11595 SW GREENBURG ROAD 11595 SW GREENBURG ROAD
1
L
c
`n
V
a
n,YWMYWYw1.wwM1�...
CITY of N° 0371
BUILDING PERMIT APPLICATION TIGARD DATE— -- 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWN--'R PHONE—_OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS.
OWNER ADDRESS b0I�DER PHONE_
— -- -- --------�
ENGINEER
I to"jt1t)rlatcaRC
❑ HIT
ECT DESIGNER
_r-_1 Ar-1
STRUCTURE ONEW REMODEL ADDITION OREPAIR_ ❑RENEWAL ❑FIRE DAMAGE ❑DEMr-OLITION
❑ IIESIDENCE []COMM ❑EDUCATIONAL OGOV'T ORELIGIOUSOPATIO ❑CAR PURI ❑GARAGE C1 STORAGE[]SLAB ❑FENCE
❑BOND ❑MOVING []CONDITIONAL USE ❑DESIGN REVIEW [:]COUNCIL APPROVED OSIGNS
HEAT_
OUPANCY LAND USE ZONE_-_ BLDG.TYPE FIRE ZONE__ PLAN CHECK BY
CC _
Construct 1tJ x 12 f raga* addition On elid
QCC l_OAD. FLOOR LOAD 40 1b HEIGHT NO.STORIES AREA 121D VALUE
BUILDING DEPARTMENT - SET BACKS FRONT - REAR LEFT SIDE RIGHT SIDE -
Permit r1•U0
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plat,Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THF PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
0 cording ASL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT l4AIVE
RESTRICTIVE COVENANTS. CONYRACTOR AND SUB CONTRACTORS 1'0 HAVE CURRENT CITY BUSINESS
% joveo
,20 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tot20 2❑ APPt tCANT nR AGEN1
Appclot e ht No
ADDRESS NIONF
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATF
7_-ZS•>S �121/�Q20/ Contractor
.11LIJ) 1-1-A � I I I 1 11 Permit No.
77 f2Ah ,n
Fixture
-Final
HEATING-
-—-—-—- Contractor
Permit No.
Gas or Oil
Routh-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
Address Permit No.
Name of Occupant `✓` =^� t— Permit chargees
IV�(Gona�cAtm
Paid by__
Date connected
Type of Building Inspection fee-------
` Date-
1-1 -- - — —
Service Rate 14 Paid }-y
_ �/� �--�—�
Contractor_----------. _ --- Assessment__,�j�_._Paid-�____.
J "
Si-te of connection