Permit Tu, Aur \ -EF4 GttE604 w.oy /m 10 2 `t33
BUILDING PERMIT APPLICATION C0F TIGARD DATE 19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 8
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
12,Igo - IZI?c -12120 - I) -1 -7 7axLOTNO. SIU /-✓ZL i5i - 34e
OWNER JOB ADDRESS ilia' F f HOME ADDRESS
4-1 Q ARCHITECT
BUILDER ADDRESS /0s 17 31. � (3 /� ,714 DESIGNER
STRUCTURE ❑NEW ❑RE - MODEL ❑ADDITION 0 REPAIR DRENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE ❑COMM DEDUCATIONAL ❑GOV'T ❑RELIGIOUS ❑PATIO ❑CARPORT ❑GARAGE ❑ STORAGE ❑SLAB ['FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW DCOUNCIL APPROVED ❑SIGNS
OCCUPANCY LAN• SE ZONE - BLDG. TYPE M FIRE ZONE PLAN CHECK BY HEAT
. ) ' Tenant Modifications, Y4ans oy ,iarcury ,L
',uvc,n L I DsCicco Pits — Plane by Mots Supply Co.
, E •
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES 1 AREAStT RENO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit - 1400
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 12.00 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 36.00 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 • 9c LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total a.St►. 9b
By
J APPLICANT OR AGENT
Approved Receipt No. r
ounr,P
DATE INSP. TYPE INSPECTION REMAR - PLUMBING DATE
Contractor
� =�� / . / Permit No.
'QQ -67-4- 44-0.l' . Rough-in
4 AA ..,--..---• Fixture j
.. , 2 3 Final
�j i J I
•
����`�% " 111
Contractor HEATING
,/
Permit No A' /TSS ?7,-,64. / -16-to 1121 x/75/ /1 /- 7 -."
Gas or Oil
Rough -in
Final
SEWER
Final
DRIVEWAY
. Final
Storm Drainage
(Rain Drain) Final
1. � L -
/C # 7 - GCLL-.i�ni Sidewalk
. Cl R. - ace-d /o P.i Curb & Street Final
Approach
BLDG.. FINAL TEMPORARY CERTIFICATE OC AN� Final
2 - / z/ CERTIFICATE OCCUPANCY f 3
' , / . Landscaping
c)6T)1 J Zoning Final