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BUILDIPI�'a PERMIT APPLICATION38 TIGARD onrE -__� _ 19
3
THF UNDL: 'Vti .:,NED HERL BY APPLIES FOR A PERMIT FO'-! iiE_WORK HEREIN INDICATED BUILDER PHVNE _
OR AS SHOWN Al 10 APPROVED IN THE ACCOMPANYING PLANS AND:,PECIFICATIONS. OWNER PHONE
LOT NO.
OtVNE.R __- -- :? Constr. -JOQADDRESS_11095 tidy 93rd Court _
ARCHITECT
ENGINEER
BUILDER ADDRESS
P955 SW Cc7r'r,,,.� c-1%1l St.DESIGNER AichereII
^_ r �-'
STRUCTURE Q'NEW L" PEMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE (J COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —__ -- LAND USE ZONE " _BLDG.TYPE ? FIRE ZONE w_ __PLAN CHECK BY dw h HEAT
1..-iict sin, le. family dwel n 3 flied,roor n
�<ti:` ;I1n [3rO Court) _
..IsY j v ,T aA` l�L.-15'[2� irt'�' C'J "d 2,aG' &WA& —
SEWERPERMITM _ t ,; � Ili '7caY't7ge 32.9 sq,ft.
_OCC.LOAD FLOOR LOAD 4 fi HEIGHT 12 NO.STORIES _ AREA 87 0 NO.BEDROOMS VALUE
BUILDING DEPARTMENT SETBACKS FRONT a':' REAR 44 LEFT SIDE RIGHT SIDE
Permit 1:.,1 .i�(1_ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _ 1. `.r'�? WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 1•Ori RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
(1.04 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax ,
— --- SDC— '> °i �O I
:t iii.0 A r
Total
PDC# $100.00 APPLICANT OR AGENT
By
Receipt No. ---------_
Approved 4 a y I ATDRE88 -� �PWONE
DATE IINSP. TYPE_INSPECTION REMARKS PLUMBING DATE
Contractor.
f _ _ Permit No.
Rough—in
G— O _ _
Fixture
Final —
HEATING
Contractor i
Permit Nol
Y �_A Gas u,Oil
Rough-in
Final
SEWER----- -----
- �V` Final _—_--
DRIVEWAY —
'—�—'-- ---�— Final --
Storm Drainage
(Rein Drain)Fit al
Sidewalk
Curb&Street Final
_ __ Approach
TEMPORARY CERTIFICATE OCC NCY
BLDG. DEPT.FINAL
Y_1r•ERIIFICATE OCCUPANCY Final
Landscaping
Zoning Final
04 9
BUILDING PERMIT APPLICATION TIGAR.0 DATE_ L.__�
THE UNDERSIGNED HEREBY APPLIE-S FCFi A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOIM,PANYING PL;\NS ANN SPEC;FICATIONS. OWNER PHONE ~
e DDG� �1 LOT'!O. e��s
0114 :ER FAL C 0 N 1:/�0U1•�'( UCTj8'yARESS I� l y w l3'��' y� '__ �_
ARCHITECT
Q Gc+ �11' O ENGINEER
BUILDER—d�AwtP� ADDRESS , ?%aDwi q'C DES:GNER /�tch _1Nel�,TNc
STRUCTURE NEW ❑ REMODEL _ r ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEILOL; I0t
RESIDENCE C COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS V PATIO ❑ CARPORT ❑ GARAGE ❑ STOR Gc ❑ SLAE❑ FENCI
G--_ u'rANCYLANDUSEZONE-_R-J BLDG.TYPE N__FIREZONE " PLANCHECKSY HEAT
_._ t i3a-44•
_;FWE;R PFa.arr a
OGG.LOAD FLOOR LOAD O HEIGHT ?NN
/z NO.STOiR ES- AREA 9lO.BEDROOMS VAL U-
(-- AUILCI�IG D'cPARThtENT SET BACKS FRONT za REAR �LEFT SIDE /O RIGHT SIDE I�T
P^rmit _ 157-00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EUILDING CODE,MCN!,
i REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 15 HEREBY AGREED THAT T HI
PI?.n Check 1D'f�0 WORK WILL SE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIA!dC:
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS FE9M'IT DOES NOT WAIV:
Sub-total ���00 RESTRICTIVE COVENA'JTS. CONTRACTOR AND SU5 CON i RACTO aS TO HAVE CURRENT CITY BUSIN
G`O LICENSE.SEPARATE PER'JIITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
:State Tax •
r� SDC— e
total /tY 1•0� l._t-���1 _�?t o'�`>�'�o'''_ _ --
PUG# APPUC UR AGENT
By By Receipt No. ADDRESS l--- - -
Approved PHONE
o o
o C�
;EWER CONNECTION S 7V' _
;EWER INSPEECTION `n 3y/
;EWER SURCHARGE: S
•nj?!fnof��C! R�'�d�. � '.L�'y� ._.-�. _ u� � �_�wII►MT' ""'"��.,--`�__
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