Permit SITE WORK -
IIY OF TIGARD ERMIT
PERMIT # P • SIT96 -0020
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/03/96
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S113AD -01700
SITE ADDRESS...: 16920 SW 72ND AVE
SUBDIVISION ROSEWOOD ACRE TRACTS ZONING: C —G
BLOCK • LOT •30
TYPE OF WORK: NEW PAVING? • N RESO. NO.:
EXCV VOLUME: 9500 cy GRADING? • Y VALUE...$: 0
FILL VOLUME: 5900 cy LANDSCAPING? N
ENG FILL? • Y SITE PREP? Y
SOILS RPT READ ?: Y STORM DRAINS ?...: N
IMPERV SURFACE: 231360 sf
Remarks: LIMTED SITE PERMIT: Grading ONLY on private only. No site utilities
allowed.
Owner: —• FEES
BINGHAM INVESTMENT type amount by date recpt
3939 NW ST. HELENS RD PRMT $ 238.50 04/16/96 96- 278264
• PLCK $ 75.00 04/16/96 96- 278264
PORTLAND OR 97210 5PCT $ 11.93 04/16/96 96- 278264
Phone 4*: 503 -224 -7676 EROS $ 200.00 B 05/03/96 96- 278973
ERPC $ 65.00 B 05/03/96 96- 278973
Contractor: ERPC $ 65.00 B 05/03/96 96- 278973
BINGHAM CONSTRUCTION
3939 NW ST HELENS RD
PORTLAND OR 97210
Phone #: 503 -224 -0070 $ 655.43 TOTAL
Reg #.. : 42197
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 Engineered gradi
than 180 days. Final Inspection
Permittee Si nature: j/
Issued By: 01
Y 1 !ti
Call for inspection — 639 -4175
'L2L,4 ) ►24 -L1)
Commercial Building Permit Application
City of Tigard
13125 SW Hall Blvd. , 0, ` RECC e'��w.
Tigard, OR 97223 ; 81* " v
(503 639 -4171 °� ° Si v
F ,
17 . '
Jobsite Address:
/ 4 %2- 0 l k 7z os:�. ,, � . . r
Tenant: Suite #
Office Use Only
Valuation: Rem
("LA , e y e.
Planck/Rec #
Permit # S 9t -- 002 0
Owner: :its n .o7 y. , r " ' 1-< Map & TL #
Address: .> ' 5 r / /k/ j" / //�-4. R /
• Approvals Required
- ti* 7 7 2_/ Planning
Phone: 5? 2 2. 4 20 7' n e e
Engineering. . •
,n _
Other
Contractor: , X /../ 1 K i �1f X«<�� -_
Address: f7J r /k _ $ /M 4„ ,? / .
Type of const:
/Cv /.mss,/ C >/ 771/c
.,
Occupancy class:
Phone: 5 2-2 II --- 2_ 76
&v -It) Sprinklered? Yes No
Contractor's License # 0,2 / f 7 - <!_ 9 G S'G 7 y
(attach copy of current Oregon license) Sq. ft. of project:
Contact name & phone: 6e. � - • r r,,. Z2 - 9 2.15 7e Story (1st, 2nd, etc.)
"i i4 l7 Jh4
Proposed use:
Architect/Engineer: /%7 <.•r .S2 /v
� Previous use:
Address: (� �, elf /% ,y, .//
Note: Plumbing & mechanical plans
70,- ' /c / Oki e(77 c / must be submitted at time of
building permit application.
Phone: 5'r 3 2. Z f (75 G)
,1
tl ).) f) G, ) "; re' _, ,,, , ,'- , --�,, d d , / t o 71A ��
JOB DESCRIPTION: g 1 7
fc ./ s ��('.- t / /�• . / r /.r � � r y .f . Al- r, .,».,.. .0... / /
,J,J � }- D.3 7 2 f 2 c 7e(
A. •licant Signature & Phone number
Received by: tldfiln, 644. Date Received: j//4/6
Permit it Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) X 23 aP 5 > '
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) 1) ti3- 11
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
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) I (( I 0.
Water Quantity (WQUANT) N S i( ?b - 6007 L �/ 1 .
Fire Life Safety (FLS) L��--
Erosion Cntrl Permit (ERPRMT) �' U� 2
0 /1
Erosion Planck/USA (ERPLAN) ( 0-4 ( S� G ��
Erosion Planck/COT (EROSN) 45 Gs
TOTALS: - 3 A y - 330