BUP1978-2286 BUILDING PERMIT APPLICATION 11 Y TIGARD DATE__
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
LOT NO.
OWNER JOB ADDRESS HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION [:1 REPAIR ❑RENEWAL ❑FIRE DAMAGE []DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE= PLAN CHECK BY HEAT
L r
p.
OCC. LOAD FLOOR LOAD HEIGHT NO,STORIES AREA NO,BEDROOMS VALUE _
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit IS'
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
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total /_ �,
By
APPLICANT OR AGENT
Aonroved RecelDt No.
DATE INSP. TYPE INSP 10 REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor r
Permit No. ?'79
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Stonin Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final