Permit C/
CI1YO FTIGARD
, SITE WORK
PERr =iI
- COMMUNITY DEVELOPMENT DEPARTMENT :PERMIT #....,...: SIT95- -0041
' 13125 SW HaII Blvd. Tigard, Oregon 97223.9199 (503) 639 -4171 DATE ISSUED 01/12/96
PARCEL: 1S136DD00801
SITE ADDRESS...; 11565 SW 67TH AVE .
SUBDIVISION ° WEST HEIGHTS . . ZONING° C -P
BLOCK.......... LOT.... ... ..... . 3
TYPE OF WORK: NEW PAVING?......... . Y RESO.. NO. a . •
EXCV VOLUME: 0 cy GRADING ?...•... .. • Y VALUE... $:. 2500I
FILL VOLUME: 0 Cy.• LANDSCAPING? Y
ENG.FILL ?.......e N SITE PREP? ° Y
SOILS'RPT READ ?: .N STORM DRAINS ?...: - Y •
TMPERV SURFACE: 3912 sf .
Remarks: • Site permit for 1900 sq.. ft. office building. , .
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MERCER, ROSS & VICKI type- amount by date recpt
11535 SW 67TH SWM $ 266.73 JDA 01/12/96 96- 2749 -
. SWM $ 148.18 JDA 01/12/66 96-274914
TIGARD OR 9.7223 • `PMT $ 170,50 JDA 01/12/96 96- 274914
Phone #: 620 -6617 PCT $ 8.53 JDA 01/12/96 96- 274914
. . PLCK $ 110.83 JDA :01/12/96 96-274914
Cont ract or : - - -- •- - - - - -- EROS $ 80.00 JDA • 01/12/96 96-274914
•LBH CONSTRUCTION . • ERPC $ 26.00 JDA 01/12/96.96-274914
19.373 NE • CALKINS • ERPC $ 26.00 JDA 01/12/96`96- 274614
•
NEWBERG OR 97132 ------ . - - - - -- - --
Phone. #e .. $ 836.77 TOTAL
Reg 4t.. e 65769 .
-- REQUIRED INSPECTIONS
This permit is issued subject to 'the regulations contained in the Erosion Control __.- _._ - ^`
Tigard Municipal Code, State of Ore.- Specialty Codes and all other . F i 1 1 Inspection __ __-_.— _____--
appiicable laws. All work will •be •done in accordance with Grading Insp _______ - _—
approved plans. This permit will expire if work is not started St rm Drain Insp ,___L_:__ _
within 180 days of issuance, or if work is suspended for more Final Inspection _.__ _ —. . „_..
- than 180 days. .
4 e r m i t t e e Signature: _ _— - ._�� -TT-7777T T ._ - __
I s s u e d B Y a _- -
Call. for inspection - 639-4175
•
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Commercial Building Permit Applic ion
• City of Tigard
13125 SW Hall Blvd. - ,j �, r
Tigard, OR 9722 kin- ° 9 'A
(503) 639 -4171 1 5'" �/
Jobsite Address:
IS6.S Sw \ /
Tenant: OW h-or Suite # Office Use Only
r + r�� /O - /�
Valuation: 2 5 , 0c70 PlanckiRec # 13
/� Permit # 'i I I r
°I5 - 00q I
Owner: ROSS V IC ( • IQ Map &. TL # I 51 ( DD - xo I
Address: 1 1 G 3 5 Sw to - 7
y� q
Approvals R egquiiirredd
&�°/ Idl� l` l 1 2Z 3 Planning � WIS
'"C01 i
Phone: G j,0' C / 7 Engineering
Other
On Contractor: O 'tv l �'i i7 t W
Address: .1 vi 7 ci Z , ` 1
Type of const:
Occupancy class:
Phone:
Sprinklered? Yes No
Contractor's License #
(attach copy of current Oregon license) Sq. ft. of project: 7 0 e e -
Contact name & phone: Story (1st, 2nd, etc.)
Proposed use:
Architect/Engineer: I 0 A (?J.F__-- LL
{� � Previous use:
Address: CJd 5 �Q_V �aR
OP 9-7 Note: Plumbing & mechanical plans
L
Foy 'I ( Q/tAa ' O 2 ( q must be submitted at time of
Phone:
2 �(I 1 ( Z building permit application.
- JOB DESCRIPTION: N) 2 Sfv V� L . U o pp
Nom) OFF tc-t
T /)/ h r—
/.►L. 2 1
Appiicant SignatureT & one number
Re • IJ' /'d C‘..0-0 Date Received: /0 - L f - l
I
1 ~:
Permit # Account Description Amount Amt. Pd. Bal. Due
Permit (BUILD)
Bldg. /.� U .�
Bid / 2u. � .
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) P •
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) f /a / /C7 ��—
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Commercial TIF (T1F -C)
Industrial TIF (TIF -I)
Institutional TIF (TIF -IS)
Office TIF (TIF -0)
Water Quality (WQUAL) _ _ _ 7
Water Quantity (WQUANT) /'1F V
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT) old
Erosion Planck/USA (ERPLAN) 2e r 2-c
Erosion Planck/COT (EROSN) .2G
TOTALS: 7 & F 36