BUP1976-1185 BUILDING PERMIT APPLICATION 11T TIGARD DATE 12-1-76 19 1185
OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE .2n.2-son-
OR
2n .2-soOR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
/. L LOT NO.
OWNER ' � t'uerd 0nrtPXJOB ADDRESS 8015gI,t 14tln?_ikPr }TOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMODEL C1 ADDITION ❑REPAIR [:]RENEWAL [-]FIRE DAMAGE []DEMOLITION
❑ RESIDENCE [:]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑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
C� .jdin- rasp oar aoorowed plan, toaaoxxianx+ahm
Inspection when footings ready to poor and whtan wall Prows i atoll in
;ilnr,n ready to pour
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES _ AREA NO. BEDROOMS VALUE boluo.
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 36.00
18000 00 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 1,62 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 55.62
By
AP" ICANT OR AGENT
Approved ) Receipt No.
ADDRESS PHONE
DATE INSP. TYPE I SPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
/ ¢
Rough-in
'oo ..
Fixture
�=S' Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
r
nl rr I ERV CITY
/�PPLIC/�T,C�! t � �t` F DATE 12 � � 19=Y-L N2
�:LDING P�
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVE N THE ACCOMPANYING �PLANS AND
/S'P'ECIF CATIONS. ORW(N�ER PHONE 2
Ncp & ADDRESS IS l K.� BUILDER PHONE 2� 1 +�
0W
ENGINEER
91 11
ARCHITECT DESIGNER
STRUCTURE 01NEW REMODEL Z(AODITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE COMM uEDUCAT!ONAL ❑GOV'T ❑RELIGIOUS OPATIO ❑CAR PORT- ❑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
S Pte' — a�
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE /0/ Old
BL'!LDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
� Permit �i � — --
� I 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
Recording it ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR A'. Al CONTRACTORS TO HAVE CURRENT CITY BUSINESS
°o State 162, LICENSE. SEPARATE PERMITS REQUIFIED FOH .vER, PLUMBING AND HEATING.
Total
Py I' ! APPLICAN-I Jk i1G��•:. —�.
Approved I Receipt No.
AODnESS PHONE