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12920 SW CARMEL STREET-1 — 12920 SW Cannel St. r G- JA \� I U N I NAL i i AAI i i i i g1Nl i i BUILDING PERMIT APPLICATION KING CITY DATE--___-__ 1- _ ,19- __ 140 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNEP P ��ll?kE.�KK(( �_— LOT NO. OWNER (.bir.1. 14A:asiussut JOB ADDRESS 12920 :ilk Cannel St. 251 ' to ARCHITECT ENGINEER BUILDER •`la'.)C ADDRESS DESIGNER STRUCTURE ❑ NEW ❑XREMODEL ❑ ADDITION ❑ REPAIR CJ RENEWAL ❑ FIRE DAMAGE El DEMOLITION CA RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT CJ RELIGIOUS ❑ PATIO ❑ CARPORT rJ GARAGE ❑ STORAGE C SLAB FENCE OCCUPANCYAl—LAND U:;E ZONE __ _BLDG.TYPE _�NFIRE 7.ONE PLAN CHECK BY tip.2 HEAT--- A H-ltiull ;.0 reaidenc& f•7r suttrwa (non-imbi.table) SEWER PERMITO _ OCC.LOAD _ FLOOR LOAD HEIGHT _ NO..STORIES 1 AREA 12I'_ NO.BEDROOMS VALUE 91�:_�� BUILDING DEPARTMENT SET BACK$ FRONT REAR LEFT SIDE RIGHT SIDE Permit • 4.1U THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULATIONS AN,� ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE Plan Check 48.43 WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMH.!ANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES 140T WPIVE Sub-total _ ---� RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTOI,S TO HAVE CURRENT CITY BUSINSSS 3.73 LICENSE.SEPARATU PERMITS REQUIRED FOR SEWER,PLUMBING SND HEATING. State Tex Total 126.66 SDC— PDC# ANPLMANT OR AGENT ey 48.43f Receipt Nov;,f.,0/ �/7 — Approved �$.�.� PHONE DATE INSP TYPE INSPECTION REMARKS PLUMBING DATE ContraLtor Permit No. ♦ Rough-in Fixture HEATING Contractor Permit No. 0as or Oil -Rough-in Final SEWER Final DRIVEWAY Final Sto;m Drainsp Main Drain)Final Sidewolk Curb&Street Final Approact, CERTIFICATE occuPANCY DEPT. FINAL TEMPO CFinal CIENT71CATE CUPAI CY Lan scdpi,19 II Zoning Final_ MUM ,-ksh Pc' tklo PLAN CHECK NO._­e, for inspections call 639--4175 C, PERMIT NO. CITY OF TIGARD 639.4171 DATE BUILDING PERMIT -f pp,,��,,� P.O. Box 23.397, Tigard OR 97223 TAXMAP 25j-16 4OLOTNO. 1._L_I vv SUODWISION OWNER L lc SV12 1155 C' v\ JOB ADDRESS I�`7 c l�J -� �: �A h"Y✓I L t A------ BUILDER `;t OU STATE REG.NO.. EXP DATE ---- BUILDER'S PHONE ---- ARCHITECT-___.__ - -- _ PHONE._ OTHER_ STRUCTURE ❑ NEW ❑ REMODEL AOOIT'ION ❑ REPAIR ❑ MOVE Cl OTHER _C7 DEMOLITION RESIDENCE ❑ COMM ❑ EDUCATION ❑ NO 0 RELIGIOUS. ❑ACCES,%)RY O GARAGE Ll OTHERS OCOUPANCY ^ LAND USE ZONE BLDG.TYrE �FIRE ZONE PLAN CHECK DY ' t*EAT— - SE ER PERMIT. - ---- — LOAD _FLOOR LOAD HEIGHT NO.STORIES L AREA /2n NO.BEDROOMS VALUE rCk. ILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE i THIS PERMIT IS ISSUED SUBJECT TO'HE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULAnONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE kR. WOhK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFlCAT1C:NS AND IN COMPLIANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEKMIT DOES NOT WAIVE_RESTRICTIVE COVENANTS.CONTRACTOR AND SUD CONTRACTORS TO HAVE CUCRENT CITY BUSINESS TAX PERMRS.SEPARATE PERMITS REQUIJED FOR SEWER,PLUMBING AND HEATING Tolel / 73 SOC- APPLICA 55x _ 1v -- PC1Ca Prepd� Ll 3 - 2 3 Rece4pq No. ADDRESS PNDNE Bal.Due � Issued By— Approved By— SI)C --- $ OC - _ RECEIPT N _ DATE PD. ;f t✓CR CONNECTION 5 _ AMOUNT PD.- - - I.L/ER INSPECTION S JCR SURCHARGE S m m e n t m -- MARAMIMMELMIRARPRALMLALm sv r �1 Gity of Eina Gity _.&PPLI.C4T ON FOfc ARCHITECTURAL nNn ���13uCTur�(� �N,�►y�r ; NAME:.._� 11 a s w V 5 5 h ��'1`L�2 0 ADDRESS:�� . `•�o y'f. _0.r m I Mr. O+F. CHANGE Ri' 1Ut;5T�U: In p z ►fr d 0 y l kj o O� bbl� h � 5 I 1 ©IIAQH A PRQ gLY EXECU29Q-1-) VINU . 5 YjL 1,LAN &NI 'V'til, ,7i" FORM. NAME OF CONSTRUCT O V F ,61. (IF O'1'NFR _rHn!d Rn.—1 Dr-'NT . VOCs -A Ce, Q t=- AJELJBER C2,_j_CX2-I, S P LJA100 k R. 1!t' 0._� ADJACENT PROPERTY OWNERS MILL BE INFORMED OF THE RkUrSTr:U CHANGE:. IF TdERE 16 AN UBJECTIUN. THE Ut3JLCT1UlV LIE R1;ijilYt;iJ TU '1'l» RESIuENT. ASKING FUtt THE CHANU:;. `UbMIT THIS FORS+1 Alio ACGUiva-AN•iiiiu LIIIAl Vlliu (a% 1'U I'A'. n.G .C.,k. ADNIINISTAATOR. KAJOR STAUCTURHL CHAI*GLS AkL SUbJi'LT TU 1{LVILo nl• '1'r.L BUARD OF UIHiXTOH6. A BUILDING PEdivilT oiU:;T BE Uol'A1Nr.0 1 hbw Tliji C1':Y OF '1'IGARD 1lU:t ALL IMPROVEMENTS CUSTI NG UViR ,'100,00. ' NTAC'1' ED WALTaEli 639-4171 . A ARCH TECTU LV �J COM11TTLE: •r a.,► A� " ,4"LATE• APPRUVi:D: X C.C.A. : y�s� - ;� �� �r'L'• 4 L)AT,6 • City dt KI g City • 15396S.W. 116th Avenue, King City, Oregon 9.7224 • (503) 639-4082 • 11 y'I w z � 1� © s LL �-- ! IME 1 rJ I I i v� G I II d P to °I ��1!i I �! I• �1 M 4 K b i.qA r LIP 91 \ \ ry ♦ 1 i b it - i FAJA( COkiC � slob) p I A 3 � I Ntw S1`o►'i�-e C/o If �I 9fortje s. rb ILA fb o II 1, p N r � , r P � p o A S l: o S C. 3 0 w aL �t'$ 'x lA V. Dt�tM� NlPttM Xr'5tINA 1 1�� i s.w- CI-211e.,41 f` I II� I `I I � r� in � Q o � I � c ( s Fi ter T?WLrt