Permit T - ' .
Corn e ial Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard OR 97223
(503) 639 -4171
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Jobsite Address: ! 1 6100 't /J (fi & (4 1 \I.; � L !► : : , . .
Tenant: Y j Suite #
Valuation: C� z: - . , ry ;:,.. ,
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Owner: 1 Y��2rVb{ + UIG� x ' :F..
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Address: >v � _ , .:. z.... , � ``;�.�,,L� " , :t . •, }- ry - •
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Phone: C--06 - // /" ('/��1 1.-z-1 :a • 1 a 3y ?'' - �. ?ti ' , #f,X, - � ,:i:: : � ,.
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Contractor: . -
Address:
Type of const: 511
Occupancy Bass: /
Phone:
Sprinklered? Yes No
Contractor's License #
(attach dopy of current Oregon license) Sq. ft. of project: 21 C 7 0
Story (l st. 2nd. etc.) --
Archttect/Eng Proposed use: T'F'�t QU� .
Address:
9 Oa G NE- lia2)1 l- Avr€ Note: • Plumbing & mechanical plans
must be submitted at time of
V �Y1G6 V V �L' l We , �� buy ing permit application.
Phone: 7 . . k `1 — 7 011
cor'tt: r --e_ff tL a v
COMMENTS: sta 3 -n0 ?.L• /j ;2//6;91-. 1 R-
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'ant .�'• n Phone number 2.0G- 511-1 -- '
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Received by: , i ; Date Received: / /?,b / 9 3