15245 SW 74TH AVENUE-1 Mr � �e � �► � tr
15245 SW 74TH AVENUE
BUILDING PERMIT APPLICATION TIGARD DATE_ 4828
T!-'E UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED DUILDER PHONE
011 AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE __63Y-4!A_
NO. ------ -----.__
OWNER �{j� � :arlaug_--_ JOBADDRESS 15245 St,,' 74L"1t_ ----- --
-- �- ARCHITECT
ENGINEER
DESIGNER
ADDRESS
BUILDER _. _...._.. - .__. —�
STRUCTURE _ ❑ NEW ❑ REMODEL _ ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
C73 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑_RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE .-BLDG.TYPE _ FIRE ZONE___—PLAN CHECK BY HEAT
Fill pftrmi,t for 2Ufj-cuLyards of dirt. _
SEWER PERMIT N ;lune —�
OCC.LOAD FLOOR LOAD HEIGHT N0,STORIES AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE_
Permit15.d+'1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
_ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ""'� _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICAELE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 15.UU _ RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINt S
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax .6w
—' SDC r
Total 6.60
POC# APPLICANI ORAGENV' -
By GH
-- Recelpt No
------- —
Approved I ADDRESS PHONE
1'HE UNDERSIGNED HEREBY Ar IES FOR APERh11T FOR THE WORK I•IEFI '' INDICATED BUILDERP�Z)N-
bR AS SHOWN AND APPROVEI, .N THE ACCOMPANYING PLANS AND SI F ICAT IONS. OVINER Pmrl
LOT PIO_---
2'NNEP _ J013 ADDRESS / _
O,RCr11Tr C7
ENGINEER
ADDRESS _ —_—^C51GNE'R ---
STRUCTIIRE ❑NEW 0Fit%inDEL _ C]ADOITION,- ❑Rc.PAIRr1 ❑ c
R 'i_':IAL— ❑ [)A.
MAGE Q -M
DEOLITI
RESILE^ICE- ❑COfr.F.1 QEOUCATIONAL nGOV•T 09ELIGIC-JS[]PATIO []CAR PORT ❑(;ARAGE u STORAGE C.ISLAB ❑FEP
C CCUPAf_:Y 1;2_LANO USE ZONE—_ 0LOG.TYPE._-- FIRE ZONF_�__ PLAN CHECK BY— HEAT___
SEWER PERMIT
,aQC-Lp_p FLOQ8 L OAD HEIGHT _—P STORIES AREA NQ.BEDROOMS VALIJF_--
LI)ILCING OEPARIMENT� ,) , SFT BACKS FRONT REAR LEFT 510E RIGHT SIDE
PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUI'.DING CODE. ION
I 'r 1�t
Check -- -- REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT 1
(— -- WORK WILL BE DONE IN ACCGROANCE WITH THE PLANS AND SPECIFICATIONS AND IN CCASPLIL.N..E K'
:i.17•i�tdl ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THI!' PERMIT DOES NOT WA
(-^— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CO':TRACrORS TO HAVE CUP.FIE14T CITY BUSIPI
`.':atm Tax LICENSE. SEPARATE PERMITS REOUIRED FC'I SEWER, FLUMBING AND HEATING.
Total I s' SDC
r PDC#
APPLICANT OR AGENT
I�AFpro':pd 1 Receipt No.
1n�gf55 NUN
SDC - $
PDC - �-
SEWER CONNECTION $
SEWER INSPECTION $
I SEWER SURCHARGE
I