Correspondence JUL -31 -03 08:07 FROM-GERBER LEGENDARY BLADES 5036203670 T -240 P.03/03 F -061
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Building Division
Applicant Request to Cancel Permit
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TO: CITY OF TIGARD, BUILDING OFFICIAL JU L ' = 2003
13125 SW Hall Blvd., Tigard, OR 97223 CITY OF TIGARD
Phone: 503.639.4171 Fax: 503.598.1960 BUILDING DIVISION
FROM: Applicant Name: ( S
Mailing Address: 4 0 ,t•D X ?3 $
Cit /state//zip: tHAAA 6C2. 4 1?-f/
phone No.: c03 - t 3- l i g
Fax No.: 503 - 1 3 h7 0
PLEASE CANCEL PERMIT APPLICATION AND REFUND PERMIT FEES, IF ANY,
FGR THE FOLLOWING:
f cf I q� etmit N ELF O - PQ 1 (i + __ rJ L ►� &i . E)
V Y Type of Permit: a ez. ef 141:, u_crtki .L Out. Piece Pci*c£r1 £
C Site Address l j `c•
Subdivision: Ml
Trot No.: I41
EXPLANATION: 1_,D,,,4.‘ lwvo t 1 LA.01Z)4.12, 434
A � - ' troth • N. t.1�.� ' _ . •
i � tt. Ir ` te_tvaas £.Q ' : i _. '. — 1:
Signature: Date: 7- l_so o
Print Name. iJc
FOR Ot T'ICI:: tJSL' ONLY
Route to Admin.: Date: ay:
Permit Canceled: Date: 8 .
Refund and Processed: Date: R :
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Leutidin ffornaaRegeancelPamdt doc 04/03