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11775 SW 8URLCREST
DRIVE
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BUILDING PERMIT APPLICATION TIG;kRD DATE_ 19
�t— 75 No 0560
THE UNDERSIGNED HEREBY APPLIES FOR APE RMI1 FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE— — -
OWNER K�ilrinet,h Moore _ ADDRESS : l'4' u 4.Wo ®uric cast OrBVILOER PHONE —
ENGINEER
BUILDER _ owner --ARCHITECT —_ _ DESIGNER _
STRUCTURE LDNEW ❑FIE MODEL ❑P.ODITION ❑_REPAIRr�.yy ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION_
0 RESIDENCE ❑COMM, DEDUCATIONAL CIGOV'T ❑RELIGIGUSbPATIO dCAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OwOND ❑MOVING ❑CONDI'IONA1.USE ❑DESI,-,, +cVIEW ❑COUNCIL APPROVED ❑SIC JS
OCCUPANCY----LAND USE TONE BLDG.TYPE _FIRE ZONE__ PLAN CHECK BY_— _ HEAT-----
�Ong I'uc w X an t x s. pia o roa X 4t11 l�TEi a IiFSl IUM ruu —
-_- 4 x6wn, x 4 be&** on rear in -side dwelung --- -
_- 12 x 24 carport an side of garags 2 x 6 !batter eo:id from@ Iu>s11 alum. roof
OCC. LOAD FLOOR LUHU HEI';HT NO.STORIES AREA VALUE
BUILDING D=PARTMENT SET BACKS FR)NT REAR LEFT SIDE RIGH1 SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, BONING
Plan Check REGULATIONS AND ALL APPLICABLE CODE' AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE iN ACCORDANCE WITH )HE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCL-'. THE: ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAJE CURRENT CITY BUSINESS
11%State • 1 LICENSE. SEPARATE PERMITS REGUIRF.D FOR SEWER, PLUMBING AND HEALING.
Total
By
9PPL(CANT OR ACiFN7
Approved --- � Receipt No
��11 R_SSPNOh —
DATE INSP. TY:-E INSPECTION REMARKS PLUMBING DATc
Contractor
Permit No.
Fixture
Final
HEATING
Contractor
A [I Permit No,
7-
Gas or Oil
Final
Final
DRIVEWAY
.-.1nal
Storm Drainage______
(Rain Drain) Final
Sidewalk
Curb &Street Final
BLDG -6—FPT FINAL TEMPORARY __ Approach
CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Vindl
Pp
AddressPermit No. 10 U
�/ ----
Name of Occupant^ -_-._� Permit charge —
Connection fee--------
Paid
ee ____ —_.Paid by - ---
Date conne-.;ted , I
Type of Building _ _ _---------_--- Inspection fee---- _-.__--
Service Rate Paid by
Contractor _—__-- Assessment--- —.--- _Paid,,-----
Size
aid. _ __Size of connection __--
1
i
PERMIT TO .CONNECT
City of Tigard a)co
.�o
Permit N° 6 8 0 `
D,1TE.—�-----.�
PERMIT IS GIVIN TO '��__. / �� ���•?! Irk '
OF
TO CONNECT A_.j,L/
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREIVISES UNTIL CON
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLITID.
PERMIT FEE PAID $ CITY OF TIGARD
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CONNECTION INSPECTED AND APPROVED
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