11945 SW PACIFIC HWY #210 v
LT'-'rte BUILDER � O - ,.�.�--s� `T //e= z _�_ E _sem' -.
LOCATIONI )'
JOB Y /4AP -i / LOT .c. -_'i- - .._.---
PLI.1I,f13FR cue PER MIT 7 %- 'J -----:7:T7:;::717-----
SEWER
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SEWEPERMIP # �.e7 . aT. _ �_-FFE ar ,_ L, . , ;r
DATE
BYDATE _ _ ---
EXCAVATION. FILL s - IR CCIT)I?'TOT T „,------
FOOTINGS FOU10.1ATIC
FORMS SP 'IMER Sia":2-1 ILATION
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SLABS . _ . _
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REINFORCIIr STEEL . _ . ,-'
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STRUCTURAL STEEL nl , r. 717.1:,73,-
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WATER HEATER _._
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BUILDING PERMIT APPLICATION TIGARD DATE - -- _.-- ,19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE ,--"-,--
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 6',14.-Y)'.::-
LOT 11945
N
OWNERmoittIeson JOB ADDRESS �,' di.Lic i 1 . Z• Suite vj :$ 410
1904 S./Elliott iliott ARCHITECT
ENGINEER
BUILDER Chuck hurrot2_'ht ADDRESS Portland. 01 972;i: DESIGNER
STRUCTURE ❑ NEW LB REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL Cl FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE clComm ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB El FENCE
OCCUPANCY ='"i LAND USE ZONE C-G BLDG.TYPE 51: FIRE ZONE — PLAN CHECK BY :.1'- HEAT ------
Tenrunt modification all per ap roved plans L cone rec.untie at !
SEWER PERMIT# Looe
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES I AREA -- NO.BEDROOMS -.-- VALUE 10,00_
BUILDING DEPARTMENT , SET BACKS FRONT SET, P ,•,_REAR LEFT SIDE RIGHT SIDE
Permit 60,50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 52,33 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
13 . 3 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax C^' •22
Total
P36.05 SDC—
PDC# APPLICANT OR AGENT
By
Receipt No.
Approved EL-;:bjs ADDRESS PHONE
- • ` . . ` �
1113
CITY OF TIGARD
12420 S. W. Main Street
TIGARD, OREGON 97223
APPLICATION FOR BUILDING PERMIT
1111
New Construction n Demolish ❑ Addition n Remodel Movell
ZONING DATE ISSUED4-:-/,-,_ BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ ) , .., No.
PLAN CHECK $ ' 7_3 --11 ,-.)
7
BY VALUATION .$ Ill; Dd d
OTHER $
TOTAL / Z,F%arr$--47 o [Y� RECEIPT No./070y
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # MAP # CENSUS TRACT JOB #
Architect or Engineer n1 ' A. Ell C ;Tr.1 n
Address Phone
Owner W 1 (i W /9 M •S rilk .S /NC . /
Address //5a 8 D .3-17,v Or ,flvd �
. is i�`4U311roem Phone d3S" -S/..y'S1!-
Builder Lc.q 6,-t L I) C—(9n/S..ev c'-Ti1/V Co.
Address ,2it37 .S:w. SEt./4 ot, e [) j V f I,oierz.niv/? 44...4:eaN Phone Q?S/` -,s-v9,1
BUILDING USE Single Res . n Multi Res. n Comm. El Industrial
OCCUPAN GROUP No. of Stories / Total Height Area of Lot
Typ f Co i. I II III IV V Floor Area B/S 'oo 1 7,y/1/ 2
Set Ba s: Fror4. ack L.Side R.Side
Private Sewe ' e Size Cj--- Sewer . S Septic Tank El
Y n
Water Service Pipe Si Storm Sewer n Ditch l l Dryweil ❑
Street and Curb Requirements NO A/k
Driveway Width Jf/n4/47 - AX(/STiNe No. of Parking Spaces
SEPARATE PERMITS- REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
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Water Service Pipe Si .' JCYLIC ranK U
Storm Sewer [D Ditch
1:1 Street and Curb Requirements Drywell
Driveway Width -
J/ _A' - - 1ST/NNo, -
of Parking Spaces
SEPARATE PERMITS- REQUIRED FOR SEWER AND
PLUMBING
SPECIAL INFORMATION
40
DRESS ASSIGNED
p
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LELD CHECK BY � `
--_DATE
is thatPERMIT APPROVED BY � ' a���
all work will conform
the understoodae of Oregoneand he Citywill
with applicable codes and ordinances
t e ocate nil of Tigard, Oregon, and that the builw
a Certificate of Occupancy h on
lard Building Inspector.
has been is ullding will
/� / ued by the C1c�• of
�t
Sign ure of A G7.4.,- '/'
pplican� r •_ •