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BUILDING PERWT APPLICATION Cory TIGARD DATE 244-3794
THE UNDERSIGNED HEREBY APPLIES FOR APERM IT FOR 114F. WORK HEREIN INDICATED 13UILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PF/ONF
LOT NO. .--
OWNER ..t Y'F"Jliflt JOB ADDRESS t-67'] JW Uf;.UII Ct. HOME ADDRLzS
ARCHITECT
ENGINEER
BUILDER ADDRES, q` �� ""� DESIGNER _
STRUCTURE ❑NEW _ 0RkMt1DEL ❑ADDITION ❑REPAIR ❑RENEWAL [-]FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PAT10 ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB [-]FENCE
QBOND ❑MOVING _❑CONDITIONAL USE ❑DESIGN REVIEW UCOUNCIL APPROV_D ❑SIGNS___ _—
II-•3 R-7
OCCUPANCY LANE)USE ZONE BLDG.TYPE___FIRE ZONE_ PLAN r.iECK By__-___,.._ HEA_1_'
:Jovtruct t iiwls fftMily dW&ili(ty u/Att2Ch&1U Ijorays.
40 14 1 — 1390 3 x,44
9Q.C. LOA 1U-_ _F_LQ4P._LOAU.—__ HEIGL.L _-._._.-LQ_*MR!1=$__ ARE _--N9_3€171+►QQM;LV6LUE—.r
BUILDING DEPARTMENT SET BACKS FRONT iO4 REAR 1 T _LEFT SIDE_ _504 _ RIGHT SIDE
Permit 171.1101 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 13O•ori REGULATIONS AND ALL APPLICA�jI.E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL 9E DONE IN ACCORDANCE WITH THE P'.ANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal `'ti.00 ALL APPLICABLE CODES AND ORDINANCES. THE 4SUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR ANC SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax t''•�� LICENSE. SEPA'AATE PERMITS REQUIRED r OR SEWER, PLUMBING AND HEATING.
IJ1.1.11[J
Total �:;2U4.k)8 Petr #i 11poe ua
BY per_ --
_A--_—_ r �� APPLICANT OR AGENT
Approved Receipt No. •✓S ------- _ ... — —
��II�
DATE INSP. TYPE INSPECTION REMAR" PLUMBING DATE__
—�� Contractor
Permit No. �C
_ Go f- i BFAMRough-in
Fixture ---+
Final
HEATING
Contractor
�TP QS/•t...c — -- — —
'1. td Permit No.
mAL• Gas or Oil
--- �— Rough4n
_ _ —---- final
—_..--- --------------—
SEWER
Final
DRIVEWAY
------ -!
Final
Stone Drainage
— (Rain Drain)Final
---__--_— Sidewalk
Curb&Street Final
_ -- Approadi
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCC NCY Final
CERTIFICATE OCCUPANCY -
1 l Landscaping
Zoning Final
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