Permit i
, ..,,-
Ate CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2000 -00127
11 � DEVELOPMENT SERVICES DATE ISSUED: 05/10/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DA -00105
SITE ADDRESS: 13009 SW 68TH PKWY C 1 ,1 , (�
SUBDIVISION: HOMESTEAD VILLAGE ` / ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5 -1 HR sf N: S: E: W:
OCCUPANCY GRP: R1 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 25,000.00
Remarks: Remodel to convert 16 existing suites into 8 suites.
Owner: Contractor:
HOMESTEAD VILLAGE INC PUGET SOUND GENERAL CONT
ATTN: PROPERTY TAX DEPT 13221 OLD NACHES HWY
7777 MARKET CENTER AVE NACHES, WA 98937
El TX 79912 Phone: 509 - 653 -1913
Reg #: LIC 112769
FEES REQUIRED INSPECTIONS
Type By • Date Amount Receipt Electrical Permit Required
PLCK GEO 04/10/200C $170.79 0001284 Sprinkler Permit Required
Framing Insp
PRMT BON 05/10/200C $262.75 0002052 Final Inspection
5PCT BON 05/10/200C $21.02 0002052 ORIGINAL
FIRE BON 05/10/200C $105.10 0002052
Total $559.66
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 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Pe mt itee j, , j4 1 ,07 7 5 ---- -----
Signature:
Issued By: 1
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD Commercial Building Permit Application PIa Bak # . )5 C
131251.1. BLVD. Tenant Improvement Date Rec'd 4 a uo
TIGARD, OR 97223 Date to P.E. - — . % -
(503) 6394171 Date to DST .t
Print or Type Permit # A*PR.oao - ao 27
Related SWR #
Incomplete or illegible applications will not be accepted Called s /o -o d
56bne: / PRE g.a +
• Name of Development/Project Existing Building ❑ New Building ❑
Job HD rftz-Skra Villgy.e—
Address Street Address I Suite Building
ilOcci S tJ atkas Data •
Bldg # City/ tate Zip Existing Use of Building or Property:
G T;9ikJ a lt. •
Name .1 Proposed Use of Building or Property:
Property l}- e/,��S�iCtGi ' t/1 i�Q��
Owner Mailing Address Suite
2100 Qideteq ,t Pekwy, No. Of Stories:
City/State Zip v Phone
_ h'tG►iVi'N C a 3x5292 7 7 0 30 3 83'k, Sq. Ft. Of Project:
Occupant Name .. Occupancy Class(es)
Name
Contractor & 4 , Type(s) of Construction
�V y'e��� �.P MC l..-u
Prior to permit Maili g Address , I. o � j Suite Will this project have a Fire Suppression System?
issuance, a copy 132 2 � b ( Q ` � 5 I� G' V Yes ❑ No El
all licenses
' are required if City/State Zip ' Phone Americans with Disabilities Act (ADA)
expired in C.O.T.
database Oa _ ( WA- 9 6/931 3 6S3 (1 (3 Valuation X 25% = $ Participation
GVL
Oregon Const Cont. Board Lic.# Exp. Date Complete Accessibility Form
Project $
Name Valuation 75 ) 0 `D
A rchitect i! i-0 Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
P490 oRca Rd
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
f C ur �ua0 � ,�c , 3d 11 1 � 770 S given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws.
Engineer Name
Signature of Owner /Agent Date
sPl - n�� 0.S alb oV.
Mailing Address Suite 4110100
ntact Person Name Phone
City /State Zip Phone
9A " 1 l k 5) r 65 3 / y /3
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# - ( Land Use
Accessory Structure 0 Foundation Only 0 Alteration 0
I
Repair 0 Other b Notes: '
Description of work: _ ` k.., rej4A-- TIF:
Ki- o--t1..r04 od f Note: Site Work Permit Application must precede or accompany Building
Permit Application O .1 •
9
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COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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