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BUILDING PERMIT APPLICATION TIGARD DATE - _ +s____- 4..4.E
THE UNOEHS!GNED HEREBY APPLIES FOR A PERMIT FORTH EWORK HEREIN INDICATED GUII_DEr PHGNE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWN_R PHONE
LO i NO. _—
OWNER 111M. TRflEs IND. JOB ADDRESS 12000 .`i.. -2nd Ct.
"' i!ille�bcra� fir• ARCHITECT
ENGINEER `Jvrri ,lt1i�.�1CT)
BUILDER '�7 "�`•'� ADDRESS 2300 STN ?r*a ':r1• DESIGNER ^_
STRUCTURE [It NEW ❑ REMODEL ❑ ADDITION _ ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
F RESIDENCE ❑ COAM ❑ EDUCATIONAL GOVT [I RELIGIOUS ❑ PATIO ❑ CARPORT 11 GARAGE ❑ STORAGE D SLAB FENCE
OCCUPANCY -3 ._LAND USE ZONE l7—i BLDG.TYPE 'i FIRE ZONE — PLAN CHECK BY - �i HEAT _
---- r,Gnstrur_t jingle Family dju?elliw� wr!attachetl Carepe Plucibinc!: 9 Tr€Lps 1 IN Z GAP', Dist +;
— - — ----- - lll�rgi water - :.,. .
SEWER PERW M ' + _ —_ a:�r tc;y+�/ftAa 3 tlmdroom ) _,,nths
OCC.LOAD FLOOR LOAD 401 HEIGHT _ STORIES ! AREA NO,BEDROOM_ S 3 VALUE
-BUILDING DEPARTMENTS ET BACKS FRONT w'�1 REAR LEFT SIDE RIGHT SIDE
_ _ _ _
Permit Ir;•UU THIS PERMIT IS ISSUED SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
2i.+y•i,,0
REGULATIONS AND ALL APPLI dABLE 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
)21.41) WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES N01 WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE C ENT CITY BUSINESS
iia LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING(
State Tax -tea-c��
+.QAC SDC— �+0. .,_,u
Total !f l �f ( E J(l `y IQ/t` ;� �Iv
By PI'C#s I 1006I)t1 APPLICANT OR AGENT —
_ Receipt No. a iso k 2CJCo� 664c) . �_�1—C,,c)
Approved rtE3 _g (' d V• ADDRE156 PHONE —
i
DATE INSP. TYPE INSPECTION
REMARKS
PLUMBING DATE
Contractor
A
Permit No %
11011gh-In
Fixture
B GC
Final
Ac HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
)K,_0
SEWER
Final
nRIVEWAY
Final
Storm Drainalip;
(Rain Drain)Filial
Sldevmik I Curb&Street Final
BLDG, DEPT. VI-NAL _
_
A;iproachMORFy CERTIFICATE OCCnERT1"ITAPE OIUIANCI
fine
Lanust 131,19
Zonini,Final
BUILDING PERMIT APPLICATION TIGARD DATE_—_ 70ts�
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TI iE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNEP.PHONE
LOT NO._! —
O;NNER .,JOB ADORES
S
ARCHITE
' ENGINEE '/
BUILDER �.0 Q'�V-
' 9DRESS DESIGNE '` ,
STRUCTURE ❑ NEW ❑ REMODEL. ❑ ADDITION ❑ REPAIR Cl RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
❑ RESIDENCE ❑ COMM D EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE ❑ SLAB❑ FENCE
OC.C.ii NCY -kVLAND USE ZONE a_� BLDG.TYPE &..—FIREZONE-- _PLANCHECKBYT_r✓HEAT.r T_
SEINER PERMIT M �~ _ �._.__v_ �-_.�_—�� ,! "•`� � �� — _ /'/ —`..
OCC.LOAD 44 FLOOR LOAD l( (,� HEIGHT � NO.STORIES I AREA '111 I NO.BEDROOMS
BUILDING DEPARTMfiNT_� SET BACKS FRONT �I) REAR_ l� I—
BUILDING LEFT SICE 9�-t:J RIGHT SIDE I
EPInn
QQ_ THISPERM17 IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE,LUN!NG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
eck j, WORK WILL. BF. DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COrdPL1Al4CF
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV:
Sub-total S 2 LL}D RESTRICTIVS COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
3tato lax J o
SDCTotal --
-- PDG# APPLICANT OR AGENT
By
Receipt No.
Approved ADD ESS — — PHONE ----
Ao Al
Poc
4jJ
SEWER CONNECTION b 9 Iq.3
SEWER INSPECTION $ _ � S: o 9
SEWER SURCHARGELLILD
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