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NOTE; IF THIS MICROFILMED 2 3 4 5 6 7 8 9 10 11 12
DRAWING IS LESS CLEAR THAN
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THF. QUALITY OF THE ORIGINAL
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Address Permit No.
Permit ci.arge 2w77 C.
Owner e Connection fes
Paid by
Type of huiidinr � a/� Date connFlr.tgd
i
;grvicP rata �� Inspection Fne
r,ontractor Paid by date V
.; ize of cimnaction Assesnmpnt Paid
r
BUILDING PERMIT APPLICATION 10 Y TIGARD DATE 7_4_77
1HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HE ZEIN INDICATED BUILDER PHONE
~o-�� �►
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
LOT NO.
I.r.,APieald 15790 31J Fjjghland 0 .
OWNER JOB ADDRESS HOME ADDRESS
ARCHITECT
ENGINEEF
�,Oyf1�. �jj3nder 6 i'158446DRESf, (DRENEWAL
BUILDER , OADDITION ❑REPAIR "RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
STRUCTURE X43NRW ❑REMODEL
RESIDENCE ❑COMM ❑EDUCNTIUNAL ❑GUV'T ❑RELIGIOUS��10 ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
�1 — r1
11BOND ❑MOVING ❑CONDITIG JAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
HEAT_ --
OCCUPANCY LAND LrOC i="F --_BLDG.TYPE= FIRE ZONE— PLAN CHECK BY,
f,UnSt. mmol pit -,) +..uvo.;r oll pf,r plane b code requiremurit.s
OCGJ.QAD _-— F1D-Qil QAD_..___- -- .JJEUUHT . ____NO STORIES --AQ,_8fDJ 491YL5—. _ VALVE----
BUILDING DEPAPITMENT SET SACKS FRONT REAR— —� LEFT SIDE __RIGHT SIDEy__ —_—
Permit _ 1G�aa -="J--- -
7ri:S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS /.Nn ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED 'THAT THE
WORK WILL riE DONT IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE C')DES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax •4a LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 10040
/ Ir.I _
BY APP cAlvT oR AGEyT
ApprovedRvcvipt No.
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CITY OP 11•� 'r�jo 0574
BUILDING PERMIT APPLICATION TIGARD DATE -- tg---
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED ?rNj RPHONE�_----
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AN E eJ C U r
�ar�il�atin fu ups. cat � InS�DoRe�_15790 3*Us Higlhlend .t» eU!jpEB E---_
SINNER
ENG;NEER DESIGNER
tMpsPI1s _ -ice uu1TFrT ---'-_`
AUILQLB
STRUCTURE LJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWr-A1L _❑FIRE DAMAGE DEM��O��LITIUN
O RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT []GARAGE ❑STORAGE r❑-1SLA13 []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESI_ GN REVIEW ❑COUNCIL APPROVED _ LJSIGN5
= — --- - i HEAT
(J�'D FIRE ZONE_" PLAN CHECK BY-- _-
OCCUPANCY�._— LAND USE ZONE-- DG.T_— YFE.--
Constraet a two ebory fraw.i pork V111 ,ilrsd 5 iI'Ic� a :Cc,rcJir, � tcs—1
opplroved plone —_.------ — — -
---- 2 bedraowa
OCC,LOAD FLOOR LOAD__ HEIGHT
NO.STORIES AREA VALUE
REAR LEFT SIDE RIGHT SIDE
BUILDING DEPARTMENT SET BACKS FRONT — _
WA
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THIS PERMIT IS ISSUED S 1JECT TO THE REGULATIONS CONTAINED IN THEES AND ORDINANCES, AND IREBY A'G CODE, ZONING
T IS Glh.-IiD THAT HE
°�� WpRK WILL BE DONENS AND ANLAPPLICABLE ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND N COMPLIANCE WITH
ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO NAVE CIIRRENT CITU BUSINESS
�iH L N;E�DtI P E PERMITS REQVIH,�D FOii WER, PLUMS-NG AND HEATING.
�.( � APPLICANtOR AGENTrf'W' Receipt No ------- ---- -
ADbRE`S
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor 1 4t, t-
c�.�i.-L-► — Permit No. ry-41)
Rough-in --
n
Fixture
Ficial —,--
1_�.�r /,,_ �,► SSB _—HEFTING
Contractor
Permit No. U
SP1/-76 Gas or Oil TALS
Rauh in _
Final
SEWER//-,. 7f
_ Final
DRIVEWAY LG /--V
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final _
A roach L G /— ? F- 7,//,
BLDG.DEPT.FINAL TEMPORAFY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
r7 / Landscaping
Zonirg Final
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City of Tigard
INSPECTION REQUEST
for
Pe,IV[r,✓RY
IOPECTION TIME: ���" - PERMIT NO. :_._ .__
DATE : ._L1 ALLY DATE ISSUED
OWNERS NAME . _
ADDRESS:10.0L�_4Qsstr�r
CONTRACTOR
Tr-ST: Air Cj, Woter El , Visual, Laboratory O
�+FSLILT Approver! Disapproved E Pending []
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