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CITY OF 7' N2 06'96
BUILDING PERMIT APPLICATION TIGARD DATE _ —, 19
THEUNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICAED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
a.♦ ti'ii3L"rl ,fli LaL':o , • a\JISI<�IlliitGYlfMk1�. BUILDERPHUNE _
OWNER _ _�__-- ADDRESS -- _
3i,FP1 C ENGINEEP
ARCHITE T DESIGNER
—"'—
STRUCTURE ❑NEW QREMODEt. _❑_ADDITION_v ❑REPAIR —_❑RENEW_ AL— i1FIRED_AMAGE ❑DEMOLITION
C3F,ESIDEIICE ❑COMM [1E0UCAIIONAL OGOV'T ORELIGIOUSOPATIO ❑CARPORT 7]GAR� --F ❑STORAGEI❑SLAB_❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REV{FW OCOUNCIL APPROVE[` ❑SIGNS_
OCCUPANCY—LAND USE ZONE---BLDG.TYPEZU:IE—_ Pa AN CHECK BY__—_ _
�:onstruLt ets�R r t dwellim —
--- RNc room and t)rth --- —____--- --
— _
CICQ LOAD FLOOR LOAD HEIGHT NO.STORIES _______.____ AREA VALUE
81 GILDING DEPhRTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE —
Permit T�1�-
THIS PERMIT IS ISSUED SUBJECT 'TO THE REGULATIONS CONTAINED i!; THE SU1LDIN» CODE, ZONING
Plan Check 91EGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY Ar-REED THAT THE
-- -- WORK WILL BE DnNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— --- -- RFSTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS iO HAVE CURRFNT CITY RUSINFSS
State LICENSE, SEPARATE PERMITS RE..UIRCD FOR SEWER, PLUMBING AND HEA- Jt G.
Total
By APPLICANT OR AGFNT
Approved— Receipt No.
DAT' INSP. TYPE INSPECTION REMARKS PLUMBING DATE.
Contractor
Permit No. P.3 S
Rough-in
Fixture
Final
------ I LFi nr,,---HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final SEWER
Final
DRIVEWAY
Final
Storm g�r
(Rain Drain) Final
Sidewalk
Curb&Street Final
roach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
a rl
CE "vICATE OCCUPANCY
Landscaping
Zoning Final
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT Nt) 1063 DATE
JIFR311T IS GIVEN TO
OF
—�—""-
TO CONNECT A
TO THE (SYSTEM OF TaIGARD S�ANITART DISTRICT
i
THIS PERMIT MUST BF POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $.... ...........................TIGARD SANITARY DISTRICT
9�
BY
7v�Z-
CONNECTION INSFECTFD AND APPROVED
Superintendent
d� I
Address, i[ ��,,��'rn�''-'- a-__�•____ Permit No..../ 6 J
Name of Occupant _ Permit charge
Connection fee----
Paid
ee_ __Paid by
_. Date connected
Type of Building_---.-- -- -- Inspection fee -- - —
Service Rate_.. —.� — -- - - Paid by
Contractor_---,---__--------.__- __ _ - Assessment_ _. Paid
Size of connection
I