Permit o " BUILDING PERMIT
CI TY OF T I G A R D PERMIT #: BUP2002 -00450
* DEVELOPMENT SERVICES DATE ISSUED: 10/11/02
'=-� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12750 SW 68TH AVE PARCEL: 2S101AD -01300
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Demolition of interior space for future tenant improvement.
Owner: Contractor:
HAMPTON BUILDING, THE LLC NORWEST GENERAL CONTRACTORS
6803 SW WHEATLAND RUN INC
WILSONVILLE, OR 97070 PO BOX 25305
PORTLAND, OR 97298 -0305
Phone: 291 -6986
Phone: 291 -6986
Reg #: LIC 89425
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 10/11/02 $62.50
[TAX] 8% State Tax 10/11/02 $5.00
Total $67.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -00 t#Fough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ( 3) 246-6694 1- 800 - 332 -2344.
Issue By: _ ' / 1l _>�
Permittee I
Signature: , a ,, � _ � .
..
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application OFFICE USE ONLY
',,J f { City of Tigard Date received/ , ' 4¢- Permit no.:, �,� ko
Project/appl. no.: date:
City nl'Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: Byk eceipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 New construction X Demolition
0 Addition /alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
.10B SITE INFORMATION
Job address: 12 7 er 6 " 'An. , Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: ■ - .
Description and location of work on premises /special conditions: TEaAa7 1 IN PRAU Itrrtagpl T , STRN IJIA.I L
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
(Flood plain, septic capacity, solar, etc.)
Mailing address: c . _ 1 & 2 family dwelling:
ISZINME State: of_ ZIP: g773O Valuation of work $ 1O.0
P one: • • imci tg'"."-1 E -mai • No. of bedrooms/baths
Owner's representative: IIWIEVM.P11111111== Total number of floors
Phone: 2_C _ `i5%(. =mum E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E - mail: Commercial /industriaUmulti family:
CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.)
W , • 1 ' - • ti • New bldg. area (sq. ft.)
Address: .7.;11-1cf71.711111111M1.111111 Number of stories
IME >t State:p& ZIP: 12,1 Type of construction
�, :
Phone: 2,ql - 4 • ; . UffnifFM E -mail:
CCB no.: $ 7' 25 Occupancy group(s): Existing:
New:
City /metro lic. no.: $ s72. ss OZ Notice: All contractors and subcontractors are required to be
ARCIIITECI licensed with the Oregon Construction Contractors Board under
IMIIIIMIII provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER OFFICE USE ONLY
Contact person: _ _ Fees due upon application $
Address: - 2,11111.11111 Date received: .
EIEMV State:pR ZIP: Amount received $
Phone: 7 22.4.4 5 Fax: E -mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All pr is Ins of la an /.rdinances governing this 0 Visa 0 MasterCard
work will be complied ith w e -r : - cif/ d herein or not. Credit card number: Expires /
Authorized signature: •
Date: I D /I 1 ! /
0 Z Name of cardholder as shown on credit card
i
DA ti�-i - $
lA
Print name: /) 1 39 uSA Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6 /00 /COM)
A 6 � so