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BUILDING PERMIT APPLICATION TIGARD HATE_ u/22/ ,19__ r 3362
THE- UNDERSIGNED I IERFRY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER r'. ' 644-9039
CSR/O5 SHOWN AND APPFOVED IN THF ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_�T—
N..,IcM tax Lr,T N0.426. 2S1-300
OWNER (.ZOGst Prinut; JOBADDRESS 10920 SLI Fair.*-.-..«+ Way_ Lot 12#H .621 ru_ ewCt.
ARCHITECT —
ENGINEER
BUILDER _LOno–Fab/3.1'. 410odS ADDRESS 870 5j 123rd Ct. # Ptld DESIGNER
STRUCTURE A NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS J PATIO X CARPORT ❑ GARAGE U STORAGE ❑ SLAB❑ FENCE
OCCUPANCYII'i-1 LAND USE ZONE x-10 BLDG.TYPE bN —FIRE ZONE__-PLAN CHECK BY _r3w� HEAT —^
Constructp�rivete boat store9e accessory builc}i iq___er plena and code.
rIWner to valify deet( reg trictions ii' any.
SEWER PERMIT#
_OCC,LOAD FLOOR LOAD HEIGHT 11 NO.STORIES -_l AREA b*?6 NO.BEDROOMS -- VALU$5176.0.
BUILDING DEPARTMENT SET BACKS FRONT 80 REAR 6 LEFT SIDE 116 RIGHT SIDE 6
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND OHDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 1U.00 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 �%4.00-� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TC HAVE CURRENT CITY BUSINESS
State'Fax 4'w 1.AQ LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND H!ATING.
Total ;55.41 SDC—
_
PDC# APPLICANT OR AGENTBy P1
lRecelptNo.Approved duhADDRESS PHONE -
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Con tractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Dralnapp
(Rain Drain)Fli,.l
Sidewalk
Curb&Street Final
— Approach
QIYs DEPT.FINAL rimpoRARYi 0LCLP CY
CERTIFICATE OCCUPANCYPj Final
--
Landscaping
7-ming Final
No i M'i t
BUILDING PERMIT APPLICATION of
11TY TIGARD DATE_,.� py —_ , 19'r 9 _.. .
TI!F UNDERSIGNED HEREBY APPLIES FOR APERMI"T FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
�ryy��yy/� LOT NO.-
B p7
OWNER , �i1�4L u '�rJOADDRESS 14Q SU f*airhaven i. 49M.ADDRESS -- -
ARCHITECT
ENGINEER
BUILDER, if-igtigin .'jLQfjfJUFij1 -DESIGNER:':2,�2L3
[:]NEWr^-1
STRUCTURE
NEW ElRFMODEL ❑ADDITION LIREPAIP ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GCV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE[]SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REdIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPAI.CYP +•J—_LAND USE ZONE_1L—lr__BLDG.TYPE--- _FIRE ZONE--I PLAN CHECK BY ' j _—__ HEAT
Asci 22 A A t UK-11A i91 U2dr1)0M Ind 9aatPt
PltJmbia4 Permit ►�aquirvd*
QLOAD_ FLOOR AP 40 _--EFJ-th'T `�� NO 6-T-OaL� � —AR=�----�U.FQRQQMS VA.LJItJtQCJ��'
BUILDING DEPARTMENT SET B14CKS FRONT REAR LEFT SICE RIGHT SIDE
Permit —� ;04121 IOU � ---------- --- -- ----- - —_—_
- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ,;,�0113 REGULATIONS AMD ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ? �UO ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT ;NAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
StateTax A 2.08 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ion.ou
By . APPLICANT OR ACFN1
Appro�ed�� ' Walden Receipt No. 222q
3! , f
DATE INSR TYPE INSPECTION REMARKS
PLUMBING DATE
_ Contractor
No. �tl. `M''79
e+/— 77 av' _lµ,,N !'u�w t O.� Rough-In
Fixture
—
Final
_HEATING --_ ----�^�
Contractor
Permit No.
Gat or Oil
Rough-In --
Final
SEWER A
Final
DRIVEWAY —�
Final —
Stormi Dralnege
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach -----
BLDG.DEPT.FINAL TtMPORARY ERRTIrICATt?OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final