE 0 STORAGE C] SLAeLI FENCE
OCCUPANCY _I 3 LAND USE ZONE r'_ '' ._BLDG.TYPE �' ''_FIRE ZONE— — .PLAN CHECK SY ? --HEAT
Conq*rurt singlo 31R42m Fxiiiy 13wrtlltnq wlattached garaje
Zvp < nrv.rection Rhr-pt
SEWER PERMIT# !34)13 r Ar .ge 4 3 Q
OCC.LOAD FLOOR LOAD 4 0 _HEIGHT 1.n NO.STORIES' AREA 1 a' NO.BEDROOMS _3 VALUE 49 ',:00
BUILDINGDEPARTMENT- � SETBACKS FRONT REAR LEFTSIDE _RIGHT SIDE
Permit ,00 _ THIS PERMIT IR ISSUED SUBJECT TO THE REGULATIONR CONTAINED IN THE BUILDING CODE, ZONING
Plan Check T 3.9') 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 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal r _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
} LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
Tota! SDG-- 400.00
I i f'DC# 9 1�{�•Qt7 -AP�LICANTORAOEN __r _. ----- --
By
Receipt No. _.
' r1
Approved ;.,i',
ADD !88 --- PHONE — -----
l
DATE INSP. TYPE INSPECTION REMARKS PLUM! DAT?
�or 0 n
Contractor
Permit No.
Rough-in
0 e-e-V
Final
HEATING
Contractor If a0f
Permit No. .2 7 /D'257 V2
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidevolk
Curb&Street Final
Approach
BLDG. DEPT.ritii,t., liMPORARY
CERTIFrICATf:OCCUPANCY Final
C EWT I PI C ATE OC CU Pf,INCY
Landscaping
ZL,iing Final
i t
ago
BUILDING PERMIT APPLICATION TIGARD DAT�__���. �� 65�8•��0�
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT FOR THE WORK HEREIN INDIC 1 TED BUILDER PHONE
OR ASSHOWNAND ROV D1 NN THS:C PANYING PLhNS AND SPECIFICA.TICNS LOT N PPHON
-fib" �b.^,'y„t' LOT NO. -�
O'JUN EF' '0. U�J B A DRESS C>O So �..a l/�A✓+��►o►. C'f'.
ARCHITECT
. ST7/ LENGINEER
BUILDERS L _ ADDRESS 16 DESIGNER4 b
STRUCTURE , NEW ❑ REMODEL Cl ADDITION ❑ REPAIR ❑ RENMIAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE Q COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS Cl PATIO ❑ CARPORT Cl GARAGE ❑ STORAGE Cl SLAB❑ FENCE
04-C, FANCY LAND USE ZONE R �--BLDG.TYPE FIRE ZONE_ PLAN CHECK 13Y - HEAT_�,�■'�____
all
mc
SF7A'ERPERMIT N
OCC.LOAD FLOOR LOAD 410 HEIGHT 1Z, NO.STORIES- AREA 11D I NO.BEDROOMS 3 VALUr�? 700
JILDDINGDEPARTMENT SETBACKS FRONT I-V REAR Z.7 LEFTSIDE CO RIGHTSIDE
F'�!rrntt THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
IPIinCheck V7.�7 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
!�— WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVS
I
Sub-total �• RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRI+CTORS TO HAVE CURRENT CITY BUSINESS
r 11 LICENSE.SEPARATE PFr M1TS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;Stato Tax 0 7 Z w-
_ SDC—
Total PDC-# -APPLE IC NORAGEN�
By
Receipt No. -- — —
Approved ADDRESS PHONE
DC -
�00
PDC — --
SEWER CONNECTION $ S2�
SEWER INSPECTION
SEWER SURCHARGE14
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