11965 SW 119TH AVENUE 11965 SW 119TH AVENUE ---
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CITY OF April ri 76 W 074
BUILDING PERMIT APPLICATION TIGARD DATE -• 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN THE ACCC"APANYING PLANS AND SPECIFICATIONS.
OWNER it-',in Kel.tiny -��-_- ADDRESS ll`. 6,) "''.,!. 11'Jt.11 BUILDER PHONE
ENGINEER
BUILDER
_ aRc HITC•CT DESIGNER
STRUCTURE ❑NEN' _❑REMODEL ❑_ADDITION_ E1 REPAIR [:]RENEWAL ❑FIRE DAMAGE— JDEMOLII_ION
❑ RESIDENCE ❑COMM [:]EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑-BOND C%IOVING _❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVE ❑SIGNS
OCCUPANCY- LAND USE 2C'NE=--BLDG TYPE - FIRE ZONCHEC
E PLAN K BY HEAT
Conotr uc,t J.L. ' A,'Q I adds`v;on on veer dwcj . fig --
install ltd' above car �Jnd alt MIT111lny puu:l, construct dock around pool.
-- - -- -
OCC. LOAD FLOOR LOAD_ HEIGHT NO.STuRIES AREA - VALUE
BUILDING DEPARTMENT SET HACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZUNINO
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
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- - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL'.ANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANff OF THIS PERMIT DOES NOT WAIVF.
- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING
Total '
APPLJCANT OR AGENT
Approved Receipt No.
ADD Eff
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DATE INSP. TYPE INSPECTION R—EMBARKKS PLUMBING I DATE
Contractor —_-- -
___ �+ Permit No. _
•.t -T �_,.� eFixture
Final
HEATING
/ Ghs-� — �/• t +-r G�-t'� Contractor
' Davy/ Permit No.
Gas or Oil
R ooh-i n
X1'30-7 AiM GJl ��J S,Te Final
U__YDi//YArJ�D•tJ /�GtCf� CiY//'�i SUSER -- -
L't')1 2l n/G, Final
�O �G ✓�a/1, /. vim':_—p��-L/j/1J.S DRIVEWAY
Final -
�%10 �� Storm Drina e
(Rain Drain) Final
Sidewalk
Curb&Street Final
A p poach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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PERMIT T4 CCNNE".'T
City of Tigard
?@rnilt Nf) X48 —
•
PERMIT IS GIVEN TO_ �
OF ----
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TO CONNECT A_____
TO THE SYSTEM OF CITY OF TIGARD
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AT—
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL COW
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID ;__ �} CITY OF TIGAR/D`
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CONNECTION INSPECTED AND APPROVED
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