Permit ' `, ,' CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00210
1i DEVELOPMENT SERVICES DATE ISSUED: 5/10/2004
13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639 -4171 PARCEL: IS136CD -01000
SITE ADDRESS: 11745 SW PACIFIC HWY 100
SUBDIVISION: ZONING: C -G
s 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:
Remarks: Demo 8' x 8' opening for overhead door.
Owner: Contractor:
MONAGHAN FARMS, INC GFC CONSTRUCTION INC
14120 EAST EVANS AVE 17017 CANAL CIRCLE
AURORA, CO 80014 LAKE OSWEGO, OR 97035
Phone:
Phone: 685 -9702
Reg #: LIC 88411
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[TAX] 8% State Surchari 5/10/2004 $5.00
[BUILD] Permit Fee 5/10/2004 $62.50
Total $67.50
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
952-1e -II • : gh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
c- ng (503) 246 -66•' or 1-800-3 -23
ssued By: • i' �l �� - it/L‘
Pe - ',ee V /
Signature: . ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application A FOR OFFICE USE ONLY
Cl of Tigard Received ��
`J g Date /B `T
�L / / /./ / /ice It
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Date /By:
Phone: 503.639.4171 Fax: 503.598.1960 Uaaa I�ItI � Other Permit:
�� ��
Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I 17 y 5 5w "Pgelfi _ p1 7 New dwelling area: square feet
City/State/ZIP: k -p 0a 9 772. -5 Garage/carport area: square feet
Suite/bldg. /apt. no.: /00 Project name: T:30 2. Rtwt00t1 advaN1 wafer Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
PtC61f 1C V ■1 `' Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
De 11 10 S t x G • opcwiN Valuation: $
F� g�LI. ye INA 02
Existing building area: square feet
1�I'SrIL.t_ N �
New building area: square feet
❑ PROPERTY OWNER ENANT Number of stories:
Name: g c orp. p k_,- Type of construction:
Address: b 5 Z 4 hl g 1 _ 4414(„ Set Occupancy groups:
City/State/ZIP: jL,i J o 04 'I 721 3 Existing:
Phone: (O3) T.Sr7 .. 67 iS3 Fax: (S S ) 2-825 ■ EIJID 13 New:
PPLICANT ❑ CONTACT PERSON NOTICE
Business name: 1E44 tjtu. 51,4 o'er um IN tor All contractors and subcontractors are required to be
Contact name: �� y ��5 lib �` licensed with the Oregon Construction Contractors Board
1 under ORS 701 and may be required to be licensed in the
Address: 10,5 0 $E w Pss hi A 1 "h jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
Ci
176 run �' b apply:
Phone: (SDS) L5M - i,2- l Z I Fax:: (s'r) ) 7 54 — 67 bl
E -mail:
CONTRACTOR
Business name: { F. G Co rrux,nt��
{ BUILDING PERMIT FEES*
Address: 17b 7 C qL CITE
Q Please refer to fee schedule.
�
City/State/ZIP: vE �ttut 0 0' 1 7o 5�
�} Fees due upon application
Phone: (%9 3j -1 - Fax: (503 ) 67 - Es Tor Amount received
CCB lic.: (6(64 ` I
,- Date received: 4
Authorized signature: / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
i Print name:.. A1"4E-5 ig 0 wau_ Date: * Fee methodology set by Tri-County Building Industry
Service Board. # / 7-c°
\ \ Permits \
i:Building BUP- PermitApp.doe 12/03 440-4613T(11/02/COM/WEB) �f