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BUILDING PERMIT APPLICATION TIGARD DATE- `'-_' ,19 .___ 3895
THE UNDERSIGNED HI '4_113Y APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE (12-0-05883
OR AS SHOWN ANI)APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER JaY "4ilTrr, Vlc?r,40BADDRES_S 97(5 F11 ri;)0]c rnurt LOT NO.
— ARCHITECT
ENGINEER
BUILDER Q3amc, ADDRESS P.O.PoxiP3?91�7'i�nrd DESIGNER Piercy-Iiarcli
STRUCTURE NEW ❑ REMODEL ❑ ADDITION f-i REPAIR 11 RENEWAL ❑ FIRE DAMAGE _❑_DEMOLITION
_
E X RESIDENCE r-] COMM_l_ EDUCATIONAL E GOVT ❑ RELmiOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY m..3 LAND USE ZONE _15—PI)BLDG.TYPE -_�'�] FIRE ZONE_.-" PLAN CHECK BY '3wh HEAT
Conmtrvct sinnle farily duelling i+%.at-te-tcheci q'-4r(-+r1r. 3 PP_cAroo'rt; - ? Pat!
SEWER PERMITM 1123 - 'tF10.nr) r1�?ri�;r` 4`+i rm.ft:. _
OCC.LOAD FLCOR LOA[, 4`' HEIGHr ' NO.STORIES I — AREA 1230 N0.BEDROOMS 1 VALU154, 1
BUILDING DEPARTMENT SET BACKS FRONT ? 1 REAR 3 LFFT SIDE 5.2 5 RIGHT SIDE
Permit 1 ) �� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan CheckC' .c� WORK WILL BE DONE IN ACCORDANCE WITH THE PtANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCE. THE ISSUANCE OF THIS PERMIT DOES NOT A'1IVE
Subtotal 245.3( RESTRICTIVE COVENANTS. CONTRACTOR 'kND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 71'3!
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATI:�:
DATE INSR TYPE INSPECTION
REMARKS PLUMBING DATE
Contractor
Permit No,
2 6• c. Roughan
Fixture
—Qfi `4 it,,t. �i o.... Final_/_�_
l4EATING L
Permit No. 1-6i4 1-i6
Ges or Oil
Rough-in
Final
SEWF_R
DRIVF.i'AY
Final
Storm Drainage
(Rein Drain)Final
Sidevolk
Lurb&Street Final
_ Approach --
BLDG. DEPT.Irl,ZA TEMPORARY CERTIFICATE OCCUPA
CERTI.1CATE OCCUPANCY �Y Final
/d - YG •�1 gyp-
ULandscaping
2,,.ing Final
i
Maine
)