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CITY OF T,GARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Bella Code, the
following item(s) require correcting:
F
A?
Date:—
Permit No.
Inspector
CALL FOR REINSPECTION
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' ► 9426
BUILDING PERMIT APPLICATION 11TY TIGARD LATE �__ �' '.f—a� _ 19'•" 04
01-
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 'THE WORK HFREIN INDICATED BUILDERPHONE ''A 31 JI
OR AS SHOWN AND APPROVED IN TNF. ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE --
LOT`lO.�� _�—
OWNERLyW4JOB ADDRES% J�7 + a—i. ►fit* ;++..i�1- w iUWEADDRESS
ARCHITECT
ENGINEER
BUILDER _ADDRESS �1�_ DESIGNER
STRUCTURE NfW ❑REMODEL ❑AUDITION OREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCF ❑COMM ❑EDUCATIONAL EGOV'T ❑RELIGIOUSDPATIO ❑CARP(--- ❑GARAGE ❑STORAGE OSLAB ❑FENCE
❑BUND DMLIVING 000ND1TfONAI USE []DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANC'Y.�„y.,�LAND USC ZONE BLDG. TYPE �L.__.FIRE ZONE,— PLAN CHECK BY__-_ ,,, _— HEAT_
..A"1t1b-._all tfTEft
1.' '• !-1.1 ; _14PLA:111 Qaf'
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- — } uun'I' _U,4)n vrm,tt. Issuad 10/lij/71b g23t.4
H.EIQHT_ -----_N9 $T_ Jr AREA� {l�LyO I��.QN2QNS VAL 5�•� ' �C�fi9
BUILDING DEPARTMENT SET BACKS FRONT REAR J LEFT SIDE RIGHT SIDE
Permit —
`1 Tr,"S PERMIT IS ISSI.IFD SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20NING
Plan Check REG'JLATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WOR1, WILT_ BE DONE IN ACCORDANCE WITH THE PLANS A14DSPECIFICATIONS AND IN COMPLIANCE WITH
S,Jb total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
—'-' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFFS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
46n.r, 6
By
--- APPLICANT OR AGENT
Approved RP(:Pil)l No
CATE INSP.1 TYPE INSPECTION REM"i-KS PLUMBING DATE
Contractor
Permit No
Rough-in
S
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Firal
Sidewalk
Curb&Street Final
Approach
BL6G. DEFT.FINAL Tf:MPORARY CERTIFICATE OCCfANCY
CERTIFICATE OCCUPANCY Final
Landscap,rg
Zoning Final
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)'(JILUING PERMIT APPI-.ICATION r;,HY TIGARD OATE1
.,AF IINF)F RSIGNED HEREBY APPLIES FOR APFRMIT FOR THE WORK HERE;N INDICATED BUILDERPHON '
t-+l AS SH,)WNd ANP 4PPROVFD IN THF )�QPAI�NG PLANS AND SPECIFICATIONS. OWNER PHON�
�zjj I-OT NO (a
( B ADDRESS ARCHITECT
ENGINEER
DERADDRESS DESIGNER _—
JCTURE e<EW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑F-IRFDAMAGE. ODEMCLITION
K!OfNCF ❑COMM ❑EDUCATIONAL OGOV-T OREI.irooUSOPATIO OCARPORT ❑GARAGE ❑STORAGEDSLAB [IFENCE
I:_POND_ -OMOVING- []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
..CL'PANCY� LAND L!SE 70NE� BLDG.TYPAL_ FIRE IONE� PLAN CHECK 8Y HEAT
Ink j
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AREA 1� 5(
':c_._Q4.Q____.�__E.►.S�QAL.S�.AR.._- ------_ Neic:Nt—____-..—►.��SIQflI��. ARI`_ NQ,"12R40M§7�. VA U6391,
FU LPING DEPARTMENT SET BACKS FRONT V REAR LEFT SIDE RIGHT SIDE
omit
-4'7
�` Cx-�yzrSni_Cri
------ —' TH•FS PERMIT IS ISS .D SUBJECT TO THE RFGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
'Ian Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCFS, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS A140 SPECIFICATIONS AND IN COMPLIANCE WITH
:Ub-10181 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- - RESTRICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
,tate Tax LICENSE. SEPARATE PF RMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
oral r ��
3v
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----__-__--_. APPL(CANT O(0 NT
rpprcved Receipt No.
— --- — r�__ -- — ---- ----»�.--------__—
AC1f1HL55 PHONE
CITY ►��► ,
PUILOING PERMIT APPLICATION OF t . ARU DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE_
OR AS SHOWN QND APPROVED IN THErING PLANS AND SPECIFICA'1IONr. owNE1dPHONE_
�J
OWNER JOB ADDRESS � 0 Lake 5IL;(? HOME ADDRESS
-- ��— ARCHI-ECT
1-NGINFER
BUILDER ADDRESS DESIGNER
STRUCTUHE ❑NEW ❑wmnDEL ❑ADDITION ❑REPAIRt-1 ❑RENEWAL ❑F,REDAMAGE ❑DEMOLITION
C3 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED [:]SIGNS
QCCUPANCY ' LAND USE ZONE--'----I _BLDG_TYPE___ FIRE ZONE;— PLAN CHECK BY_� y. — HEAT
V,it� i �amLly juiii.vrgy I @issue iirlll!!is
(juridetion 01"71L.
Purt'nit #174'7',
OCC-AMP ____._ELQt)j3 LOAQ t1€1�fiL _��ST RIE -_— AREA 13-'fir {SL�Et2H.S7_QM, _—__Y3L5t --_
I BUILDING DEPART%'ENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BVILDING CODE. -ONING
Plan Check REGULATIONS AND ALL APPLICABLE C%;7ES AND OR[1INANCF,, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE Wil H TAE PLANS AND SPECIFICAI'.uNS AND IN COMPLIANCF WITH
Sill) total AL1. APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB r.ONT9ACTCRS TO HAVE CURRENT CITY RIISINFSS
State Tax LICENSE. SEPARATE PERMITS RFOU;AED FOR SEWER, PLUMBING AND HEATING.
Total
By
----- ------- APPLICANT OR AGENT
[Approved Receipt No
IT'
.-,IJlLDINGI PERMIT APPI_ICAVION `pF Tl(-4,kRD DATE` -fid N9
�Ar LIND[ RFIGNED HEHEBY APPL If S I OR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON` �►'�.2
CSR AS SHOWN AND APPROVED IN THE ACCM N PLANS AND SPF IF ANIONS. OWNER PHONE_ —
4� LOT NO..__.�'�A–
HUM AUDRE55
ARCHI'fEC7 �—
ENGINEER
pE-SIGNER
-R _ ADDRESS
— � ]ADDITION C�HtPAIR DRENGWAL ❑FIRE DAMAGE _DEMOLITION
;RE R'tiLyyClDHEMODEL
[:]SLAB []FENCEv,.}�^• p! NCE —Of.!iNIM 0E. — D_GOV'T DRFLIGIOUSDI'AT10�_CARPORT ❑GARAGE ❑STORAGE
❑MOV ING Y—M DCONDITIONAL USE DDLSIGN REVIEW C3COUNCIL APPROV LJSIGNS
_,-- BLDG.TYPE . 1!l— —FIRE ZUN —PLAN CHECK BY _ HEA -
�} NC USE 70NE ---- �—
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STQRJS_ AREA �. DROOMSI� VAL!�F�S�—tr.�1t
F L 4.09�QflLL_-__----__.
RE AR LEFT SIDF RIGHT SIDE
T
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hiRMENT SE
GK5 T BAFRO - - ---- _ �_
—r NT -- —�=—- _—
THIS PERMIT IS ISSUED SUBJECT TO THE OFGULATIONS CONTAINED IN THE BUILDING CODE, 70NING
^1k` REGULATIONS AND ALL AP.'L'CAt%LE CODFE AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
8n Check WORK WILL BE DONE IN P.GCOADANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
— Y ALL APPLICABLE CODES AND ORDINANCES. THE
",uh 1nt81 � ISSUANCE OF THIS PERMIT DOES N07 WAIVE
_ RESTRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
te71H Tex `— LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, Pt UMBING AND HEATING.
To181—
By
I,I„rwed _ -- - -- Receipt No.