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INGPERMITAPPLICATION TIGARD
DATE-
BUILDING J
BUILt3 19
THE UNDERE'GNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHr"JE .
LOT N0. L •a 1�� .i1't'
f.�C`CJr IJ• Penrose JOB ADDRESS �.�!'n rlti • View
OWNER _ - ARCHITECT
, hove ENGINEER t7t+Ine r
OwnPY �i 1IGNER _
BUILDER _ ADDRESS _._. ---.------
_STRUCTURE _—_ ❑ NEW Cl REMODEL _E701_0DITI. . --O-REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE [-]-DEMOLITION
C F-1ED_UCATIONAL El ❑ RELIGIOUS-
L) PATIO ❑ CARPORT ❑ GAFIAGE ❑ STORAGE ❑ SLAHU FENCE
RESIDENCE ❑ COMM
I _ dwn HEAT rLam
OCCUPANCY LANDUSEZONE _ `7BLDG.TYPE 5„ _ftZONE_ PLANCHECKBY
--
-- C'c�r.^t.1'�tr,i~ t�k°r?xC7�t;, �r3f it1L`+ti1 (2nn_floor) to mingle
—family
--- ,_..-.3;I? CO]�T�t:(`.`I'XCD*> F�}•��:;�}.� ���""�f`Iai?1).
SEWER PERMIT#
OCC.LOAD FLOOR LOAD HEIGHT 1) NO.STORIES -- AREA 7_ N0.BEDROOMS 1 VALUES Rty.
_ BUILDING DEPARTMENT SETBACKS FRONT REAR - LEFT SIDE RIGHT SIDE
Permit �'3, •?I� THIS ^ERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 7.ONINQ
c o.! REGULATIONS AND ALL APPLICABLE CriDES AND 011.DINANCES, AND IT IS HEREBY AGREED THAT THE.
Plan Check • WORK WILL BE DONE IN ACCORDANCE WITH THE PL%NS AND SPECIFICATIONS AND IN CJMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE 1550ANCE OF THIS PERMIT DOFF NOT WAIVE
Subtotal •53 RE-STRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax •`'')
Total a �• •
PDCM APPLICANT OR AOENf
Approved R Receipt No. --
jwj w aw
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
yi7i _-- Ji Contractor
Permit No.
Rough-in
hixture
�— -- Final
—' HEATING
Contractor
Permit N,u, `
-- _— G,.or Oil `
Rough in
- —-- Final-- —,--�..
—` SEWER
Final
-- DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. OCPT, FINAL I TEfi1PORARY _ rCCRTiFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
L�.� �—�•— —�`• .— Zoning Final
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APPROVEC) FOR C(NSIO, r "tItIN �
CITY OF TiGARt, 9,t 09)
P PM �4�„"T! �1Tf nf)�317E::,' V I'&j L.G7n t
ay 3w / TITI L oA;i 3-,v ��
BUILDING PERMIT APPLICATION TIGAR:)
THE UNDERSIGNED HEREBY APPLIES FOR A PERmIT FOR THE WORK HEREIN INDICATED BUILDER PHONF—of- 7.
Ol.AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AMD SPECIFICTIONS. OWNER PHONE 1 �
�""",, yLOT NO. 000
()ANEPc.V. L,_P�v�s� JOB ADDRESS j;S& T h)_L 4-_(a* LGM'C --
���� �v ARCHITECT
NM�/'"'
BUILDER V//��wMt'r ADDRESS ENGINEER —
/Jf0�Je+� DESIGNER W
STRUCTIJRE F-1NEW
— ❑ REMODEL ADDITION REPAIR ❑ RENEWAL —❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE J COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT [i GARAGE G STORAGE ❑ SLAB❑ FENCE
C)CC;UPANC'Y _.2_.LAND USE ZONE -LS' __BLDG.TYPE __—FIRE LONE—" PLAN CHECK BYHEAT_,�+___
SEWER PERMIT N ,
OCC.LOAD FLOOR LOAD HEIGHT �� NO.STORIES L.- A1EA f+L� NO.BEDROOMS !ALUr�(,I&'G
_ BUILnINGDEPAR7MENT SETBACKS FRONT ^ REAR LEFTSIDE RIGHT SIDE:
Pemit 9!' v THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZON!NG
t REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TPAT THE
Ilan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
— WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF arms PERMIT DOES NOT WAIVE
Sub t_etal _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES:
—�- LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;Staty Tax
^ SDC—
Total PDCN — --- -- _____ ---
APPUCANTORAGENT
By
Receipt No. -- --- --
Approved ADDRE.:S � PHONE
S(JC -
PDC - -
SEWER CONNECTION $
SEWER INSPECTION $
SEWER SURCHARGE $
c
V07 aca.0 40 z&jV 02AF76-oot-w j
/r fa 4 rl- � a-t141<7 sat"V_ 161MV&
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO.:
DATE: DATE I - --,JED:
OWNERS NAME : �?- t,) CS-01L
ADDRESS : Z2,kO- .ik,
CONTRACTOR 'e4-
TEST' Air CJ, Water 1', Visual$ , Laboratory
RESULT*. Approved Disapproved El , Pending L-]
SKETCH'.
——--—-----------------------
, T
'A
NSPtE(;TOR DATE
EN OTE Attach supplemental test data herst:01