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BUILDING PERMIT APPLICATION TIGARD 5379
THE UNDERSIGNED HEREBY APPLIES FOR A PE;MIT FOR THE 1.6,11K HEREIN INDICATED BUILDER PHONE _02-3+3
Oil AS3HOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEC IFI('ATIQN�S. OWNER PHONE
LOT NO.
OWNER T�,tan YrO�lRrties JOB ADDRESS Ik_._23(1_ Sid Fat�da- CQek ek IY
20945 Sid IV highway ARCHITECT
K Y EN e'NE,_R
BUILDER SARK. ADDRESS AlQha, OR 97( 6DESIGNER
STRUCTURE 11 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL U FIRE DAMAGE ❑ r)EMOLITION
RkRESIDENCE ❑ COMM O EDUCATIOIIA_L ❑ GOV'T O RELIGIOUS ❑ PATIO ❑ CARPOR7 ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _._LAND USE ZONE _ �_._._BLDG.TYPE 5N ^ FIRE ZONE PI ",A CHECK BY'..Abt HEAT
GOnetruct eirLqle faAi_ ly d1jelling with attached_ wytlr+agee
Re—Issua of Permit 04843
2 Bathrooms 3 13edrooar.s Garai 315
SEWER PERMIT# 2$425
OCC.LOAD FLOOR LOAD 40 HEIGHT_ 13' NO.STORIES 1 AREA _1061 NO.BEDROOMS ;, VALUE 41
BUILDING DEPARTMENT SETBACKS. FRONT 17 REAR 32 �LEFl. F_ 10' RIGHT SIDE 13"
Permit 269.50 THIS PERMIT IS ISSOED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ANLL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
P,anCheck 40.00 WORK WILL BE DONL :N ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCIFS. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 309.50 RESTRICTIVE COVENANTS. CONT TACT. fc ',ND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
4 10.78 LAgENSE.SEPARATE.PERMITa REOUIPLD FOR SLNER,PLUMBING AND HEATING.
.fate Tax , DC,
Total 320.2$ SDC— a(111,;1U
—'---- PDCN jt y1g(1�0i) �PP[.ICANTORArEHt
BY (:i:
V Receipt No.
80
Approvsd C,DDR t38-� PHONE—
i
-1DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Permit No.
Rough-in
. .
a2 Fixture
9 000
_ -- Final -- - -
(r �� HEATING -—
� s7t Contractor —
����T.- •--1./-l���V ------ --
Permit No.
v
- '—_ Gas or Oil
Rough-in
_.— ----- -- —__. Final --- r.---
SEWER
.—.--- ------ ----- --- ---- Final
- ~-- ---____--- DRIVEWAY .
Storm Orainagn
(Rain Drain)Final
_— `— ------ Sidewalk ----
Curb&Street Final
Approach
BLDG DEPT. FINAI. TEMPORARY CERTIFICATE OCCUPANCY
^_ERT rICATE OCCUPANCY Final
— I an,inc, ing
Zonin-'�=inel
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