12380 SW KING GEORGE DR - r - _ .. - - - - --
CITY OF
BUILDING PERMIT APPLICATION' TIGARD DATE 9.3 1 N9 _
• THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED I
OR AS SHOWN AND PPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE !p 7 - �7�
OWNER , I wed.. (I 1� r a w � ADDRESS 1120' 1 64-7
BUILDER PHONE 7 ).:34 , " - 2..7,-5 .
ENGINEER 1
BL'I LDE �r�11 RCHITECT DESIGNER
STRUCTURE ❑NEW I_I REMODEL 0 ADDITION ❑REPAIR RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
• RESIDENCE ['COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSDPATIO ❑CARPORT. OGARAGE ❑ STORAGE DSLAB OFENCE
DBOND ❑ MOVING ❑CONDITIONAL USE ❑ DESIGN REVIEW OCOUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG. TYPE FIRE ZONE_ PLAN CHECK BY HEAT .
a P h 41.,1.12-dtA-
1- -i -- e0-1717-tt , -.. 5/14-7
1 41 ®® - 1 11 : 13 . 4. '
OCC, LOAD FLOOR LOAD HEIGHT NO. STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit / (a O O •
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS C 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
RESTRICTIVE COVENANTS. CONTRACTOR AN . JB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
° S State L0 LICENSE. SEPARATE PERMITS REQUIRED FOR _ • .NER, PLUMBING AND HEATING.
Total
By ��.
f APPLICANT JN AGEN/
Approved . 1 Receipt No. _ -
ADDRESS (. ; PHONE
•
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