15835 SW QUEEN VICTORIA PL King City CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE S c II , 19 N2 10 6 4
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
rit;1jitis tioo$$.n ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW 0 REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ['DEMOLITION
❑ RESIDENCE ❑COMM DEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE QSLAB ['FENCE
DBOND El MOVING DCONDITIONAL USE ❑DESIGN REVIEW DCOUNCIL 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
APPLICANT OR AGENT
Approved Receip
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
1'1,7'76 7e;
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG.DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
• 4110g Final
BUILDk 1 I Lk lm I- 1 I l `Y ^ l f. C 0 l F N..-. 3
(-: e c F . 6 DATE— — — • 19 --- -_l\i
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 63P„49,,�/ 7
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PI4ONE _
X
/�j' y��y� Uj��2dyy
C'=',`NER POC /� J( Dei £,A•ADDRESS / Q 3,c sru-�i .1;�� =_ " BUILDER PHONE
ENGINEER
P!_!!LDS RtiJ a` It//eorrr-tARCH ITECT -- — DESIGNER --- ——
t-1 I REMODEL CI REPAIR) ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
.TRUCTURE �tiEW rr rr �� t—� t�--11 ------ r � --
J RESIDENCE` ❑COM.M DEDUCATIONAL DGO_V'T DRELIGIOUS��PATIO DCAR PORT tDGARAGE 0STORAGEDSLAB �]FENCE
E130 ND 0MOVING QCONDITIONALUSE 0 DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS — —
)CCUPANCY LAND USE ZONE BLDG.TYPE____ FIRE ZONE__ PLAN CHECK BY_ - HEAT-_________-__
-_ _ pe-, ' .'t- frii,1)6 'R.- , - --
DCC. LOAD FLOOR LOAD HEIGHT _ NO.STORIES AREA VALUE
BUILDING DEPARTMENThSET BACKS FRONT REAR LEFT SIDE RIGHT SIDE —
Permit �oC do --- — —