16685 SW KING CHARLES AVE '� —^ _ .._ ._ .
CITY OF -
• BUILDING PERMIT APPLICATION' TIGARD DATE .j pT _
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND R OVED IN THE ACCOMPANYING PLANS AND SPECIFICATIO OWNER PHONE
• OWN ERD ADDRESS /GGg - "S DER PHONE
ENGINEER
RL'ILDER 0 ARCHITECT DESIGNER
❑
STRUCTURE ❑NEW REMODEL -- ❑ADDITION 'fEPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
• ESIDENCE ❑COMM DEDUCATIONAL DGOV'T ❑ RELIGIOUS OPATIO ❑CAR PORT ❑GARAGE ❑ STORAGEQSLAB ❑FENCE
❑BOND ❑ MOVING ❑CONDITIONAL USE ❑ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE 7_•NE BLDG. TYPE FIRE ZO ,E_ PLA 0, l; CK BY HEAT . yaw am Appwf
A iml- RIPPWANOMIERZI..._---ii .i.ii.c...-.1._
J NO. STORIES AREA VALUE C P O
OCC. LOAD FLOOR LOAD HEIGHT
I BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE ` �
Permit 1l /0 r '
1 1P THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
`Plan Check II REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Recording I
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
1 RESTRICTIVE COVENANTS. CONTRACTOR Ar. JB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1 % State 3v �ll LICENSE. SEPARATE PERMITS REQUIRED FOR .NER, PLUMBING AND HEATING.
Total I /0. .1. ' . Ce3-1i.e a .,
• 1_13 II APPLICANT i1H M..
I
A pproved 1 I Receipt No.
ADDRESS PHONE
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