14325 SW PACIFIC HIGHWAY ADDRES .,,,
i:\records\microflm\targets\building.doc
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE ___, 19 W 0727
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ADDRESS _ _BUILDER PHONE
ENGINEER
RUJIDEA ��yyf ARCHITECT DESIGNER
STRUCTURE _ ❑NEW_ C REMODEL ❑A.DDITION ❑REPAIR ❑RFNEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RES_IDENCE COMM ❑EDUCATIONAL ❑GOWT ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
MOND IROND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW DCOUNCIL APPROVED []SIGNS
OCCUPANCY---LAND USE ZONE—_BLDG.TYPE__F IRE Z'JNE_ PLAN CHECK b HEAP
gSLQ LOAD_ FLOOR LOAD s HEIGHT NO.STORIES AREA VALUE _
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RICHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGUI ATIONS CONTA" FD IN THE BUILDING CODE, ZONING
AN
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, D IT IC HEIEBY AGREED THAT THE
-"`—— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recordi;lg ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAVCE OF THIS PERMIT DOES NOT WAIVE
�— RESTRICTIVE COVENANTS. CONTPACTOR AND SUB CONTRA^.TORS TO HAVE CJRRENT CITY BUSINESS
1%Slate LICENSE. SEPARATE PERMITS REOIIIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
--- - - -
---- ---- APPLIC/',PIT OR AGENT
Approved Receipt No.
ADDRESS PHONE
DATE INSP. 1'fPF INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
fRough,n
Fixture
Final
HEATING
Cotitractur
Permit No.
Gas or Oil
Rough-in
Final
SEWER
lFinal
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
—JA roach
SLOG.C P*i.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIF!CATE-,,,rUPANCY Final
Landscaping
Zuning Final
A d d r eq /36 5 s �7.5�S .� � ��� � Permit No.
Permit charge___�
Owner Connection fee ��. � �.
Paid bl,__ ��
Type of building Date 0 Date connec ted
Service rate _ Inspection fee
Contractor r Paid by Date
Size of connection �i� _ Assessment _Paid
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171
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PHOFESSIONAL REMODELING THAT BUILDS VALUE
BENSON
NORTHWEST
BUILDERS
JACK K. BENS014, 636.6557
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