12140 SW HALL BLVD 4
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12140 SW HALL BOULEVARD
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BUILDING PERMil APPLICATION IIT TIGARD DATE _, 19 79
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDvERPHONE --_--
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
LOT NO._ _
OWNER ' Oil Moes-' JOBADDRESS 12140 9"'1 Hall Blvd. HOMEADDRRSS
-- ARCHITECT --J
;�ANIEI 1023 Lund L.1!. ENGINEER LI�b-�Qgit/
BUII.GER ADDRESS _� DESIGNER
��SIRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL []FIRE DAMAGE ❑DEMOLITION
AF.SIDENCE LCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIr,IOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE.❑SLAi3 ❑FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY__. LAND USE ZONE. BLDG.TYPE _FIRE ZONE— PLAN CHECK BY__ HEAT_ _
LltarRalitit3il (if >residencs - Foundation to be demulisharti and ela b to be L'Cok*�- ,
-� SenitaLy sewer to tae tipped per CoV* at pxuperty lirte.
IC.C-LQD -_._FLQUR-L�2AD -- N9 -WI NO.BEF �MS LBL -----
BUILDIAG DEPARTMENT SET BACKS FRONT REAR I.FFT SIDE RIGHT SIDE
Permit °1 C1. 010 -
-- THIS PERMIT IS ISSUED SUBJFCT TO THE REGULATIONS CONTAINED I'V THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TME
WORK WILL PE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS '; AMIT DOES NOT WAIVt 1
RFSTRICTI,/E COVENANTS, CONTRACTOR AND SUB CONTRACT ,,AS TO WkVE CURRENT CITY AUSIIAI
Slate Tax A .40 LICFNSF SFP'.^ATE PERMITS REQUIRED FOR SEINER, PLUMr,NG AP!_^ !!GATING.
Total it).40
By p1
APPI_scANT OR AGF N1
Approved T!J Receipt No. 147()2.
DATE INSP. TYPE INSPECTI-INREMARKS
PLUMBING I DATE
Contractor
PerNo.
mit
_ --
Rough-in
Firturo --
Final
HEATING -
Contractor
Permit No.
Gas tx Oil
-�� Rcogh-in —
------__ - -Final
SEWER --
- Final
DRI-1 r--WAY
_-_---- Final — -
Sto,-Drainage
(Rain Drain)Final
_----•- -- _.— Sidewalk --
----- Curb A Street Final
Approach
BLDG.DEPT.PINAL TEMPORARY CERTIFICATE OCCUPANCY
CER'T'IFICATE OCCUPANCY Findl
Landscaping
Zoning Final �-`^�—
CITU OF
BUILDING PERMIT APPLICATION TIGARD DATE_e_ L'h 26 ,A 7f; W 0730
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 1HE WORK HEREIN INDICATED -13
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE----
OWNER L.61Qr1 C>1X --- -- AJDRES3 L.C14O �W• Hall l31VCi• BUILDER PHONE
Parry's Oioplay ENGINEER
BUILDER
_- ARCHITECT _ DESICNER
ST -TURF r-ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FI!-REDAMAGE ❑DEMOLITION
Qtrr' DENCE 0CCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO OCAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
_LIBOND ❑MOV ING r - ❑CONDITIONAL USE — ❑DESIGN REVIEW ❑COUNCIL APPROVED OSIGNS
UCCUPANCY LAND USE ZONE BLDG.TYPE ---FIRE ZONE__ PLAN CHECK BY HcAT
F x Ia® Sitsnding Polo Sign .lc .t•��, -- — -_=
Copy - Fox Rox Hand Crafted it..ms -- cglars wirti.-.r brown bwcksjtuund
C LOAD FLOO9 LOAD HEIGHT £� �•
Qom---- NO STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 00 - - ---
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICA13LE CODES AND ORDINANCES, AND IT' IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AI.D IN COMPLIANCE V4ITH
Recording ALL APPLICABLE_ CODES AND ORDINANCES. THE ISSUANCE O' THIS PERMIT DOES NOT WAIVE
RESTRICT4VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State LICENSF. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AN3 HEATING.
Total 7 TM Du—
By
-- APPLICANT VR AGENT
Approved Receipt No.
-- .-'-..�-. ADORES$ ---------- ---.....-------��C)NE--- -.__.�`------
PERM-? TO CONNECT
Tigard Sanitary District
PERMIT M 642 DAT
PERMIT IS GIVFN r0
OF
TO CONNECT Ar�/� J��'L4 ----
TO THE SYiiTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST RE a LISTED ON THE INNIECTION
RIBF.D PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF HAS BEEN COM-
PLITED.
PERMIT FEE PAID ;.2, !..O..v.............TIGARD SANITA ISTRICT
By
.AAAMAAAMM
CON NECTIONV INSPECTED AND APPROVED
-��-- �nam- up
��----. ...
Se e,dent
Address./12/ !V Q Z'w j ALS.�c Permit No. IS
-�-
Name of Occupant_cel Lt�rL, ' L Permit charge 1�� C/ 4-1f
A- Z4 Iv
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'
-- - Paid by �—I --
Date connected
Type of Building i! �� — Inspection fee/dS.O _._
Service fiats .,[ Oy Paid by _Date Ju.,,,4 24''Gti
Contractor /^ t�-t/) � _ _ Assessment
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Size of connection