14370 SW 92ND AVENUE �'-w w
_-- L4-'x70 SW 92ND FVF;NUE ---
v
C
Q!
ro
C
N
m
3
0
M
�Y
� � s
BUILDING PERMIT APPLICATION of TIGARD DATE ___—_, 19 ���`
THE LINDERSIGVED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE� _ +
y LOT NO I
OWNER ° t dT�1�T'Ei JOB ADDRESS '4370 02M Ayentio HOME ADDRESS _
ARCHITECT
b•1 r� ENGINEER
BUILDER _— ADDRESSDESIGNER
STRUCTURE ❑NEW ❑RFMODEL OAUDITION C3 REPAIR ❑RENEWAL []FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑S'rORAGF❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS —�
OCCUPANCY_ LAND USE ZONE -BLDG.TYPE_ FIRF ZONEPLAN CHECK. Bv__ HEAT_
+'�rl�:'Lt.U:t: U`:t",1!Jt'.I ;)LH}Z• :1,�.�, 1.141C' �].mIt7N d1'Y'? C'Ar�l''. —.___ ___ _
w �• rr _..-----
C1CC.-L4AD_–_._— FJ.S2QR_LDAD ____. NO,ST_ RIES__.—._AREA__ 1YQ BUILDING DEPARTMENT DEPARTMENT SET BACKS FRONT TEAR LEFT SIDE RIGHT SIDE
Permit OC
--- — ----- --THIS PERMIT 15 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Ched. IG.Oo REGULATIONS I NO ALL APPLICABI.E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 14 000 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
e RESTRICTIVE CO,IENANTS. CONTRACTOR AND SUB CONTRACIORS TO HAVE CURRENT CITY BUSINESS
State Tax 044 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total XI
Br, ---- p, R,---- -- -----= - -
APPI ICANT OR AGENT
Approved -�^ -' Receipt No. -)6r
DATE INSP. TYPE INSPECI,ION REMARKS PLUMBING DATE
01C I Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
------ Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Sjtnnli Drainega
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT._FINAL -TtMPORARi A OCCLW%NCY
CERTIFICATE OCCUPANCY Final
Landscaping
IIZoning Final
/A� 0 �'�
DIN PERMIT APPLICA PON L0 FY TIGARD GArE_ • �W,�.
D�1 � G /••
THE UNDERSIGNED HERE61f APPLIES FOR APERMI f hOR THE WORK HEREIN IN,JICAI 7 SUIILULRP40NE_(!!�•����'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING Pi-ANS AND SPFCIFICAlIONS CV.'NEI?PH��rr�/39.ayZ'�
LOT^r�_7_—p`M M"^Y-
f�WNEP A_•_^O 1175 ADDRESS
.�iiCFIKY!ea. Q`
G I EMGMEER
ADI RE'SS � f1640-Ph. //!l�I• oiW
STRUCTURE F11-VfICEL _ A00!TION _ L�REPAIR ❑RENEWAL ❑F'IRE DAMAGE I_1.
1 i N OMM ❑EDUCAtIOr;AL GOVT 6RELIGIOU5L�PAT10 IJ CAR PORT ❑GAF', c I�STOF E❑StA6 []
U 1115 LIE CE C(. �
Or';T,,cArCY L n
OLDG TYPE _ FINE IONF PLANCHECk P HEAT
411
SEWER PERM.111
OCC LOAD L( . HEIGHT _ �� NO STORES AREA _ .r NO B( )NOOMS __VAI I
BUI1 ^'%1j DEI =-' BACKS FRONT r1E4R LEFT SIDE RIGrIT Slui
[Per.MIT �G. 00 -
PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE 7ONtt
(plan Ck I SIG 1IL.ATIONS AND ALL APPLICANIE CUUFS AND ORDINANCES, AND IT IS HEREBY AGFIEEO THAT TI
ilk WILL BE DONE IN ACLORUANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMFLIt,.NC.V 1•.,
L APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT U:[S NOT hA
STRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT Cr T v ALI N
j;ntP Tax / �� FNSE SEPARATE PERMITS REOUIREO FOR SEWER, PLUMBING AND HEATING
I(
Total r
r
10PLI(4N7 Ju "CIE NT
v,w Nu
SQC 1�T✓�` _._
RDC _ --_ ---- --- — �.
11A R r: ',NI. I T ION_$
SEWER INSPECTION $
SF'WF R SURCHARG S..
Comments:
a
9 /117d
Address—"��''�p J y- xt{� Permit No._�
1
O � L Permit charge
Owner Connection fee
Paid by
Type of Building �� ;;L Date connected
Service Rate Inspection fee 1 "
Contractor Paid by Date
Size of connection (' Assessment Paid
PERMIT TO CONNECT P. f► ? `� �
Tigard Sanitary District
PERMIT N9 1 ti 5 6 DATE �_ �' 62
PERMIT IS GIVEN TO ( /►-
OF
TU CONNECT A__�,
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
S
ATTHIS PERMIT MUST BE POSTrD ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE ANP INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID s...$'..a. ................TIGARD SANITARY DIPTXICT
By-
..�..�.�r....
CONNECTION INSPECTED AND APPROVED
Date -- Supertntc ident