Permit \ SITE WORN.
PERMIT
, CI lY O F T I GARD D ATEIISSUED: SIT96-0001
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 539 -4171 PARCEL: 2S 101 AA - 09001
SITE ADDRESS...: 12585 SW 68TH AVE
SUBDIVISION • WEST PORTLAND HEIGHTS ZONING: C —P
BLOCK LOT •29
TYPE OF WORK: NEW PAVING? Y RESO. NO.:
EXCV VOLUME: 0 cy GRADING? Y VALUE...$: 38700
FILL VOLUME: 0 cy LANDSCAPING? • Y
ENG FILL? • Y SITE PREP? • Y
SOILS RPT READ ?: Y STORM DRAINS ?...: Y
IMPERV SURFACE: 15443 sf
Remarks: Develop a 4,500 square foot office building.
Owner: FEES
MARK DANA type amount by date recpt
7160 SW FIR LOOP S -101 SWM $ 1052.93 JSD 06/19/96 96- 280762
SWM $ 584.96 JSD 06/19/96 96- 280762
TIGARD OR 97223 PRMT $ 233.50 JSD 06/19/96 96- 280762
Phone #: 620 -9229 SPCT $ 11.68 JSD 06/19/96 96- 280762
PLCK $ 151.78 JDA 01/16/96 96- 274938
Contractor: EROS $ 80.00 JSD 06/19/96 96- 280762
J. T. ROTH CONSTRUCTION INC ERPC $ 26.00 JSD 06/19/96 96- 280762
ERPC $ 26.00 JSD 06/19/96 96- 280762
12540 SW 68TH PARKWAY
TIGARD OR 97223
Phone #: 639 -2639 $ 2166.85 TOTAL
Reg #..: 080970
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 Excavation Insp
applicable laws. All work will be done in accordance with Fill Inspection
approved plans. This permit will expire if work is not started Grading Insp
within 180 days of issuance, or if work is suspended for more S t r m Drain Insp
than 180 days. Misc. Inspection
Final Inspection
.11 /
Permittee Signature t,, /,try
Issued !�fl �' '
Call for inspection — 639 -4175
� k•' �.7 n 2
Commercial Building Permit Application (
City of Tigard 4 �� s'- a- y g -
13125 SW Hall Blvd.
Tigard, OR 97223 \ J t' 7 5 _ CX;6 i
(503) 639 -4171 1-k v �
Jobsite Address:
/ Office Use Only
Tenant: /Id ,t Suite #
Pr44 -. ° ff' ` .c. d / Planck/Rec # N - 9 �6
Valuation: -P 5S - 700 .
Permit # 7 1 r iy PI , Zr) / '/r/,,, ;
Owner: /2'( L , Z o' ` CI Map & TL # ,7 ( a rr't j r I(.Ot
Address: r7 (l'l) ) 1 ,t4 L (-717 . 1 4
Approvals Required
l it Planning • _.1> t r . 72 t r >° Le 1. ;'rf °;
Phone: .. , i r�`/.'(. 1 I
Engineering 1
r O 6,1 l i ;': '• Other
Contractor: c.i• % , /corEi c
Address: /cSyO SLU 68 P -7 —' / •i T ?
Type of const: IT- A!
/ / 7 arol Dg 72Z3
Occupancy class: CP
Phone: 6.37 Z4. 39
Sprinklered? Yes o
Contractor's License # 3/ 700
(attach copy of current Oregon license) Sq. ft. of project: /Jo 0
Contact name & phone: �i.•1 K rZ- (S------ ) Story (1st, 2nd, etc.) / .S,✓
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g' c a
' / �/ ',A
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Address: .SE /QZkJC
Note: Plumbing & mechanical plans
Arl_-/ Q2
must be submitted at time of
�/ building permit application.
--
Phone: 5 LV.
JOB DESCRIPTION:. 71/4-04-1 ' -
Ai). - • • - ure : - one number
1 Received by: 4 ' �ro." / Date Received: i/ M /
\
Permit # Account Description Amount Amt. Pd. Bal. Due
'SIT a l19'DQ) 1 Bldg. Permit (BUILD) 2 3 7 z 3
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
J
State Tax (TAX) /
Bldg:
Plumb:
Mech:
Plan Check t Pt c / I � ' I . , 7g —e—
Bldg:
Plumb: {�
Mech: -Z7 to
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Commercial TIF (TIF -C)
Industrial TIF (TIF -I)
Institutional TIF (TIF -IS)
Office TIF (TIF -0)
Water Quality (WQUAL) /0 3'.Z 93 /erg,
5 �
Water Quantity (WQUANT) . S� C,/ A ✓ , 1'V
Fire Life Safety (FLS)
Erosion Cntri Permit (ERPRMT) 6 k-O
Erosion Planck/USA (ERPLAN) 2
Erosion Planck/COT (EROSN)
TOTALS: 1 GG °Pr I bl, 7g
-