Permit PERMIT . •
PERMIT .
DATE ISSUED: 01/25/96
25 / 9tC -1c'14
' COMMUNITY DEVELOPMENT DEPARTMENT '
13125 SW Hall Blvd. Tigard, Oregon 9722308199 .,(503) 839 -4171 , PARCEL: 1 S 136DD 001E`01
SITE ADDRESS...: 1155 SW 67TH AVE _ '
SUBDIVISION.,..: WEST PORTLAND HEIGHTS ZONING: C -P.
BLOCK........... LOT. o ........... . . .
TENANT NAME. :MERCER OFFICE BUILDING • .
USA NO .: FIXTURE UNITS...: 17
-CLASS OF WORK...: NEW . DWELLING UNITS..: 1 .
TYPE OF USE .....: CON NO. OF BUILDINGS: 1
INSTALL TYPE....: BUSWR IMPERV SURFACE: 0 sf
Remarks: 1900 sq. ft. new office building,
Owner: •- _ -_ -_- �.__. -__ -- FEES -__
ROSS MERCER type amount by date recpt
11535 SW 67TH - PRMT $ 2200.00 J SD 01/25/96 96-275310
. ' INSP $ 45.00 JSD 01/25/96 96- 27531.0 •
Phone #:
Contract or: - -••- • __.__ —___
LBH CONSTRUCTION , .
19373 NE. CALKINS .
NEWBERG 'OR 97132 -------
Phone #: $ 2245.00 TOTAL
Reg L. 65769. .
- REQUIRED INSPECTIONS --- _ - - -._
This Applicant agrees to cooply with all the rules and regulations Sewer Inspect ion _ _ .
of the Unified Sewage, Agency. The . permit expires 180 days frog _ ___ _•_� _ �_ _
the date issued. The total aoount paid will be forfeited if the ,_•_•_ ;. __
permit expires. The Agency does not guarantee the accuracy of the
side.sewer laterals. If the sewer is not located at the oeasureoent • .
given, the installer shall prospect 3 feet in all directions frog _
the, distance given.. If not so located, the installer shall purchase �,•_�•,
a "Tap and Side Sewer" Peroit and the Age' will install a later. - . _ _ __
C - ' e r m it t e e S i : . � - _ _____ _ _ _ • r�
•
I s s �_� e d► y : 1 ��ii� __�T _ _ _� _� _
Call for inspection - 639 -4175
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. c7 i- a-7 s3 /. h
Commercial Building Permit Application
City of Tigard S 6 Wad
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639 -4171
Jobsite Address: /535 51 7 � 7764h2D
Tenant 05 S/t4e1 2 -Caa Suite # Office Use On1Y
Valuation:
Planck/Rec #
Permit # C- APL"'/?
Owner: 5 Me12C6Y2
Map &. TL # .
Address: / / 's 3 S 67 Approvals Required
"7 223
Planning
Phone: 2-0 - (6 r7
Engineering, •
Other
Contractor: t 8 H s i 20- c;iors Jac.
Address: Pa Bc -301?
Type of const:
NPkJL3 E2 6 OR. f7 /3 Z
Occupancy class:
Phone: 538
Sprinklered? Yes No
Contractor's License # (06
(attach copy of current Oregon license) Sq. ft. of project:
Contact name & phone: Story (1st, 2nd, etc.)
Proposed use:
Architect/Engineer: 'j Ar - -
Previous use:
Address: 806 5 i-ta2AA
Note: Plumbing & mechanical plans
PewtA v- ,, tJ' 91 2l L{ must be submitted at time of
building permit application.
Phone: 231 l lZZ
JOB DESCRIPTION:
ov) (o to -Cv lo C7
Applicant Signature & Phon number
x / L7 6
� F �
Received by: 1 Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
•
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
-- > '•7 )
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Commercial TIF (TIF -C)
Industrial TIF (TIF -1)
Institutional TIF (TIF -1S)
Office TIF (TIF -0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: