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12350 SW BELL COURT
BUILDING PERMIT APPLICATION TIGARD DATE ___,is 3300
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED EIUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. uWNER PHONE 639-2187
LOT NO.—'.,i :k7WC1Al�r
OWNER LE 13 jCf1p01{ IOQADDRESS 12400 SW 131911 Court. _ .t 1100 ZS '4AA
_ �-
ARCHITECT-_---._--�-�
ENGINEER
BUILDER Weritside F emodsler1 ADDRESS 1255a SI: Summercrest 'MSIGNER
STRUCTURE F] NEW ❑ REMODEL ADDITION ❑ Hi_DAIR L; RENEWAL _❑ FIRE DAMAGE _❑ DEMOLITION
CJ V9ESIDENCE ❑ :CMM D EDUCATIONAL ❑ GOV'T F_) RELIGIOUS Ll PATIO CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABJ FENCE
OCCUPANCY _ -_-LAND USE ZONF R`7 _BLDG.TYPE .. �� _FIRE ZONE_. A CHECK BY �__ffw_ff__HEAT G e c e
- ------^ -- r:t additiun (na*k & deck) to existing single family duelling.
"I+P"ECTIQN SHLET ATTACHED.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 4A HEI 3HT_ 10 _NO.STORIES j AREA 14; NO.BEDROOMS ..-VALIt'Lj�;�(]
BUILDING DEPARTMENT - SETBACKS FRONT --••- REAR LEFTSIDE '~---- RIGHTSIDE --
Permit is,44.00 THIS PERMIT IS ISSUI=D SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ;J•(Jq REGULATIONS AND ALA APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
_ _ _ WORK WILL BE DONE IN At'XCRDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
00 WITH ALL APPLICABLE _0!)ES AND ORDINANCES, THE ISSUANCE OF THIS PERMI' DOES NC- WAIVE
Sub-total I_ • RESTRICTIVE COVENA10S. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURB ENT CITY BUSINESS
State Tax 1%,75 LICENSE.SEPARATE P& HITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
F
tal ,7• ?6 SDC-
PDC# APPLICANT OR AGENT -- - - ---
By R1 _
Receipt No.
Approved-- --- tihrh - ADDRESS --------- - - - PHO# --
r � t ! I .,s�➢�qih tike
i y
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE "
Contractor - - - —
`�-"=L---
Rough-in
- ---- ----------------------_ Fixture i' . ------
Final
HEATING G
Contractor
- ------------- -- ------ Permit No. %
Gas or Oil
Rough-in
-- -- --- -- .—A-T_- Final -- ---- -- --
_— - SEWER
- .------------ ------ Final -
- ----- _--� I DRIVEWAY
Final —
Sturm DralnagP
(Rain Drain) Final
Sldewelk
Curb A Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFIC AT QC ANCY -
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
Address /-275o Permit No, 3aG
Permit charge
Owner �..>>�>.�< , �, Connection fee 2plre°"'
Paid by
Type of building Date connected 3 -z2c. ,,o
Service rate �, Inspection fee
Contractor Paid by Date
Size of connection_- Assessment_ - -Paid
PERMIT TO CONNECT
Tiga,-d Sanitary District
PERMIT X119 13G`6
DATA;
PERMIT IS GIVEN TO = �� 'Llcte .:,.,T7 ► - -
OF
TO CONNECT A_ .11
TO THE STSTEM OF TIGARD SANITART DISTRICT
AT --
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BF.F.w, COM-
PLETED.
PERMIT FEE PAID ;.. .,a...'.....-.......... .....TIGARD SANITART DISTRICT
By
CONNECTION INSPECTED AND APPROVED