15980 SW QUEEN VICTORIA PL - I --- ------ - - -----.__
BUILDING PERMIT APPLICATION COF _Z07-A1, .r 9
,Y� DATE— , 19
HE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE __
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
_ r \y //) (// LOT NO
,R__ . �+ JOB ADDRESS i6?B.v S c GJ.Ul2?�/ E A RISS
ARCHITECT
ENGINEER
=_R4 ADDRESS 31 DESIGNER
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JCTURE DNEW REMODEL ❑ADDITION ''REPAIR ❑RENEWAL ❑FIRE DAMAGE DDEMOLITtON
E`IDFNCE firCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CAR PORT ❑GARAGE ❑STORAGE DSLAB ❑FENCE
1BOND ❑MOVING ❑CONDITIONAL USE 0 DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
CUPANCY.._.___LAND USE ZONE BLDG.TYPE __FIRE ZONE_ PLAN CHECK BY HEAT
d,
_ LR•
_ORD _ FLOOR LOAD -- HEIGHT --- NO STORIES AREA NO. BEDROOMS VALUE ` -Z
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
ermit /c9• 0® -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
?Ian 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
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
` tate Tax ft y/0 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
( Total Mr 4/6
1By L Clow Roofing and Siding Co.
--------- ------- --- APPLICANT OR AGENT
Approved Receipt No. 4311 N. Tillamook St Portland 281 1238
ADDRESS PHONE
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