9460 SW LAKESIDE DRIVE 9460 SW L.AK.E SIDE DRIVE
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BUILDING °r7RMIT A CITY TIGARD __. 1978
APPLICATION of f)A,E____
THE UNDERSI( REBY APPLIES FOR APERM11 FOR THE WORK HEREIN INDICATED bUILDERPHONE'' �� I
OR AS SHOWN AN, 'PROVED IN THE PCCOMPANYING PLANS AND SPECIrICATIONS. OWNER PHO N�_.--
LOT NO.-_
OWNER'i in. .�L .L l_y(ti ij, 5W Lakes J l"'• L a HOMO ADDRESS
ARCHITECT
ENGINEER
Blr_LDER ADDRESS DESIGNER __
SfRUCrUR_E ❑NEW_ ❑PCM_nDELCIAUDITIION OREPAIRr--tt ❑RENEWAL ❑FIFE DAMAGE_ ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO OCAR PORT ❑GARAGE ❑STORAGE l JSLAB ❑FENCE
❑BOND ❑MOV.NG ❑CONDITIONAL USE ODESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY�_LAND USE ZONE---L PLC)--, TYPE_ �N____ FIRF.ZONE.— PLAN CHECK BY—�i 7 _ _ FEAT
kap-Imauca aamg a k Gr9lerr; Q f t llr>c lcuz
I vammij Ti3wah�2www wZeLtat:hsr; ;iarai.w 2 6ath-�*
i .wc;r i3ormit 1.':f . 3ci — �625eOU1 --
UC��.Q9�._ .�HflSitiT-_ N4__U.QP1 _An Al 'r_,d) Np.BF�844(1�5 -�A-_.L�►l<_`__ t.
BUILDING DEPARTMENT SET BACKS FRONt�gN GI I.a `IREAR LEFT-SIDE RIGHT SIDE
PPr ITl1 t
- - THIS PERMIT IS ISSUED SU6!ECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check r(� REGULATIONS AND ALL APPI_r:ABLF. CODES AND ORDINANCES, AND Il IS HEREBY AGREEn THAT THE
WORK WILL BE DONE IN ACCORDANCE'•NITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ,� ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SLID CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax I, LICENSE. SEPARAT f�RMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Vii- yj��tl$ULi
Total I i3_26
APPLI(AN1 OR AGENT
Approved . N E�1 i Rereipt No.134' _
I�
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
y.t-7vS def sr�
Rough-in
Fixture
Final _-
HEATING
Contractor
- Permit No, 2k:
Gas or Oil
Rough-In
Final
SEWER �--
DRIVEWAY
V� Hnal
g -tn Drainage
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL A TEMPORARY CERTIFICATE O-,CUPANCY Fine)
CERTIFICATE OCCUPANCY
Landscaping
.�.�7 Zoning Final
i
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3"[21I.DING PERMIT APPLICATION OF TI . ,RD GATE_ -- —• 19�._
;HE ;IND[ RSI GNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE_(_)__
C-F; AS SH,)WN ANh APPROVFD IN ME At :O PANYING PLANS AND SPFCIFICATIONS. OW'IER ?HONE_
LOT NO-'-"�`-'-----F-_
--
HOME ADDRESS
ARCHITECT
ENGINEER
ADDRESS _-- DESIGNER _
_1CTURE _ 0 EW ❑REMODEL _ ❑AODITION -_❑HEPAIFt ❑RENEWAL ❑FIRE DAMAGE ❑_DEMOLITION
L-f'rDfNCE_ ❑COMM_ COEDUCATIONAL ❑GOV^T ❑RELIf,IOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
I_71P_^ND ❑MOV ING ❑CONDITION_AL USE ❑DESIGN_REVIEW ❑COUNCIL APPROVED _ _ ❑SIGNS
7..'C'L''PANC�---__LAND USE Z0NE:&_- 1___8LrG.TYPE. __FIRE ZONE _ `CHECK BY 'T' L HEAT_
yL o. C i.tom
:C �Q9.D- --- FL.QQR LOgp _HFIGHL AREA NO,C7 NOB DRUOMS`_�l VAmao�C"100
BUILDING DEPARTMENT --'I SET BACKS FRONT R `R LEF1 'IDE RIGHT SIDE
—L�— THIS PERMIT IS ISSUED SUBJECT TO THE RFGULAT:ONS CONTAINED IN THE BUILLING CODE, 7ONING
'Ian Check I U� VU REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WOPK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
:ub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RL'',1111CIIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HLVF CUHRENI CITYBUSINES"
Tate Tax 1 :CENSE. SEPARATE PERMITS FIFOUIRED FOR SEWER, PLUMBING AND HEATING.
•oral 1 i •�� I
lyIL
�_4 <
APP(SCANT OR GE NTv
klir)f oved Receipt slo.
ADDRESS
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