Permit ,.. CITY OF TIGARD
% DEVELOPMENT SERVICES BUILDING PERMIT
°� �� I F'ERM I T # • BUP97 -0204
+L .. .. . 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171
DATE ISSUED: 05/09/97
PARCEL: 1 S 136CA -01600
SITE ADDRESS...: 11655 SW PACIFIC HWY
SUBDIVISION • ZONING:R -12
BLOCK • LOT JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:ALT FIRST • 0 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP.:U2 TOTAL 0 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD • 0 p s f LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:Y
BF_DRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 25000
Remarks : Tank placement, construction of wash pad, oil water separator, and
toilet dump
Owner: FEES
HALL, DONALD, GRACE, JOHN type amount by date recpt
C/O WALTER AMAN PLCK $ 0.00 JH 04/23/97 97 -293630
PO BOX 19089 FIRE $ 0.00 B 04/23/97 97- 293630
PORTLAND OR 97216 EROS $ 80.00 B 05/09/97 97- 294383
Phone #: ERPC $ 26.00 B 05/09/97 97- 294383
ERPC $ 26.00 B 05/09/97 97- 294383
Contractor: PRMT $ 170.50 B 05/09/97 97- 294383
PARSONS EXCAVATING INC PLCK $ 110.83
19600 —A CIPOLE RD FIRE $ 68.20
TUALATIN OR 97062 5PCT $ 8.53 B 05/09/97 97- 294383
Phone #: 936 -7800 $ 490.06 TOTAL
Reg #.. : 000645
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Foot /Found Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Structural weldi
applicable laws. All work will be done in accordance with Misc. Inspection _
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
t 180 days.
i
Permittee Si nature: /,i` ■�, di-W
Issued By: r 1 i/ ' G.^....— _ _
Call for inspection — 639 -4175
n i
Com mercial Building Permit Application '; /' "7
City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 c
(503) 639 -4171 Li
D �
Jobsite Address: OFFICE USE ONLY
Tenant: 12(, . , " Suite # _ Planck/Rec. # ® � � ;''' 1
Valuation: 7 ( 0l' Permit # r. it'i r I°' 9 -' , -t '
O Iv. � � k ' rl1G t�{r(� a-trC Map & TL #
Owner: Ver4.4 - fm .C.Q
dk 1,' k „� � Approvals Require
Address: 1k4U t.A Raw
Planning MfItI'S.(% 11',/= f . A d7
Engineering
Telephone:
• , ' Other pa ., "
, 44 4 1 ,,,,,,
G
t-fkk't
Address: l l f-1l'O k- a . i `
u d i64 me_ 17 'L7- Type of constr: Z-
Telephone: LOC "' Occupancy Class: (4 – 2,
Contractor's License # Sprinkler? Yes No
(attach copy of current Oregon license)
Sq. Ft. Of Project: i
Contact name & telephone:
Story (1st, 2nd, etc.):
Architect & Engineer:
Proposed Use: 4 v'A Or ( )(
Address:
Previous use: )2,4-c K
Note: Plumbing & mechanical plans must
Telephone: be submitted at time of building permit
application.
`
: OB DESCRIPTION: .41,.41,,i , ; g y p % , . < II -
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1. 1, - 9dd T 7?- i A ,�
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(Applicant Signature & Telephone Number) wir 0, i
Received by: /i/r/ Date Received: v �� 77 .
PERMIT/ Account Description Amount Amt Pd. Balance Gue .
Building Permit (BUILD) 1'17°
Plumbing Permit (PLUMB)
Mechanical Permit (MECH)
State Tax (TAX) `5`_3
Bldg.
Plumb.
Mech. ,
Plan Check (PLANCK)
1 1 0 2 ' �� - ✓ — C�
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 -IS)
Office TIF (TIF -O)
Water Quality (WQUAL)
Water Quanity (WQUANT)
Fire Life Safety (FLS) • Wd
Erosion Cntrl Permit (ERPRMT) ' c 1)
Erosion Planck/USA (ERPLAN) ) L 49- Z�0
Erosion Planck/COT (EROSN)
Q -611
TOTALS: "I /� 0 1(0 / ,
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