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City of Tigard
N "' TION REQ', 'EST
f o r
W"PECTION TIME' Y PERMIT No.
DATE : DATE ISSUED
OWNERS NAME :
C 0 N T R A C,T 0 R tQW4619�,o
EST : A-r U, Water El , VISUOI 0 Loll
F-SULT: Approved1 Lisa PProved r Ing
SKETCH,
DATE
aF1t
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CITY OP
BUILDING PERMIT APPLICATION TIGARD DATE 19
71
N-0
' 0703
THE UNDERSIGNED HEREBY APFLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNPfI PHjNIf .j 4,*,Bk
to ata tt R H 71-0,10
QWNEA _ ADDRESS _ — 8 11-OD1ER PHONE
,lWnN:• ENGINEER
BUILDER _ ARCHITECT DESIGNER >'.Ia91gR
SrRUCTURE ❑NEW ❑REMODEL ❑ADDITION —❑REPAIR ❑RENEWAL❑FIRE DAMAGE ❑DEMOLITION
C3 RESIDENCE ❑COMM ❑EDUCATIONAL. ❑GOV'T ❑RELIGIOUS❑PATIO [:]CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE _❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS--
OCCUPANCY--LAND USE ZONE BLDG.TYPE FIRE ZONEPLAN CHECK BY HEAT
,,SLIULL i4bfs u4, (IL. f Lima c1W>fral ioI j w •a •t On at '-rwu'
— -- ., 'root;p acCarL1 Lig O �tppCuv�rr p 84,1 ,
6P<,,,,:,,,, ISO& _
- — ---- t(300
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT - SET BACKS FRONT aJ`F REAR 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 AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
j9P 04 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1 i6 State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By _
Approved Receipt No.
ADDRESS ----
' t�■r w tlww Im In
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/, _ Contractor
3 .6907 — [tL�- a-,� � � Permit No.
Rough-in
4C- Fixture
3 '�'7FJ Final — --- --
-/b-7(i HEATING
31�" Contractor -r
/.S f [LUL /,0 L- 47 Ila'OF Permit No. 36,17
Gas or Oil �t7V— -��
<S�1117C Roughin
55
�� �����✓� ti�/��011- _ /?_kIIJE Final_ _
-- _ _ SEWER -j.�? Al
;L 76 -t Qe lotrc&- Final _
DRIVEWAY
Final
-- _ — Storm Drainage
(Rain Drain) Final
Sidewalk
CUrb&Stieet Final
A proach
BLDG. DEPT. FINAL TEMPORARY _ CERTIFICATE OCCUPANCY
( / / CERTIFICATE OCCUPANCY Final
Landscaping —
�� Zoning Final
w s = M
PLRMIT NO. -
_ PERMIT CHARGE none
OLJtJEtiw - r CONNECTION FEE
PAID BY
"TYPE OF 13UILDING � ___..__.____ SATE CONNECTED
^ _ q
'iERU10E RATE INSPECTION FEE o?.S Ou
CONTRACTOR LAID 13Y _ -- _ DATE 3110
5I7F OF CONNECTI ON _� — ASSESSMENT _ PAID
33 �� ' �