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PUILDING PERMIT APPLICATION TIGARD PArE______4 21L_ ,19_ 80 3148
TI IF UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HFREIN INDICATED BUILDER PHONE -f- -4100
CP AS SHOWN AND APPROVED IN THE ACC'�MPANYING PLANS AND SPECIFICATIONS. 'OWNER PHONE _ 639-0090_
10 T NO.
OWNL,'11=�arry t UnrlirlghaM JOBADDRESS1013C, 511 Brookside Placrj _ _
ARCHITECT
ENGINEER
BUILDER Jerry liar tun ADDRESS222 SE .16th. Ptld. DESIGNER
STRUCTURE ❑ NEW ❑ IiEMODEL ❑ ADDITION [A REPAIR ❑ RENEWAL ❑ FIRE DAMAGE L DEMOLITION
RESIDENCE F1 COMM ❑ EDUCATIONAL ❑ GOV'T ❑_RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE [1 SLAB_ i:_] FENCE
OCCUPANCY —E-7-4—LAND USE ZONE . P-7 BLr?G,TYPE aN FIRE ZONE _PLAN CHECK BY (JWN HEAT
Install founrl-ition drain and rain drain s)(stem.,_all._Lex_code
SEWER PERMITN
OCC.LOAD FLOOR LOAD HEIGHT---- NO.STORIES AREA NO.BEDROOMS VALUES11 '100-
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit J.00 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 Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tex 4) .40
Total t1h.40 SDG-
Af P1 -------
PDCN APPLICANT OR AGENT
LApp,��ad
Gl„HReceipt No.
ADDR€98 PHONE
DATE INSF. TYPE INSPECTION REMARKS PLUMBING I DATE.
Contractor —�
Permit No.
y Rough-in
Fixtuia
-_ - - — —� Final — -
i— -- HEATING
Contractor
Permit No.
----- - — �
Gasor Oil
—�� Rough-in
Final
SEWER
Final
DRIVEWAY
— Final ^^
Storm Drolnage
(Rain Drain)Final
Sidewalk
—' Curb&Street Final
-- - -- Approach
BLDG. DEPT. FINAL r TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Flnel —
Lnndscaping
Toning Final
S'.
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT N9 706 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DRISCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS 'SEEN COM-
PLETED.
PERMIT FEE PAID s-.. ......---TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
14UpWntendelit
PERMIT TO CONNECT
R ° _ Tigard n4tar %slict
�I
PERMIT No 699 DAT It
PERMIT IS GIVEN TO
.
OF
TO
�IT
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
� ��
AT� d (.! _S,I.J. eft,•r-'J�'-�-.��Q
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $.........:2. ...................T10*RD X TRICT
By
CONNECTION INSPECTED AND APPROVED
_.
Date 5upeclnMndent
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s
MW 1 1
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Address - /- 7( f /t"'e'�. Si�� Permit No.s
oa
Name of Occupant _ Permit charge b
Connection fes
-- --- —--- Paid
---— _ ------.---_ -- . Date connected_
Type of Building_______ Inspection fee__ C P40�e
Service Rate__- Paid by Date
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Assessment Paid i t
d .
Sizo of connection _-_-—_-.-- �. � i ,}�/�Y},.r �►,.( /~°.(.t<C !0 '+3
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