16365 SW ROYALTY PKWY King City CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE , 19 N2 10 8 3
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ADDRESS BUILDER PHONE
ENGINEER 434 N. i .a$ :9oKN M'I
BUILDER ARCHITECT DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ['FENCE
11BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
' WORK WILL BE DONE 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
' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total .
By
AP
Approved • Receipt No. ANT OR AGENT •
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/,-/S 7� Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG.DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
• • _Zoning Final
T y
C� tkaG CITY / l
BUILDING PERMIT APPLICATION 15 AVEN FEf'E ()Qt.14 , ,9. 76 . N2
QRTIAND OREGON 97223
THE UNDERSIGNED HEREBY APPLIES FOR APE MITT I-UR tHE WORK HEREIN INDICATED 63'9 7444
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER Dexter Dougherty ADDRESS 16365 S.W. Royalty Part{uras}/ILDERPHONE 281 1238
ENGINEER 434 N. Tillamook Portland
BUILDER Clow Roofing & Siding (AOICHITECT DESIGNER
STRUCTURE CD NEW 0 REMODEL C3 ADDITION 0REPAIR DRENEWAL ❑FIRE DAMAGE ❑DEMOLITION
0 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T 0 RELIGIOUS OPATIO ❑CARPORT ❑GARAGE ❑STORAGE DSLAB OFENCE
DBOND 0 MOVING ❑CONDITIONAL USE 0 DESIGN REVIEW ❑COUNCILAPPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT .
Reroof house complete with Certainteed 2401b Seal Tab shingles
•
as per UBC Sec. 3203 E 33 Fire Retardent roof covering. Cost X1, 365. 00
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE I) i(`9
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
IT
Permit �i / it (DC) .
1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check IIIj REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
!j WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording it ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
i1 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
3%State '( 2— LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total /11 `'It-1-- Clow Roofing & Siding Co .
t
I APPLICANT OR AGENT
Approved ij I Receipt No. 434 N. Tillamook St,Portland 97227
ADDRESS PHONE
II 4