Permit „,
CITY OF TIGARD
DEVELOPMENT SERVICES DUILDIN PERMIT
,,,,,,,,,,,, PERMIT � : RJn9�-n���
��� "�l 13129S0�H@8Bhv��ummi��9�0��0WW���Y�� ^ ' ^ ~ ^ ^ ^ ^
' Tigard, ' ' DATE ISSUED: 06/18/98
��
� `
PARCEL: 28101AA-09100
SIT': r-rDDRESS...: 1 SW 6979`AV7
SUBDIVISION....: WZST PCRTLP| 'HEIGHTS ZONINC:MUE
BLPCK..........c LOT.............:e3o JURISDICTIJN:TIG
--------- ------ ------ __ • --------------------------
REISSUE: FLOOR AREAS--------- EXTERIOR WALL COMSTR'iCTION-
CLASS OF WORK. FIRST....: 768 sf N: S: r.r: W:
TYPE OF USE.—;SF SECOND...: 3 sf PROTECT OPEKINGS?
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP.:R3 TOTAL------: 768 sf RCOF CQNST: FIRE RET?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR. 0 HT: 0 ft ]A9AGE...: 7i sf OCCU SEP. RATED
B5MT?: MEZZ?: REM SETBACKS-------- REQUIRED-------------------
FLOOR LOAD....: 0 psf LEFT: 0 ft RGHT: 0 ft FIR 8PKL: SOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
MORNS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $: 0
Remarks : Demolition permit for fire dazaged residence. All debris to be
removed. Septic tank to be pumped filled & inspected. TIF credits to be applied
once finalod.
Qwner: --------------------- ----- ----------------- FEES --------
BRIAN REICHER type amount by date recpt
19363 WILLAMETE DR 4509 / / ~ ^ PPM $ 25.00 DEB 06/18/98 98-306673
WEST LINN OR 97060 5PCT 1.25 DEB 06/18/O3
EROS $ 25.00 DEB 06/18/98 98-306673
Phone #: 650-6132 ERPC $ 8 DEB 06/18/98 98-306673
ERPC $ 8.45 DEB 06/18/98 98-306673
Contractcr: --------------'---''------
BRIAN CLOPTCN EXCAVATION
P 0 BOX 509
WILSONVILLE OR 97070
________________ _______________
Phone #: . • 69. :1 5 TilTfl':L
Reg #..: 000503
--REQUIRED ACTIONS or INSPECTIONS----
____
This permit is issued subject to the regulations contained in the _ ������ ��O
Tigard Municipal Code, State of Ore. Specialty Codes and all other _______ _
applicable lams. All work will be dime in accordance with €4. ., ief7 -____
approved plano. This permit will expire if work is cut started 4,J4.M~ ___ _____
xithic 183 days of issuance, or if work is suspended for aore __
than In days. ATTENTION: Oregon law requires you to follow the ____ . ._____
rules adopted by the Oregon Utility Notification Center. Those — _ __ ____
rules are set forth in CPR 952-001-2010 through OAR 952-V101987. __________________ ___ ____
You uany obtain a copy of these rules or direct questions to OI<C _ ____ ______ __ __________
by calling (503)246-1987. _ __ ______ ____
_____________ ____ _ __
_ _ ____ . •
Permitt:ee Signature: sue� By _
+ + ++++++�++++++++++++++++++++++++++++++++++++++++++++ ... +++. :-++++++'�+++++++++++++
Call 639-A17E by 7:00 p. c. for an '_nspection neee27'. the rzxt '7usiness �6
÷ 1-...,-+++++++÷4-+++++++++++÷-1-++++++++++++4.1-4-4-4-1-++++++++++++++++=r+++4-1-:-F+1-1-++++++
'' J
CITY pf TIGARD Commercial Building Permit /v. ok 113 Read By .2-a9-
13125 SW HALL BLVD. Tenant Improvement Date Recd , GP •-", k-`!
TIGARD, OR 97223 , � � ' Date to P.E.
Date DST ^
(503) 6394171 W/ ' Permit* t.(. �i _
rent or yp Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
y i Job to ur? rop fp FF /C .
Address Street Address Suite Building
11s SS Sc €J �0 f � -- Data •
Bldg # 1 City /State zip Existing Use of Building or Property:
T A-V-4) t 1 Y .
Name
Property ISl e'r / 'r"F � Proposed Use of Building or Property:
u Owner Mailing Address ` Suite
/ ,�./
(� � Gurl'�a -r►t;� Or, co , No. Of Stories:
City/State Zip Phone
SST CI .14-0 pt. ` Sq. Ft. Of Project:
Occupant Name
Occupancy Class(es)
Name
Contractor j j le f?-0 C ,, _ Type(s) of Construction •
Prior to permit Mailing Address Suite -
issuance, a copy V P. v 5 , ' L Will this project have a Fire Suppression System?
of all licenses
are required if City /State Zip Phone Yes ❑ NO ❑
expired in C.O.T. Americans with Disabilities Act (ADA)
database �Y IC � ( 02 - O` �L D Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp Da Complete Accessibility Form
5 3 3 7 5 2,0 Project $
Name Valuation
Architect Plans Required: See Matrix for number of sets to submit •
Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information I
given is correct, that 1 am the owner or authorized agent of the owner, and f
that plans submitted are in compliance with Oregon State Laws.
Engineer Name 1
S' ure of Own / e�IAgent Date I
Mai' g Address Suite / 4/(e/4)
Co act Person Name Phone
City/State Zip Phone �r rt k p,I6 1 e -) ( , c 0 - (o / 3 Z,_
/' 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
Repair 0 Other 0 Notes:
Description of work:
TIF:
Parks: Estimated # of Employees
DO
Note: Site Work Permit Application must precede or accompany Building � " � 01.6 00
.
Permit Application x
EQ.P e . y s ,
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1 -
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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::sr nature: ti:i �e:::su ervisin
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DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- —
B (New or Add) 1 1 -- -- 3 (j,o,w) -- —
F (New or Add or Alt.) 3 3 -- — 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- —
B & M (New or Add) 1 1 -- — 3 (j,o,w) -- —
P (New, ,='dd. or Alt) 2 -- 2 -- -- 20,o) --
B & M & P (New or Add.) 2 1 1 -- 3 0,o,w) 20,0) —
E (New, Add, or Alt) 2 -- -- 2 — _ 2(j
B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
' :. .:........................ . .
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::::.:hr::::.: .. � ::::::::::::::. i:: is
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NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and o = Office M = MEC
completes, updates and adds actions. f = Fire P = PLM
u =USA E =ELC
ibti :•... hatiOd areas es� - natO Ai > : ::> .: :::::<>: >:< : »:: >:: >::::» :::: >::: >:::> ::::-: = -
.:.:. ,: :;. ::::::,<:. �:.::;:.::::::'::.:::#( �����Y. r.:<<:>:.;:: :<.;::. <::::,:::; w Wash. County F -FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
I:1matrix.Doc
2 S.W. ELMHURST STREET
SEE MAP
3800 '19, 1 I ' 1 r ° 1 1 ' ' '
2S 1 148 g .73 Ac. I 5100 5200
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- - - — SEE MAP—