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BUILDING PERMIT APPLICATION 1,_fy 'nGARD DATE i' 31'78 3
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE--
OR AS SHOWN AND APPROVED IN 1-14E ACCOMPAN"ING PLANS AND SPECIFICATIONS, OWNEPPHONE___
LO' NO.
OWNER Brian F-3tricl, JOB ADDR �S12Q-V SIV Liurlheights
HOME_ADDRESS
ARCHITECT
BUILDER 8*418 ADDRESS ENGINEER
DESIGNER__
)OM
D�lJ H
STRUCTURE_ ❑NEW 0 F'EMODEL _ ADDITION OREPAIR�--1 ❑RENT WAL _❑FIRE DAMAGE ❑DEMOI-ITION
RESIDENCE ❑COMM ❑EUUCATIUNL ❑Gn\/'T ❑RELIGIOUS PATIO ❑ R
CAR FORT CIGAAGE ❑ r-
STORAGE CISLAB []FENCE
DBOND ❑MOVING C]CONDITIONAL USE DESIGN REVIEW 13CCIUNCIL APPROVED ❑SIGNS
I IL-7 5N
OCCUPANCY. LAND USE ZONE-_ BLDG TYPE FIRE ZONE . __ PLAN CHECK BY eLba HEAT ` __
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OCC•JQ9Q_ _YFL44H_t�A2�-_--...__HE1Gli7� ��.�TQB1F�_ _ AREA NO.ftDB_QDM5 VALUE 425.
BUILDING DEPT?*%%NT SET RACKS FRONT REAR
LEFT SIDE RIGHT SIDE
Permit 5090
- �- THIS PEgM-T IS ISSUED SUBJECT TO THE REGULATIONS CnNTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATION0 AND ALL APPLICABLE CODES AND ORDINANC"S , AND IT IS HEREBY AGREED THAT THE
%'qRK WILL FIE .NONE IN ACCORDANCE WITH THE PLANS ANDS'"CIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRirTIVE COVlNANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State T+[x •20 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEAr,NG.
Total 5.20
BY
AP (CANT OR AGENT
Approved Lw Receipt No.
(,
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w w w
AZ
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATr
Contractor
Permi• No,
Rough-in
Fixture
_ Final
HEATING
Contractor
Peru-;, No.
Gas or Oil
Rough-in
Final _
SEWER
_ Final
DRIVEWAY
Final
Storm D,aina e
[Awrosch
ain Drain) Final
ewalk
rb a Street Final
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCYCERTIFICATE OCCUPANCY nal
ndscaping
ning Final
t
Address 12 Permit No,--/ 7
Name of Occupant __,_ Permit charge
Connection fee
Paid by
Date connected J/ - 4-7
Type of Building Inspection fee J0 01-- -
Service Rate— Paid by _ Date
Coniractor Assessment—------------Paid
Size of connection
i
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PERMIT TO CONNECT
Tigard Sanitary District �
PERMIT N° 1010 DATE
PERMIT IS GIVEN TO 1 ti
OF
1
TO CONNECT A
TO THE STSTEM OF TIGARD SANITART DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREM13LS UNTIE.CON-
NECTION IS MADE AND INSPECTION OF CONNEG"I'ION HAC BEEN COM-
PLETED.
PERMIT FEE PAID $............ .................TIGARD SANITARY DI8TjIc?
CONNECPION INSPECTED AND APPROVEV
Dato Superintendent