13915 SW 104TH AVENUE 13915 SW 104TH AVENUE
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BUILDING PERMIT APPLICATION TIGARD DATE 4 _,19_ `n 3498
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
OWNER '. it Canstk. �,OBADDRESS 13915 SW 104th Avenue
ARCHITECT
ENGINEER
BUILDER AEame — ADDRESS : 203 SE 28thp IJtld• _DESIGNER R. Jars^: Lioelc�l s
STRUCTURE M NEW O REMODEL Cl ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 11 DEMOLITION
RESIDENCE n COMM I❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _LAND USE ZONE .—f�--7 BLDG.TYPE {7N—FIRE ZONE- `w PLAN CHECK BY _ dwh HEAT— L n
_:I,etruct single Tamil ry duelling u/attnchad garage.--3 Qw:drooms I
.:1,E--ISSUE t,i Permit ;;'3.197 (13931b SW 104th Avc,nus)
SEWER PERMIT# �,� Qd: 75f1_L]LI
-- � - � � ARO sQ,. f t.
OCC.LOAD FLOOR LOAD 40 HEIGHT 12 NO.STORIES 1 AREA 1()i7U NO.BEDROOMS J VALUE
BUILDING DEPARTMENT — SET BnCKS FRONT REAR '52 LEFT SIDE RIGHT SIDE
Permli a 3.UO THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
10 Qn REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
•
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEPMIT DOES NOT WAIVE
Subtotal 173.an_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
• LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,FLUMBING AND HEATING.
Stile Tax
-- — SDC— 44UU.Ui!
Total 179. ..
— -- PDCN 11 f 100.00 APPLICOR AGENT
By P1
Receipt No.
Approved ADSRE�t3 ^� _ PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING_ DATE
Contractor
Permit No. oZ 0- �•2 Y— Y3 '�7)
n, AsGam. Ait�T=�. 's!-zt "ry/ Rough-in
C / Fixture
Final
— HEATING
-- Con tractor
--__—_—� Permit No.
Gas or Oil /
— �-------� - Rough-in
Final
-- ----- ----- - SEWER —
Vnel----- ----------
DRIVEWAY ---
-- — ------------- ----- Final —
Storm Drainage —
(Rain Drain)Final
Sidewal k
Curb 6 Street Final
- Approach ---
BLDG. DWT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY --
Landscaping
Zoning Final
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BUILDING PEP,M;T APPLICA T ION TIS, ��
THE UNDERSIGNED HEREBY APPLIES FOR A PERIMIT FOR THE WORK H=-A FIN INDICATED BUILDER PHONE Ux-V176
ORAS SHOWN AND APPROVED IN THE ACCOt.1PAfVYING PLANS AN
SPECIFICATIONS. Ov:;.Ea rH NE
•'ER J 't-J17�_�GM1��, JOB ADDRESS I,J�I�r 5��� LOT NO.
ARC;{ITECf K
[�_ ENGINEER ^7�
9ull^E}� m!� AIJORESS.7.lA3 2� DESIGNER-R.,1eAy 5 yFh� h
STRUMRE NEW ❑ REMODEL ;C ADDITION ❑ REPAIR —�
—.—�---_^ _— ❑ {IENE�YAL - ❑ FIREDFMAGE Ci DEM-OLITIOt:
RESIOENCF C COMA ❑ EDUCATICNAL L-_1 GOV_T C RELIGIOUS ❑ PATIO ❑ CARPORT C GARAGE C STORAGE [ eU,B❑ FFNCE
C-CCOFANCY � LAND USE ZONE �_ BLDG.TYPE .5-ti--FIRE ZONF PLAN CHECK BY
` '
HEAT__ --
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SEWER PERM IT 7vV ---
OCC.LOAF' FLOOR40_LGAD HEIGHT �z NO.STORIES --AREA �D_08 NO. BEDROOMS VALUE
44,
L_ BUILDING JEPARTh4ENTIf
SETBACKS FRONT Z2 REAR 3-� LEFT_.•_r ��.-_r`_, � RIGHT SIDE „r
Pcrrnit THIS PFAMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EU�LMNC CODE,t0P.:14G
REGULA'IONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGPEED THAT TF'_
°Ian Cheek WORK WILL BE DONE IN ACCORCANCE WITH THE PLANS AND SFEC1FICA T IONS AND IN C070PLIAUC'
r 4 WITH ALL APPLICABLE CODES AND OROINANCES. THE ISSUANCE OF THIS FERMIT DOES NOT WAIF:
�St.;�tata )7 RESTRICTIVE CGVENANTS. CONTRACTOR AND SUB CON i RACTOP3 TO HAVE CURF?ENT CITY @USINFSZ
LICENSE_SERA RATE PERMiTS REOL'IRED FOR SEWER,PLUP.13ING ANO HEATING.
5:ata Tax + (y,f l Q
Total `� SOC- &4
J BY J Pocro APPLICANT OR AGENT �- -- -----
�—
Receipt
Approved I pt No. -
ADDRESS i _--'.�----__-_�_—__--
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,EWER CONNECTION n
EWER INSPECTION S
'EWER SURCHARGE $
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