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CITY OF g-232 03.�4
BUILDING PERMIT APPLICATION TIGARD DATE19
THE
THE UNDERSIGNED HEREBY APPLIFC FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN.; AND SPECIFICATIONS. OWNcRPHONL—. ____
OWNER !` ADDRESS J.J 3UU r �IiL 0 , BUILDER PHONE
ENGINEER
=.LDER — ARCHITECT DESIGNER
STRUCTURE ❑NEW __0 REMODEL [:]ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEM�-O�ILITION
Q RESIDENCE [:]COMM ❑EDUCATIONAL ❑GOV'T ❑REL.IG10US❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND 0MOVIP!3 ❑CONDI'TICNAL USE ❑DESIGN REVIEW ❑CCUNCIL APPROVED ❑SIGNS
OCC,UPANCY_.L-_LAND USE ZONE.__ �-7 BLDG.TYPE- FIRE ZONE__3 PLAN CHECK BY-- -. HEAT
dd construct 873 lack* ft. frame addition mm,rding to approved p1mlinsIts 13 17, 9100
--
OCC. LOAD "3 FLOOR LOAD 4'U ib HEIGHT _ NO.STORIES —� AREA VALUE —
BUILDINC DEPAPTMENT SET PACKS FRONT REAR LEFT SIDE RIGHT SIDE
�:�
Permit 64,00
—--- --- ----
2.OU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THATTHE
--' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
1Vitate --96.64
-� *64 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING A'YD HEATING.
Sr
T o•`1`-- v r 4 I 1! 3 �? 1 .L.•�rf r ..r t,.�i:10 .
By - _.
APPLICANT OR., GEN- r
Approved r I Receipt No 1
ADDRESS P-40 —�—
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DATE INSP. TY"E INSPECTION REMARKS PLUMBING DAi I
7-3/-75 ontractor,/
of Permit No. 7S
�r1� f°�fJ�*�� ��QA Rough in
Fi,ture
V17 Final
HEATING
Contractor
Permit No-
Gas or Oil
fo h-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drai la
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
A-
r-w.nowilT TO CONNECT
City of Tigard
Permit S Y DATE_.---!_ —
�C
PERMIT IS GIVEN TO
OF
TO CONNECT A '7I.. _A7,, .c------
1") THE SYSTEM OF CITY OF TIGARD
THIS PERMIT MUST BE POSTED ON Tt1E DESCRIBED PREMISES UNTIL COW
NEt.TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FES: PAID $_�lwl CITY OF TIGARDD,
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CONNECTION INSPECTED AND APPROVED
DRIP Svperinhnnd94
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