15280 SW PACIFIC HIGHWAY 152RO SW PACIFIC HIGHWAY
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BUILDING PERMIT APPLICATION TIGARD DATE-_J_'J�.-c._l::__ I9.. 4109
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOn TI G WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN; AND SPECIFICATIONS. OWNER PHONE
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OWNER Bob Luton JOB ADDRESS 152.8,05'
J .M• _ilacific HiLlimay
— —. — ARCHITECT
ENGINEER
BUILDER_ ;t:,U, ADDRESS DESIGNER
STRUCTURE L NEW U REMODEL— ❑ ADDITION _ [A REPAIR ❑ RENEWAL [ ] FIRE DAMAGE __LQ DEMOLITION
RESIDENCE O COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS C PATIO ❑ CARPORT ❑ GARAGE [❑ STORAGE U SLABCI FENCE
OCCUPANCY ----,--LAND USE"ONE — BLO..TYPE :_FIREZONEPLAN CHECK BY HEAT _
Pet•tove exis3 .ink',—buildiazx_ trotu 'i'ax_Lot `()(j all �ter_S�QL!fj. _
CAP SF-sr;*k jine at Dr4verti line ani! umla gidA
�� ex..stir;tr�:�tic tang,•.,_
x sMe (.ode .
SFWERPERMIT# call. far Ig;sp. t'ihe;l romplat.
OCC.LOAD FLOOR LOAD HEIGHT NO.S1 OR; AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT
SETBACKS FRONT REAR I.EFT SIDE RIGHT SIDE
Permit — �— THIS PEPMIT 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 PI ANS AND SPECIFICATIONS AND IN COMPLIANCE
j WITH ALL APPLICABLE CODES AND ORDINANCES. THE . SUANCE. OF THIS PERMIT DOES NOr WAIVE
Sub-total_ _--_ RESTRICTIVE COVENANTS CONTRACTOR ANLL SU9 CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PEPMITS REUUIRE:D FOR SE:',ER,PLUMBING AND HEATING.
State Tax
SDC-
Total
DC-Total
PDC# APPIusr;TORRAGENT
By
td M' ltReceipt
/No.
ApprOed_ Z -
PHONE
DATE IINSP. TYPE INSPECTION/ REMARKS —PLU1481Na's DATE _—
/�';'' Contractor
Permit No.
Rough-in
-- —.—__ Fixture -----
Final 4
HEATING -
— — Contractor
y Permit No. —
Gas or Oil Rough-in
Final
-- SEWER
--- Final �- -
DR'VEW 4Y
final --
�Storm Drainage
— _��- - ---- (Rein Drain)Final ---
Sidewaik
Curb&Street Final
APproech
BLDG, DEPT. FINAL TEMPORARY CERTIF11ATE OCCUPANCY Final
CERTIFICATE OCCU!'ANCY —_
I I Landscaping