8635 SW SCOFFINS STREET 8635 SW SCOFFINS STREET
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CITY OPo i
BUILDING PERMIT APPLICATIQi: TIGARD DATE ,y_ N- 0067
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER !" � r01
d ADDRESS BUILDERPHONE_
ENGINEER
-��r' �11 ARCHIT C _ DESIGNER
STRUCTURE ❑NEW 0 REMODEL OADDITION _ UftEPAIR ORENEWAL _ ❑FIRE DAMAGE ❑DEM�-OLITION
l.J RESIDI-NCE ❑COMM l_IEDUCATIONAL ❑GOV'T ORE' IGIOUSOPATIO ❑C.AR PORT ❑GARAGE ❑STORAGE SLAB QFENCE
_ L]BOND GMOVING ❑CONDITIONAL USE r❑DESIGN REVIeW OCOUNCIL APPROVED ❑SIGNS
OCCUPANCY —LAND W&E ZONE, L G. TYPE_ "'J „ _FIRE ZONE __ PLAN CHECK BY _ HEAT,-._._-
s
OCC. LOAD FLOOR LOADHEIGHT _ NO.STORIES _ AREA VALUE
_ BUILDING, PSA—RT-M _ RIGHT SIDE
SET BACKS FRONT REA1 LFFT SIDE
Permit
"- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED 'N THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CLDES AND ORDINANCES, AND 'T IS HEREBY AGREED 'THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC-TIONS AND IN COMPLIANCE WITH
Recording Ali. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE Oc HIS .'ERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRA.C.TOR AND SUR CONTRACTORS (J HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING ANO HEATING.
Total
BY ----
.aPPLICANT OR AGENT
Approved Rpcelpt No.
ADORESS
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DATE INSP. 'TYPE INSPECTION REMARKO PLUMBING DATE
��� :12 �' Via, �'t�;,.t• 71'C i�r� C�'�c�' __ Contractor -- - - --
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Permit No.
Rough-in —
^— Fixture
Final
HEATING — --
Contractor
Permit No.
Gas or Oil
—
Rough-in
F i roil
SEWER
_ Final
— DRIVEWAY
-- -- -- -- - �— Final -- -- ---
-— —^-- — — ------ - Storm Drainage--Y-
(Rain Drain) Final
Sidewalk
— Curb&Street Final
A roach
^— BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY `
CERTIFICATE OCCUPANCY Final �— —
Landscaping
IZooing Final --�
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Address .3 v_��1'�' � Permit No.
Name of Occupant 1,([,� ? a . Permit charge
Paid by
Date connected
Type of Building Qt.,4�4/1 Inspection fee _
Service Rate _ I �� Paid by ._ Date__"__�
C-,ntractor Assessment ZjJL,l l _Paid
Size of connection
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