14815 SW 79TH AVENUE-1 --- 14815 SW ;79TH AVENUE
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t.,(jprk5hCC7�- PLAN CHLCK NO.
for inspections call 639•-4175 PERMIT N0._
CITY OF TIGARD 639.1171 DATE
BUILDING PERMIT 2:;1, l L/, '�
P.O. Box 23397, Tigard OR 97223 TAX MAP LOT NO:-�"'CrO SUBDIVISION
OWNERk i cK A-k_.,,L C4 JOB ADDRESS ---
BUILDER STATE REG.NO.. EXP.DAIE _.
pUILDER'S PHONE6"--~ 9– r
I
ARt:HITECT _` PHONE OTHER
STRIh:_TURE ❑ NEW ❑ REMODEL ❑ '.m;TION ❑ REPAIR ❑ MOVE_ I OTHER 0 DEMOLITION
Li "FSIOENCE ❑ COMM (3 EDUCATION ❑ INn • ❑ RELIt;IOUS. ❑ACCESSORY O GARAGE ❑ OTHER ❑ FENCE
CK'CUPANCY LANG USE ZCNE _.BLDG.TYPC- _—FIRE ZONE PLAN CHECK BY ►*AT
G
SEWER P,:RMJT 0.
O(X.LOAD FLOOR LOAD FEIGHT - NO.S_TCRIES AREA NO.BEDROOMS VALUE -
BUILDING DEPARTS/ENT
SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permll - THIS PERMIT!S ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COBE,ZONING
'REGULATIONS AND ALL APPLICABLE CODES.AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE 'SONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
W"1111 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Pl.Ck.FM* FtMRrCTIVE COVENANTS.CONTRACTOR AND SLI'!CONTRACTORS TO HAVE CURRENT CITY BUSINESS
¢�• TAX PERMITS.SEPARATE PERMITS RECIUIRED FOR SEWER.PLUMBING AND HEATING.
Slate Tac SS(X
Total �� �'S APPLICANT OR AGENT –.__,–" -- -- ---
` POG
Prepd.
A(l0E1E55
/ ��.
Bal.Due Receipt No
Issued By----–-
5DC --- $
Dc
RECEIPT #
DATE PD.
EWER CONNECTION 5 _ , AMOUNT PD.
EWEN INSPECTION S
WER SURCHARGE S
)mmento: — - --- - I ;