9440 SW LAKESIDE DRIVE 9440 SW LAIT SITE DRIVE _
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PERMIT NO- 17
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pERP11 , CHARGE rune
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PAID BY
TYPE OF FUlLnUlG DATE COt;"'--CTEO
SERVICE RATE INSPECTION FEE
Cg';TRAr-TOR -- — PAID BY DATE
SIZE OF CO ,NECTION J ASSESSMENT PAID
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CITY' ' 36
BUILDING PERMIT APPLICATION ()1= TIGARD E __-____ 19 _
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILDERPHONE
OF; AS SHOWN ANn APPROVED IN THE ACCOMPANVING PLANt_" AND SPECIFICATI',N,;. OWNERPHONE_
LOT NO._._
OWNER;LC lEi1 iI1 EYV_ _ , JOB ADDRLSS J�� I F� }� ji(j�j [ MOM.=-ADDREiS
ARCH.TECT
ENC,IF+EER
BUILDER r� ADDRESS _ DESIGNER
STRUCTURE ❑NEW 1:1 REMODEL ❑ADDITION , _❑REPAIR _ DHENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL_❑GOV'T ❑RELIGIOUS❑PATIO nC,•H PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND QMOVING— _❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUI_'ANCY.—i_—LAND USE ZONE ?,-BLDG.TYPE FIRE ZONE PLAN CHECK By ! •IFAI
i,rtmtdn — He—Igo ismft pe 103Zr" rit,.! Lreenloof Tsria�'Q.
_ FramrsLf Towrtl,4,usu 90,4 ad garegs. 34 2 Usdroutu
Jsw t :.Iormplt ._i'l .41 - ��622,j.00
HEIGHT ----- -- NO�IS2�!€�2__ AREAL7(3,NQ.
dUiL01NG DEPARTn'EN7 SET BACKS FRONtfJIF 11,1�tl
_ REAR LEFT SLUE RIGHT SIDE
Permit .00 — — — - _..._ -- _ --�____
THIS PERMIT IS ISSUED SUBJECT TO THE REJULATIONS CON-AINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANI.: IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE. WITH
Sub-total 1 73s 00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENAATS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CI1 Y BUSINESS
State Tax �j� � LICEE. SEPARAT PE ITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
�ONS – 04UL;.1 i'
Total ail_�. , 1 ,�., #2 sim or
By pl __
- - APPLICANT OR AGENT
Approved LJ►atlden Recriht r4o.1.341:,
DATr INSPP, TYPE INSPECTION REMARKS- PLUMBING -- DATE T
- - Contractor
F'ermlt No.
Rough-in
Fixture
-._- — Final
Hr ATING
.GC L Contractor \
----- Permit No.
Gas or Oil `{V�
---- -- ---- --- ----- ----------- Final -------
- - ---- - ---------- - --------- - ---- SEWER--
------_--.- �-- ---------- - -----_- Final
-- -- - --- - ----- ---- ..--- DRIVEWAY —
- - - --- _ - Final
-- --�- �-_- Storlh Drainage
— IRain Drain)Final
�— ------ � Sidewalk
- T Curb&Street Final
--- -- Approach
BLDG.DEPT.FINAL T<_TAPORARY CERTIFICATE OCCUPANCY Final -
CERTIFICATE OCCUPANCY - -- -'
Landscaping
t
Zoning Final
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.;IJI[_LIN(, PERMIT APPLICAI-ION 1OF
1T TIG ^RD DATE�f _..._. ,�111!4 , __ N'� 43
,iF 01.401 RgIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEF,EIN INDICATED BUILDER PHONN ),.J AOWNE �.
F AS SHOWN AND APPROVED IN THE.: CCS IVIMNYING PIANS• LOT NAND SPFCIF ICA1 IONS. LOT N PHONE--
L O�
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RE_5 � �t�G� t,fl U. ���HOME ADDRESS --
ARCHITECT
ENGINEER
nER ADDRESS_____-_ ______. — DESIGNER
JCTURE CJ^:EW _❑REMODEL ❑ADDITION C]REPAIR ❑RENEWAL C-11-IPE DAMAGE ❑DEMOI.ITIL'N
�!7fN_CE ❑COMM-❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO []CAR PORT ❑GARAGE [:1STORAGE❑SLAB ❑FENCE
':]POND ❑MO.VING _ OCONDITIONAL USE ❑DLSIGN REVIEW- ❑COUNCII. APPROVED ❑SIGNS _
PLAN CHECK BYj[,L��!-,___ HrAT-_)t T
'.CIIPANCY�L4hD USE 20N R=.J BLDG.TYPE �.-fIRE 2ONE.,�1 _L__
C1_
_ — ►v_�SI4alEs�. _CFEA� _EVR00M
_— BUILDING DEPARTMENT SET BACKS FRONT LEFT SIDE RIGHT SIDE
omit .— ---_�-�,, - — - __ -=- ------- ------------
THIS PERMIT IS ISSUFD SUBJFCT TO THE RFGULATION, CONTAINED IN THE BUILDING CODE, 20NING
'len Check 11 C)
Cv REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE 'KITH THE PLANS ANDSPECIFICATIONS AND IN COMPLIANCE WITH
;Ub total ALL APPL ICARLE CODES AND ORDINANCES. THE ISSUANCE Of THIS PERMIT DOES NOT WAIVE
— ---- -----��'-- RLSTRICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO DAVE CURRENT CITY BUSINESS
;tet[ TeX jam. LICENSE SEPARATE PF RMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
otelTl IZk5,. _
iy APT O GENT
>pproved -- Receipt No.
--- — ADDRESS �S�_��
11
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