11550 SW 72ND AVENUE-1 11550 SW /2ND AVENUE
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BUILDING PERMIT APPLICATION TIGARD DATE.—_ 4,01 20 ,is 4383
THE UNDERSIGNED HEREBY APPL IES FOR A PERMIT FOR)HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_-jj-j34AA.—
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LOT N0.
JOhTt goon tak 11550 4 . .�2nd
OWNER _ JOB ADDRESS _ _ —
ARCHITECT
ENGINEER
BUILDER ADDRESS SaMe DESIGNER
STRUCTURE I_] NEW C) REMODEL M ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE O DEMOLITION
j '9 RESIDENCE ❑ COMM Cl EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR FORT ❑ GAFIAGE ❑ STORAGE ❑ SLAB❑ FENCL
OCCUPANCY _._ LAND USE ZONE BLDG.TYPE __ FIRE ZONE._.—PLAN CHECK BY .— HEAT_
tPatio Cowr Gonst. to n.silt uplift~ for wind loud 16' x IR'
SEWER PERMITk
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS VALUE 1,0(X
BUILUING DEPARTMENT SET BACKS _FRONT REAR LEFT SIDE RIGHT SIDE _
Permit __r, THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE;', AND IT IS HEREBY AGREE►)THAT IIHE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECiFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total ' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER PLUMBING AND HFATIPIG.
State Tax
Total .��i
—�— SDC—
By (;-,j PDC# APPLICA0 OR AC ENT
Receipt N
Approved Ctsa ADDRESS PHJNF
w w-
DATE INSP. TYPE INSPECTION REMARKS _ PLUMBING DATE -
-
Contractor
Permit No.
Rough-in
Fixture
-.—.� ------------ --_ Final
---- --- --^- HEATING
Contractor
-� Permit No.
--- — — ,ies or Oil
- Rough-in
—" —_-! Final
SEWER
-------a--.�. —_--- ---_-` Final
T-- -- DRIVEWAY
------ -----_—�_------ -- Final
Storm Drainer
---_ -- --- (Rain Drefn(Final
----- -------...___`_----- Sidewalk
C,jrb&Street Final _
Approach _
BLDG-DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final e _
CERTIFICATE OCCUPANCY —
ILandwiping
Zoning Final
BUILDING PERMIT APPLICATION TIGARD DA-1C-- � � 1-� � to
THE UNDERSIGNED HEREBY APPLIFS FOR A PERtAIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER,PHONE 5 Q
/ ( 1 'J LOT NO. _
OWNER JI)A -I'l C.� 1 FiJ08ADnRESS -
`— ARCHITECT
ENGINEER
BUILDER ���-2��/ (,' _ ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL l ADDITION �� REPAIR L7 RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
RESIDENCE 0 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAP,PORT Cl GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCX,UPANCY LANDUSEZONE BLDG.TYPE FIRE-ZONEr._PLANCHFCKBY _.HEAT_
SEWER PERMIT N
OCC.LOAD FLOOR LOAD _ dAI>=S AREA a '—'10i "�EDROOMS- VAIU
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit _ �S .U,�, THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 6UILDmG CODE,ZOH!NG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PI-in Check `""'" WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
1 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
utrtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUA CONTRACTORS TO HAVE CURRENT CITY t3USItvESS
LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
I State Tax � VU
U SDC—
Total /�__
POC-0 APPLICANT OR AGENT
By .
Receipt No.
Approved ADDRESS -----"--- ---- PHONE ---------- -
ol
5oC - —
PDC
SEWER CONNECTION b
`EWER INSPECTION $
SEWER SURCHARGE b �_
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