11955 SW QUEEN ELIZABETH ST 7
King City CITY OF -
BUILDING PERMIT APPLICATION TIGARD DATE , 19 N° 10 5 8
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ADDRESS BUILDER PHONE
G1` .f f i th C.i,. ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW 0 REMODEL ❑ADDITION 0 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
DBOND 0 MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED DSIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
" 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 AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total •
By
AOANT OR AGENTill
Approved III Receipt No.
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
/ 77 y Final
HEATING
./ / j
�
Contractor
Permit No.
Gas or Oil
�/�j r -l)/1 Rough-in
Cien,
Final
if
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG. DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
• 1111 Zoning Final •
CITY of ` i
BUILDING PERMIT APPLICATION 4:,i D TE �2S , 197,4 Ng-
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK EREIN INDICATED
OR AS S N AN PPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ADDRESS // 1,5a ~� ( C ILDER PHONE-443 / l�_
,
JF P- ENGINEER /
BUILDER ARCHITECi-ITSw /11A7-?(
DESIGNER 1
i RUC TURE ❑NEW ❑REMODEL ❑ADDITION ,REPAIR DRENEWAL ❑FIRE DAMAGE DDEMOLITION
XRESIDENCE ❑COMM DEDUCATIONAL ❑GOV`T ❑RELIGIOUS DPATIO ❑CAR PORT ❑GARAGE 0 STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING DCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED_ ❑SIGNS
OCCUPANCY LAND USE ZONE____JLL L _BLDG.TYPE_ __FIRE ZONE PLAN CHECK BYtC.- " HEAT- _._ I
_ 0 / c i
i.d ► ,� /t,„ a %C�/- ICL_ 1
—47';d Zf /x /` /i f_= - / 4- L r /
L
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUEff.2o
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
-
Permit gg.e_
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 AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Io State :may LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ? t -
By
_ APPLICANT OR AGENT
Approved 4:"41 APPLICANT
Receipt No.
ADDRESS PHONE
•
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