11875 SW 79TH AVENUE-1 11875 SW 79TH. AVE[qUE
I
I
a
,c
,..,,r.,y..., .«.». n•..r�s�prwlrw 'a1q+r'R��T
BUILDING PERMIT APPLir.ti T�G", FY TIG►ARD DATE l,.c: -' iq_ r 72
THE 2NDERSIGNED HEREBY APPLIF." FOR APERMIT FOR THE 'WORK HEREIN INDICATED BUILDERPHON 47, '� �'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER11ON 09-4629
LOT NO.
OWNER �x• LJ:iD= JOB ADDRESS . 1875 SW y79tw HOME ADDRESS
�— ARCHITECT
t INFER
BUILDER L1810 IJ- Jones ACDRESS Rt- 2t Box 142, I'cM nevi=XNER
STRUCTURE ❑NEW_ ❑REMODEL OADDITION 0 REPAIR t,, NFNEWAL FIRE-DAMAGE UDEMr-OI_ITION
0 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ORELIGIOUSCOPATIO ❑CAR PJRT ❑GARAGE_ ❑STORAGE EISLAB OFENCE
❑BOND ❑MOVING ❑CONCATIONAL USE ❑DESIGN REVIEW_ ❑COUNCIL APPROVF_D ❑SIGNS
- f
OCCUPANCY LAND USE ZONE �--BLDG.TYPE_'- FIHE ZONE `� PLAN CHECK BY _ HEAP
_ Rebuild yarnyu_erees damaged by fire. -:1- mechatucral to Us brought tai --
cr oa ruquirelmente3, an for ao vanting for oil tarat — On® hour wall _
reayuyrad bM weeen yarnys and living z erva.
QC(;.LOAD ___f149F3 LQAD _-- HEIGHT NO,.STQB.IE.$,-fig NQ.BliDnOOMS. VALUE
rBUILDING DEPARTMENT SET BACKS FRONT HEAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SJRJECT TO THE REGUI ATIONS CONTAINED IN THE RLIILDING CCDE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AN;t) ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WI'rH
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSJANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVI WANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax • 'O LICENSE SFPARAT - t'ERMITS REQUIRED FOR SEWER, PLUMBING A%ND HEATING.
Total $24. 96
BY
APP`(CANT OR AGENT
Approved I r�cc� l,t N r
BUMS
1
+i
1 r
3UILDING PLRMIT APPLICATION 1O1F TIG,kO DATE_L__� 19� Np
-�--- ..�. 72 ��Z .2..c
`14c UNDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON
Up AS SHOWN AND A?PROVED IN THE ACCOMPANYING FLANS AND SPf CIF ICA110NS. OWNER PHONE
u Tµ LOT NO._
JOB ADDRESS O 7r 5� 7 Y HOME ADDRESS ,.
- ARCHITECT
psi G pt ire-,e, ffNGINEER
0 S ADDRESS 1Y DESIGNER
JCTURE QN_EW ❑REMODEL ❑ADDITION �— HEPAIR ❑RENEWAL IRE DAMAGE ❑DEMOLITION
XF 1ENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
�PJND _❑MOVING ❑CONDITIONAL USE ❑_DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
' LtTANCY:r�--_LAND USE ZONE ? - BLDG TYPE._!L__-([__.FIRE ZONE `PLAN CHECK BY `HEAT
f ��a✓�-t� ��..
c10 _;_ .. _ 'a aE' is t�y-l��•vim A)& -�r 2 Q�� C `T� u,,K •
'I Coe,
_BUILDING DEPARTMENT SET BACKS FRONT REARLEFT SIDE _- RIGHT SIDE
_ .Imi _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pian Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUE)iptdl ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
`tate Tax y' >L tICENSE SEPARATE PF RMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total �-
Byl'ANt, OR - ---------- --— - -_--
1AGE N?
RPCPII)I NO -
-
'tl
9 �
Address f s7� >��v yy _ Permit No .— Z. /
P-arm-t---shams-ge _
Owner l�G >>_ ��.�cl�� �4rt- Connection fee 375
Paid by
Type of building__ . Xt -), Date connected
Service rate G -(,v Inspection feex �
Contractor Paid by ,Date
Size of connection` Assessment Paid
At,ye
i
w
r�r
PER1411T TO CONNECT �� 4
Tigard Sanitary Dist-ict
PERMIT N° 1351 DATE 7 !t '
i
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITART DISTRICT
AT
THIS PERMIT MUST BE POSY ED ON THE DESCRIBED PREMISES UNTIL.CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED. Q
PLRMIT FEE PAID a••• • ?s•••• TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
Date 3up^rinteadent
)K
i