Permit BUILDING PERMIT APPLICATION VOIIMEAmw DATE , 19 , 497
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR - I HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER Ernest Marx JOB ADDRESS 10500 SW Cascade Blvd.
ARCHITECT Z24 -4570
to be bid ENGINEER Mackenzie
BUILDER ADDRESS DESIGNER
STRUCTURE ❑ NEW L.REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE CR COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY P LAND USE ZONE IP BLDG. TYPE SNT FIRE ZONE PLAN CHECK BY GS HEAT
iestall culvert, canopy and landscaping. Subiect to Fire Dept. approval.
SEWER PERMIT#
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA NO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 10. 50- 1 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 40.63 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
25.00 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub -total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
- 313 • LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
State Tax
SDC —
Total 131.26
PDC# APPLICANT OR AGENT
By _p" pd.
Receipt No.
Approved all due ADDRESS PHONE
-
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
7 1 (DX Contractor
4_ .21.r�� /� Permit No.
V 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
LDG. DEPT. F.f4AL TEMPORARY CERTIFICATE OCCUPANCY
F.. RI' IFIC OCCUPANCY Final
Landscaping
Zoning Final