9885 SW JOHNSON STREET 9885 SW JOHNSON STREET
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BUILDING PERMIT APPLICATION cOF TIGARD,D,1 TE _- `� 19_�- 77
THE UNDERSIGNED HEREBY APPLIES FOR APFRMIT FOH THE WORK HEREIN INDICATED BUILDERPHONF �' -���Z
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWN1,RPHONE
_ --
LOT NO.—.
OWNER i' tI JOB.ADDRESS r,�� •) �' Johnson w r HOME ADDRESS _
1 — — --'� ARCHITECT
ENGINEER
�IJILDE_R c+':1' ADDRESS _— �_ DESIGNER
F.;HUCTURE ❑NEW tNEMODEL _❑ACDITION J ❑REPAIRr-1 ❑RENEWAL [:]FIRE DAMAGE ❑DEMOIATION
�IIESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT EIGAFIAGE ❑STORAGE nSLAB ❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW LJCOUP-CIL.APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE-----BLDG.TYPE_vFIRE ZONE __. PLAN CHECK BY, HEAT_
iismove winfirlwo 1 cool, it: .nstail 1 11,,u 1.!int�ul, , �rnL;vo tt�z�htut�
--':;n• ingtall ahowQr within - .- ---- -- _._. .-------
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OGC L0�1p _ _—F �P_L4A.Q �__.�i�1Ci►iL----- -----� LQF3l ...__ 1{AEA._ _y.4-_Bf1�H99M ..--- [ALUE_. q ' -
BUILDING DEPARTMENT SET BACKS FRONT —REAR J - _LEFT SIDE_ _RIGHT SIDE
Permit
- - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY ACREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANCA IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State.Tax •l: LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 5.1:
By _ ArIPI ICANT JR AGENT
Approv d ETU Receipt No. 1
ADDRESS
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Tax Lot 2 SI 2 BA 1.900 23-10 North Tigardville Addn
Assessment 497.93
I,ateral 70.98
568.91
11-1-61 28.45
& SA thcreafter
Address Aermit No,
Name of 0-jc upar,t_Uc Permit charge _2119 0
connection f e e-z.6—Lao—
Paid by. y ur"
Date connected`,t-jj
Type of Building A.
Inspection fee--/
Vr
Service Rate Pail by
�-11/144 Date--q-M2,
Contractor
Assessment-6
Size of connection lilt
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 658 DhTX,1,4-+l. •� � "�f
PERMIT IS GIVEN TO � �7d/1.�f - � 00
OF
TO THE STS'-EM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT mup r BEtoON THE DESCRIBED PREMISES UNTIL CODI-
NECTIVN IS MADE AYD INS CTION OF CONNECTION HAS BEEN COM-
PLETEI),
PER(AIT FEE PAID ;. I.��. TIGARD SANITARY DISTRICT
By r
CONNECTION INSPECTED AND APPROVED
Date Superintenditt