15770 SW QUEEN VICTORIA PL 2v _
C ic/ F 6104G CITY /�
BUILDING PERMIT APPLICATION Po r ; AVENUE
LION 971281E `J Vin' 19 77 N2 v �] -
1
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 620 2022
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER Raleigh Meyer ADDRESS 15770 S.W. Queen VictoriEILD SHONE 281 1238
Clow Roofing & Siding CENGINEER
BUILDER 434 N: Tillamook otT-FficU.and,Oregon DESIGNER
STRUCTURE ❑NEW ❑REMODEL 1-.3 ADDITION 'REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
p RESIDENCE ❑COMM DEDUCATIONAL ❑GOV'T El RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE CI STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING DCONDITIONAL USE ❑DESIGN REVIEW DCOUNCIL APPROVED ❑SIGNS
Fr- ./ _i}
OCCUPANCY LAND USE ZONE --g- ( BLDG.TYPE S // FIRE ZONE J PLAN CHECK BY HEAT
•
k' / t�-'tC/ )! ,,,f /rel fK�1dAAz
/ t ..e B 4+G ' /.{. �R /V ./Zj/(KA ��
aC,t-�
'17).. : e7r �1-41.l L .."r. ..,.�;Zrf SLL+wGe 67.i ' 4 2 7 / 7
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE - - "
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
PermitI / 7.
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
2)%State 7 / LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
1.
Total 17. ) Clow Roofing and Siding Co
By /12k i------ 4 � L` APPLICANT OR AGENT <' '` /�' -`
ATZWINNFA.-- fit 'Ir
pproved , Receipt No. 31-1 N. Tillamook St 281 1238
'� ADDRESS PHONE
Portland,Oregon
4 / <)4 7/(- c