Permit 4, • ' , CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00254
Zr DEVELOPMENT SERVICES DATE ISSUED: 6/2/2004
s`�'` ,.�.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11744 SW PACIFIC HY PARCEL: 1S136CC -02100
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SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 7,250.00
Remarks: Demo 1100sf building. DEMO CREDITS APPLY FOR SEWER. TIF AND PARK CREDITS TO APPLY.
Owner: Contractor:
GRUNBAUM, HANS H AND MARILYN K KONELL CONSTRUCTION CO.
TRUSTEES 36000 SE INDUSTRIAL WAY
2113 e 90 SW EDY RRD SANDY, OR 97055
S PLipOD 503-33 -33 00
Phone: 668 -3516
Reg #: LIC 122459
FEES REQUIRED INSPECTIONS
Description Date Amount Ersn Cntrl 681 -4444
[BUILD] Permit Fee 6/2/2004 $62.50 Cap sewer line
[TAX] 8% State Surcharl 6/2/2004 $5.00 Final Inspection
[ERPRMT] Erosion 6/2/2004 $26.00
[ERPLN] Ero Plck -CWS 6/2/2004 $8.45
(additional fees not listed here)
Total $110.40
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: igee„, 41.4 Ze,(2.414.0
Permittee � ' .
Signature: t / /
Call -4175 by 7 p.m. for an inspection the next business day
04/19/2004 17:07 FAX 5035981960 CITY OF TIGARD a002
. ■
4.. : .
Building Permit Application rcm 014'IC E USE ONLY
City of
13125 SW Hall g B Tiard Received / _ i
paen3y ,y 3 Permit No.:?0 Pa X /1- sv _ 1.
lvd., Tigard, OR 97223 ' • 61
Plan Revi
Phone: 503.639.4171 Fax: 503.593.1960 /4111P11°
z Datc/Ely: Other Permit;
Inspection Line: 503.639.4175 'L Ready/By; Jurist la See Attached Cheeld151 for •
I www.ei.tigard.or.us . Notified/Method: Sepplemental Information •
0 0(C 42 la/VI/Wei/,r '-- c4ite_../ . /
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0 New construction :.",! Demolition Permit fees* are based on the value of the work performed
-
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement 0 Other equipment, materials, labor, overhead, and the profit for the •
i.■,;:iy.iti t.,q•iittlip ,•::;.":•:q,Td :: i: :'-..id , work indicated on this application. •
* •
Valuation: $
0 I. and 2-family dwelling Commercial/industrial ,
• o Accessory building 0 Multi-f Number of bedrooms:
mily
•
(,:l Master builder 0 Other: Number of bathrooms:
i' : ...1:•::; Total number of floors: •
•
Job site address: I I '7144 s p Ac, 1 F t c. , i_t New dwelling arca: square feet •
City/State/ZIP:-, (44g.° 0(z , Garage/carport area: square feet
- r
Suite/bldg./apt. no.: Project name: ,,L 6. , i A di Covered porch area: square feet
— ,
Cross street/directions to job site: Deck area: square feet
•
J6L4f-21-47 Other structure area: square feet •
. .: . .
: '.1tEOVIRtiPPATX; COMMERCIAL4JSE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
equipment, materials, labor, overhead, and the profit for the
;4 ••••• : ,:,•• '. • • • • ; :;'.5.1:,i.ii;i;ii'i:iiia l iiiiihif8§ • :: 1 0:1Woitie!..; • •;;;,11''. , :,;y • i',111!„ ;::..... work indicated on this application. .
Valuation: $
f)eno. . 0 G ' i I 0-IN C.
Existing building area: square feet
•
New building area: i /co square feet •
/
;':''':'''•••••• • ; •• • • •:''Ai'Oi144 .' •iffitiel•iiiiiii....i•lilf.i !•: .y••
h H•lw.i 0,1 l'•':q41111 NP441rk•ItH•Ri i 'l -. .,•:•.• 4 i Number of stories: i
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Name: C-TRAN.N114(r. FAT)719/ TgiA.11-- Type of constmetion: w 4: 124 4 )4/1€
Address: Vs, AZ S . 2-0 1 Occupancy groups: •
City/State/ZIP: igLpii\19 CQ._ . 9 Existing: •
/ .
Phone: ( 55) - :' , 3 ) 5 _3 3 0:7 Fax: (503) 5-7I52_ New:
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Business name: Ulryv. 5. MA21G447 V- ?q55 0 cl . All contractors and subcontractors are required to be
Contact name: I
licensed with the Oregon Construction Contractors Board
))1 (.. A , RAZIC under ORS 701 and may be required to be licensed in the
Address: e cl N , gi 55E/4 ,c-r . S . ?0 1 jurisdiction in which work is being performed. If the •
applicant is exempt from licensing, the following reasons
City/State/ZIP: acn,,,eli\jo at s i --7z,z,""/ aPPIY: .
Phone: itp ) - B Fax: : ( ,. 4) ? _...7/52., '
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E W n'ef WM .5 (Air 1 c-
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Business name: Kni■ ) 1 .t, C.C71/4).TIZI.A. Cr 1 CA..) , '''. 1:! ' [ •• • ••• : • i• ••i '1; I iiiiiiitlIkb •PtfilSitt PEItglE•iF!•i • •• • -:'
Address: '3600 C? SE tOrgASTR.bit_ 4,411 Please refer to fee schedule.
City/State/ZIP: SAN) CP C . f 76 55 Fees due upon application . .
•
•
Phone: Go3) 6 I: - ,., Pax: (56 . : -35 •. •
•
-. Amount received
COI lie.; all:4_:c , 0 ,
Date received:
Authorized signature:
if This permit application expires if a permit Is not obtained •
/ A within 180 days after it has been accepted as complete.
Print name: Liliu CAA kc. HI" OF Date: * Fee methodology set by Tri-County Building Industry
Service Board.
iAlkildineemils‘BUP-Permiti■pp.doe 12103 4404613T(l 1/02/COM/WES)