Permit i
Commercial Building Permit Application pio
City of Tigard
13125 SW Hall Blvd. �'
Tigard,' OR 97223
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(503) 639 -4171 fLe pe)\-
Jobsite Address: 141 ` i- A,) v 16 6 5 114 ' .- 1 ---
Tenant:' J Iyl[ T �- uite # Office Use Only
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� - Planck/Rec #
Valuation: Uv " �.�y
Permit # \--- ;
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Owner: ► ;i. _ ,ts:, Dim '. r , . Map_& TL # VG .. i .0 -- �` °- '
Address: A Required
C1 c- 5 0
Planning V bi :( 1 240
Phone:
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Engineering
Other 'rJ I 0 - F ,t tl
Co (a 1L (Y ,},A I LY ,
v . Address: , _ , ij iI► _ l
"17 '� (.—}1._ Type of const: 174 !-( y ti . M,
✓ � Occupancy class: 0- Z.
Phone: L t5'- - 7
� Sprinklered? Yes
Contractor's License # r� - 1
(attach copy of current Oregon license) Sq. ft. of project: 2e__412
Contact name & phone: J Story (1st, 2nd, etc.) (.9)'► ef
Proposed use: f ? ,1e/ Jr, 4 z 7 1' m
Architect/Engineer: r \9 t+V 44. AA. LJ
7t!2 j . ^ �G/ r1 Previous use:
Address:
Note: Plumbing & mechanical plans
°111 -- A91 # )� must be submitted at time of
/ building permit application.
Phone: 5 - 2'Z4
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JOB DESCRIPTION: ,0j 1,16 I . tt_._ .4 A ! !y 0 r1 -7SeS .. (a -`.Ay Ilnt?S
-Ctbin iLk6D Q c, lAtol, * D HI 9C Eft 1D5 {v % -
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A•. ignat• & Phone nu -,
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Received by: Date Received: J C7
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Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) /7 '
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) Y �%
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) .1 — j J (o' "
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 -1)
Institutional TIF (TIF -1S)
Office TIF (TIF -O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS) 71 - 7 (I6
Erosion Cntri Permit (ERPRMT) r(/
Erosion Planck/USA (ERPLAN) 2 t 2G
Erosion Planck/COT (EROSN) ZL 2e
TOTALS: �' r ;7.0 , tI _
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