9570 SW LEWIS LANE °e° -w
9570 SW [.fsWIS [,ANE
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BUILDING PERMIT APPLICATION TIGARD DATE_ NX2 0386
THE UNDERSIGNED HEP c:BY APPLIES FOR APES MIT F()p THE WORK HEREIN INDICATED
OR AS SHOWN AND A''PROVED IN 'THE ACCOMPAi4YING PLANS AND SPECIFICATIONS. OWNER PHONE__—.--__.__...__
9te1oVIN Gr�fc1�.9t� il..,le L:�1ai! ! �Qllt:i
OWNER _ ADDRESS BUILDER PHONE
E_NG�NEER_
$,U11_DER :^ ARCHITECT DESIGNER
IT []NEW LI REMODE . ❑ADDITION Q REPAIR _ ❑RENEWAL ❑FIFIt DAMAGE ❑DciywLl I IUN
QRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [-]CAR PORT ❑GARAGE ❑STORAGE❑SLAB EIFENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY---LAND USE ZONE— BLDG.TYPE _FIRE ZONE_ PLAN CHECK BY HEAT--—__
YfI7tJJ1 S'Wtl .1.ii j W.Lt_Il cuILIp 3Rtt1 :yAt�;i
rsplove approx. 7 Shoots tjhsa!thirlg _-- ---
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES _ — AREA _ VALUE
BUli nING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit — -- — --- ----- — —_ ---
-- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON;NG
flan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, 4ND IT IS Hr9EBY AGREED THAT THE
WORN WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFY ATIONS AND IN COMPLIANCE Wil H
Re-ording ALL APPLICABLE CODES AND ORDINANCES. THE ISSU.NCE OF TI';S PERMIT DOES NOT WAIVE
--- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTONS TO HAVE CURRENT CITY BUSINESS
1%State •27 LICENSE. SEPARATE PERMITS REQUIRED FOR SE:.r.R, PLUMBING AND HEATING.
Total 1 .27
c v r f a+
APPLICANT OR AGENT
Approved Receipt No.
ADDRESS � HV
ij
DATE INSP. TYPE ItOSPECTION REMARKS PLUMBING DATE
co"(factor
7t
Per-nit No.
Rough-in
Fi-tture
rinal
HEATING
Contractor-
Per nit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
8 ED C-.--ri 1�f,;Ff A L TEMPOFARY CERTIFICATE OCCUPANCY Final
CERT,r'CATE OCCUPANCY
Landscaping
Zoning Final
J4
Address V .,-4 A Permit No. 61
Name of Ocrupant-_ Permit char
074--J-e b
ce"lleefifflp 3
Paid by
Date connect,)d—,.-
Type of Building Inspection fee
Service Paid by Date
-
Contractor.------______ Assessment-/-4 ,-,.T (') -Paid
Size ize of connection,