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15905 SW QUEEN VICTORIA PL CITY OF BUILDING PERMIT APPLICATION `TIGARD DATE F- , 19 77 a _ THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SH N AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE OWNER ADDRESS D-c � :.. BUILDER PHONE S -c87 ENGINEER I BUILDER ri vie •�.0 ARCHITECT DESIGNER STRUCTURE DNEW f l REMODEL 0ADDITION XREPAIR DRENEWAL ❑FIRE DAMAGE ODEMOLITION RESIDENCE COMM❑ DEDUCATIONAL DGOV_T E.:RELIGIOUSDPATIO OCARPORT- ❑GARAGE ❑STORAGE ESLAB ❑FENCE DBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED DSIGNS OCCUPAN LAND USE TONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT �— ,t� � #(9b--- ----- OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE I BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit �'ij Ie d C i t1 1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING ()Ian 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 'j ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE 0 //'�� RESTRICTIVE COVENANTS. CONTACTOR Ar: J(3 CONTRACTORS TO HAVE CURRENT CITY BUSINESS 1%State V I LICENSE. SEPARATE PERMITS REQUIRED FOR .vER, PLy BING AND HEATING. Total t / 0 . %L �i r./, / �� A ', � i t--- 'I APPLICANT L)H MGEP4 © Approved Receipt No. `C - (O 3 D / t D 3ESS PHON a