Water Reservoir 66th Avenue & Baylor - Building permit WASHINGTON COUNTY BUILDING DEPARTMENT
Permit No
NON-RESIDENTIAL BUILDING PERMIT APPLICATION Fee
Receipt No.---,-
150
N. E. Third Street
Zone
Hillsboro, Oregon Midway 8-1111, Ext. 261
Map Number
;; r.;..7_ Neighborhood No.
( t New Construction Sq. ft. of bldg.
Addition
Census Tract t
( )
( )
Alteration Value � .o� . Health Dept. l,.pproval
(Check one
Use: ) ( ) Commercial ( ) Industrial ( ) Other By
Date
%ddress— r'.G'�G,.r f , .;yis >''
_ Building pt. Approval
Between -� ,. y_ ,
BY
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�' � p t— ----:.•-P--�---�.'-�------ Road Dept. Approval
Lot_ '- ' %lock_ �"`�.__.i�ddition -., C_ _.. By �.
-
Date
Owner
�� ✓ Fire Marshal
_ . By
.«ddress _ ' . , Date
Zoning approval
Builder
a,
'- r .. By
l,ddress f _+ _.. Date -
f.
Plans BY /.,f ` Permit Issued, i
(
Architect By-
Date
y( ) Designer ( ) Owner ( ) Builder { ) Non
_ Da t e
Lot Provides j Lot Requires 1
f
Lot Area
Overhang _
Lot Width Off Street Loading
Lot D2j?th No. of spaces Sq.ft, _
Front Yard _^_ Parking Spaces
Si -LNo. of spaces Sq.ft. -.
Side Yard-R .____.r r� Sewage Disposal : ( ) Septic Tank
Rear Yard I r _1 Sewer District.
Description Plot Plan
I hereby acknowledge that I have read this application and state that thr information
given is correct. I agree to build in a workman-like manner and in accordance with
the above description, approved plans, specifications and all applicable codes and
orders of Washington County.
�' 2 7 ��, A 1
Date. '"J _ . Signature _ M{ Phone
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