12375 SW KING RICHARD DR •li ________ • , _ - -- _
CITY OF'. - , .• ` -1 - .
BUILDING PERMIT 'APPLICATION TIGARD . DATE N
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED -- ' : ' '''.- ' • -
OR AS.SHO N AND, APPROVED I' THE . ACCOMPANYING PLANS AND. SPECIFICATI ®S ,a: ` °-
OWNERPHONE
OWNER l I ` J /A - I ® / , ADDRESS /2-3 5 W " 0/BUILDER PHONE _
d ENGINEER
BUILDER ep / C.l1 ARCHITECT r DESIGNER
STRUCTURE :NEW 0 'EMOD= ❑'ADDITION s TEEPAIR ' ❑RENEWAL OFI RE DAMAGE' -, ODEMOLITION • • - - - . --
i -
IQ.RESIDENCE ❑COMM DEDUCATIONAL' OGOV'T ❑RELIGIOUS DPATIO OCAR - PORT• 'DGARAGE ❑ STORAGE OSLAB ,DFENCE
D.BOND ❑MOVING OCONDITIONAL USE ❑DESIGN REVIEW - • OCOUNCIL APPROVED :. 'DSIGNS
• ,- OCCU' • NCY ' LAND:USE ZONE . - . " BLDG.. TYPE FIRE ZONE_,_. PLAN CHECK BY HEAT `
, .. i ' ✓ L. / d _ i� ��I� � A ilfi Jf / �. // , ./.. / -
. __
OCCi LOAD FLOOR LOAD HEIGHT: ' NO. STORIES AREA VAL //‘..3 -
& / :�
BUILDING DEPARTMENT SETBACKS FRONT _ . 'REAR . LEFT SIDE RIGHT SIDE' . "
p d ,
Permit /2.... —. _
• ,
THIS PERMIT 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 •
. Recording _ ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF. THIS PERMIT DOES NOT WAIVE r ,:
RESTRICTIVE COVENANTS. CONTRACTOR AND-SUB CONTRACTORS TO HAVE CURRENT' CITY BUSINESS '
3 % State ,3C LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER „PLUMBING AND HEATING. •`
Total �� ae
APPLIC TOR. AGENT •• • •
Approved Receipt No I2 3 7 9” S''LII. 1 Rf
i/ n4i -�[Q 13 44' `..1'9= J-3/ • .
• ADDRESS . PHONE ,
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