15995 SW QUEEN VICTORIA PL King City CITY OF -
BUILDING PERMIT APPLICATION TIGARD DATE , 19 N0
° 10 6 5
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
all 'eln Hoe>`fin ; ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW 0 REMODEL ['ADDITION ['REPAIR ❑RENEWAL ❑FIRE DAMAGE ['DEMOLITION
❑ RESIDENCE DCOMM ❑EDUCATIONAL ['GOV'T ['RELIGIOUS['PATIO CIGAR PORT ['GARAGE ❑STORAGE['SLAB ['FENCE
DBOND IROND ❑MOVING OCONDITIONAL USE ['DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
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
A ANT OR AGENT
Approved • Receipt No.
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
1
Rough-in -
Fixture
Final
HEATING
)//1
Contractor
Permit No.
f Gas or Oil
�" Rough-in
/��/ Final
; )('/I'''
( ,, i 9(_._.. (p SEWER
Final i
DRIVEWAY
1
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG. DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
• 411 Zoning Final •
'y, ' ...... W_ , ..
CITY OF ^ � lQ _/ 4.0.,;:_e-' , e.4., •
BUILDING PERMIT APPLICATION T GAR DATE �' , 19 -lam N2 /
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED �J
OR AS SHOWN A APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
69 OWNER f—; E � /Li� ADDRESS / • ?�J {�(�/ •L(/", UILDER PHONE
f
ENGINEER
BUILDERzaf / x -:_,),,i,1 ?i� JiCHITECT DESIGNER
STRUCTURE ❑NEW REMODEADDITION ❑REPAIR DRENEWAL OFHRE DAMAGE ODEMOLITION
!.(RESIDENCE ❑COMM DEDUCATIONAL DGOV'T ❑RELIGIOUS DPATIO ❑CAR PORT DGARAGE ❑STORAGE DSLAB ❑FENCE
\\E BOND EMOVING ECONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED DSIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT
i4, --a'," )-zg,e_ti a, eitep 7/ 4,,i_A--/f,..e.-7, Z-(J/ ..-7...._e_,-e-ezei p--A"e,_e_4.-7 .
,..0a
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE//O c) t----
I BUILDING DEPARTMENT
1 SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
I Permit 11 // OG ----
It ( THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check I 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
I Recording i; 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,°o State 33 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
de
Total �i f
r
f �1, II
r Ir LI
APPCANT OR AGENT
Approved i� Receipt No.
ADDRESS PHONE