10315 SW BROOKSIDE PLACE R I A
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10315 SW BROOKSIDE PLACE
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CITY
0075
BUILDING PERMIT APPLICATION TIGARD DATE_
fHE 11NDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN! THE ACCOMPANYING PLANS AU40 SPECIFICATIONS. OWNERPHONE
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OWNER ADDRESS 'BUILDER PHONE
ENGINEER
BUILDER j r'T _�✓ ARCHITECTrr�� DESIGNER
STRUCTURE ❑NCW ❑REMGCCL ❑ADDITION REPAIR ORENEWAL [:]FIRE DAMAGE ❑D'PAOLITION
bRESIDENCE ❑COMM OZOIICATIONAL ❑GOV'T ORELIGIOUSOPATIO ❑CARPOR--T ❑GARAGE ❑STORAGE.ET,LAB EIFENCE
LIBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED []SIGNS
_ k. j — J
OCCUPANCY _ LAND USE ZONE. BLDG, TYPE_-:_._ FIRE ZONE_ PLAN CHECK BY HEAT
j,CC. LOAD FLOOR LOAD___ HEIGHT NO.STORIES _ AREA VALUE
BUILDING DEP TMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE _
Permit —
IAIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check -w REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND b.PECIFICATIC'IS AND IN COMPLIANCE WITH
Recording `" ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State • LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING,
Total
By
--- -- APPLICANT OR AGENT
Approved Receipt No -•
AODR 4 PHONE
4.
F.!
DATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
' Contractor
Permit No.
_
Rough- n
Fixture
Final
HEATING
Contract Jr
Permit No.
Gas or Oil
Rough in
Final _
SEWER
Final _
DRIVEWAY
Final
Storm Drainage
Rain Drain) Final
Sidewalk
Curb 81 Street Final
_ A roach
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
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Address ��3is 5 W, &0'.e Sipe toz, permit No. -1
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Name of Occupant C,(rEiC�ZE� LC/ Permit charge•
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Connection fee ;,";j
— — Paid by s l C /lo C is
Date connected �/ -3
G
Type of Building_ 4 '��k: Inspection fee
Service Rate-- ^ `` Paid by __- % i,/ &_Date-
Contractor_ 74-e LZ'i/6 L-/I Assessment Paid
Size of connection tf
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 734 DATE (r/
PLRMiT 1S GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST RE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAID $....... .........................TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
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- ------Dais 1�ipsrintendent-