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BUILDING PERMIT APPLICATION TIGARD DATE_ 19 _ 4174
THE UNDE=RSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED [1UILGtR PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
OWNER l._+., :JY' i',"t: LOTNO. l;j?= 21S �..i�.�_.-_
JOB ADDRESS
ARCHITECT
1.leorgia Parifir aF�ovo ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE L] NEW El REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL_ ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE 13 COMM LJ EDUCATIONAL 17 GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT CJ GARAGE O STORAGE ❑ SLAB FENCE
OCCUPANCY _LAND USE ZONE i- ELDG.TYPE ''1 FIRE ZONE_ PLAN CHECK BY I i _HEAT 1
is nent modification for �xi.st. tovar>,t p t;wo>r+�i�c r.ific ---_
-- AIL )r-r plans it colt'. nt^} • per-pit re—juira --
SEWER PERMIT K
OCC.LOAD FLOOR LOAD C,'(! HEIGHT NO,STORIES —1. AREA NO.BEDROOMS _VALUE
BUILDING=DEPAATNIENT SETBACKS FHONT ' ,-MAR LEFT SIDE RIGHT SIDE _
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 70NING
___f__'
REGULATIONS AND ALL APPLICABLE 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 COMPLIANCF
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA!'VE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total },' SDC -
PDC® APPLICANT OR AGEN1
By i.rri
— Recelpt No. Itr.�, �
Approved nDOREAs PHONE
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor - - —V
Permit No.
Rough-In
Fixture
—
Final ----
- --------- - -----_._—.—_ HEATING
—T^
Contractor
Permit No.
--_._ Gas or Oil
----- ----- ----— -- -- -Rough-In
Final
SEWER
Final
—.... _ ------ ---------- — D R I V E W A Y
Final
Storm Dralnaga
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT,FINAL TEMrORARY CERTIFICATE OCCUPANCY
CERTIMCATE OCCUPANCY Final
Landscaping
2oniny Final
1
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