14625 SW 87TH AVENUE 146215 SW 67TH AVENUE
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BUILD NG PERMIT APPLICATION TIGARD DATE. C/ ---19 '`'�
I HE UNDERSIGN EG HEREBY APPLIES FOR A PERMIT FOR Ti iE WORK HEREIN INDICATED BUILDER PyONE
OR AS SHOWN AND APPROVED IN THE ACCON4PANYING PLANS AND SPECIFICAT ONS. U'VNER PHONt _–
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� JOB ADDRESS
ARCHITEtT
ENGINEER
BUILDER A,f- ADDRESS v – DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL ADDITION ❑ REPAIR G RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITI
RESIDENCE ❑ COMM ❑ EDUCATIONAL 0 GOV'T U RELIGIOUS ❑ PATIO ❑ :AR PORT ❑ GARAGE G STORAGE ❑ SLAB FEt•
UGC,UPANCY LAND USE ZONE ``� BLDG.TYPE e ---PLAN CHECK BY F„ (l HEAT __
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SEWER PERMIT k
OCC.LOAD FLOOR LOAD PLIGHT NO.STORIES AREA _7�, NO.BEDROOMS VALUE; �)r,
C—�''UIIDING DEPANTrdENT SET B CKS FRONT REAR 3 LEFT SI::E RIGHT SIDE
Prn iit THIS PERMIT IS ISSUED SUBJECT TO TIIE REGULATIONS CONTAINED IN THE 8UILOING CODE,ZOrt
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED TF;AT l
P;an Check WORK WILL BE DONE IN ACCORDANCE WITH THE. PLANS AND SPECIFICATIONS AND IN COMPLIAN
— WITH ALL APPLICABLE CODES AND ORDINANCE:.. THE ISSUANCE OF THIS PERMIT DOES NOT WAI
I Sui}fetal RESTRICTIVE COVENANYS.CONTRACTOR AND SUB CONTRACTORS TO HAVF.CURRENT CITY 8U01 E
LICENSE.SEPACIATE PERMITS REQUIRED FOR SEWER,PLU1`48ING AND HEATING.
State Tax
Total —_.--- -- _
- —{ PDC# APPLICANT OR AGENT
By
Receipt No.
Approved ADDRESS PHONE
SSDC -- $
PUC
SEWER CONNECTION S
SEWER INSPECTION S
.SEWER SURCHARGE S -