Permit CI1YOFTIGARD SITE WORK
PERMIT
COMMUNITY DEVELOPMENT D Q TMENT PERMIT # SI T94 -0016
13125 SW Hall Blvd. Tigard, Oregon 97223•8 50 199 B3924171 DATE ISSUED: X5/03/94
PARCEL: 19136DA -01000
SITE ADDRESS...: 11564 SW PACIFIC HWY
SUBDIVISION • FRUITLAND ACRES ZONING: C —G
1 BLOCK • LOT •4
TYPE OF WORK: NEW PAVING? • N RESO. NO.:
EXCV VOLUME.: cy GRADING? •Y VALUE...$: 0
FILL VOLUME.:1174O cy LANDSCAPING? •N
ENG FILL? °Y SITE PREP? •N
SOILS RPT REQD?:Y. STORM DRAINS?... :N
IMPERV SURFACE.. : sf
Remarks: 11,740 CU YDS ENGINEERED FILL
Owner: FEES
MARK LAWRENCE type amount by date recpt
PO BOX 1720 PRMT $ 238.50 JG 05/03/94 —
PLCK $ 45.00 JG 05/03/94 —
BLAINE WA 98230 5PCT $ 11.93 JG 05/03/94 —
Phone #: 206 -332 -5800
Contractor:
N —B HATCH CO
PO BOX 4684
PORTLAND OR 97208
Phone #: 227 -5006 $ 295.43 TOTAL
Reg #.. : 63024
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 Fill Inspection _
applicable laws. All work will be done in accordance with Grading Insp
approved plans. This permit will expire if work is not started Final Inspect ion
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature:
•
Issued By: .i
/ Call for inspection — 639 -4175
b
Commercial Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639 -4171
/ S 5 S. ul.
Job Address: �
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Contractor: A c
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Address: P O. BOX 4 (o 8 4-
Type of const:
R3R . O • 9 7Zo8- 4684 -
Occupancy Bass:
Phone: 2 2 7 - 5
Sprinklered? Yes No
Contractor's License # -
(attach copy of current Oregon license) Sq. ft. of project: _
Story (1st, 2nd, etc.)
Architect/Engineer: WAKee 14SSo G . Proposed use:
Address: - //Cep 5. W. - .4GLEN • BL l/D, Previous use:
SeAVE27 0 i 9 7a Note: Plumbing & mechanical plans
must be - submitted at time of
Phone: - 43 4/0 - - - . building permit application.
COMMENTS: S f2cJG -/-624L 'F L L_ ( /l Z00 CL). 7 1 99 )
/
- "3410
p^l ant Laws Phone number
Received by: 04\`,1 Date Received: ctkLI
4
Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK). ao
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Oev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
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— -.._ - �� _._w
A NT).r
Fire District (FIRE)
TOTALS:-:
Page No. 1 CASE HISTORY FOR CASE NO.: SIT94 -0016
MARK LAWRENCE
11564 SW PACIFIC HWY
04/10/97
Action Description Rea/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
•
•
SITA007 Application received / / / / / / 05/03/94 JG
SITA010 Plan check by / / / / 05/03/94 PASS DS 05/03/94 JG
SITA020 Check for prcl. restrict. 05/03/94 / / / / 05/03/94 JG
SITA080 (F) Issue permit / / / / 05/03/94 PASS JLG 05/03/94 JG
SITA107 PERMIT EXTENSION REQUEST / / 03/26/96 03/26/96 EXTENSION GRANTED UNTIL AUG 1, 1996 PER 12/26/96 JT
DAVID SCOTT
SITB700 Erosion Control / / / / / / 05/03/94 JG
SITB710 Fill Inspection / / / / / / 05/03/94 JG
SITB720 Grading Insp / / / / / / 05/03/94 JG
S1TB799 Final Inspection / / / / / / 05/03/94 JG
•
•
•
•
Case summary for Case No.: SIT94 -0016 Date: 04/10/97
OaSITE WORK PERMITadaddaaadadaddadadaddadaddaddad adaddaddad&Aaaaadadaaddadad`ia4
o :SIT94 -0016: PROJECT:GRADING /FILL : STATUS:I : UPD:02/27/97: :JT : °
o PERMITTEE:MARK LAWRENCE PRIM..: - ▪ °
o SITE ADDRESS:11564 SW PACIFIC HWY JUR...:TIG: °
OaDESCRIPTION OF PROJECT ( 1) aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaac
o 11,740 CU YDS ENGINEERED FILL °
° per Tom Plescher, "this permit has to be signed off by geotech engineer °
o plus inspecton reports" 2/26/97 jeanne °
Oa ag
o CLASS OF WORK: °
o TYPE OF USE : PAVING' •N- RESO. NO.: • °
o ZONING -C -G • - • GRADING' •Y• VALUE.$: 0: °
o EXCV VOLUME.: 0:cy LANDSCAPING' •N• °
o FILL VOLUME.: 11740:cy SITE PREP' •N• °
o ENG FILL' •Y• STORM DRAINS' •N• °
o SOILS RPT REQD ?:Y: IMPERV SURFACE..: 0:sf °
OaNOTES ( 3) aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaac
o 0
o 0
o 0
a aaadaddaaataaaad aaaaraaaaaaard aaaaddataaa aaaaaaaaada `daaaaaaaaaaaaaaaaaataaaaaaaai
_ Memo field #1
11,740 CU YDS ENGINEERED FILL
per Tom Plescher, "this permit has to be signed off by geotech engineer
plus inspecton reports" 2/26/97 jeanne
Memo field #2
None
Memo field #3
None
TOTL VAL: $ 0.
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