Permit S I T E WORE:
PERMIT
CITY OF T I GA R D DATE ISSUED: 08/02/96 -aO35
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 2S 1O2CC -00600
SI T D F vd..Tigard. ?nr.,,t 4 HWY
SUBDIVISION • ZONING: C -G
' BLOCK • LOT
TYPE OF WORK: ADD RAVING? • Y RESO. NO.:
EXCV VOLUME: 0 cy GRADING? • N VALUE...$: 6500
FILL VOLUME: 0 cy LANDSCAPING? • Y
ENG FILL? • N SITE PREP? • Y
SOILS RPT READ ?: N STORM DRAINS ?...: Y
IMPERV SURFACE: 2500 sf
Remarks: Construct parking lot with 10 parking spaces
Owner - FEES
JKN ENTERPRISES type amount by date recpt
C/O KELLY KOCH SWM $ 180.00 CJS 08/02/96 96- 282456
13710 SW MARCIA DR SWM $ 100.00 CJS 08/02/96 96- 282456
TIGARD OR 97223 PRMT $ 62.50 CJS 08/02/96 96- 282456
Phone #: 579 -1372 5PCT $ 3.13 CJS 08/02/96 96- 282456
• PLCK $ 40.63 CJS 08/02/96 96- 282456
Contractor: EROS $ 80.00 CJS 08/02/96 96- 282456
EASTSIDE PAVING INC ERPC $ 26.00 CJS 08/02/96 96- 282456
PO BOX 1049 ERPC $ 26.00 CJS 08/02/96 96-282456
GRESHAM OR 97030
Phone #: 492 -7563 $ 518.26 TOTAL
Reg #..: 068962
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 S t r m Drain Insp
applicable laws. All work will be done in accordance with Final Inspection
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.
Permittee Signat re:
Issued By: iii i '•i��
Call for inspection - 639 -4175
51
•
CcrmurerciarBuilding Permit Application
City of Tigard
13125 SW Hall Blvd. 6
Tigard, OR 97223 SI/)/
(503) 639 -4171 aq
Jobsite Address: i 3 56 S -Sl ✓ Gtati <
Office Use Only
Tenant: Suite # ; ...° .. :1
/ x,
Valuation: lv Planck/Rec # . .
Permit*: c2-777-74 : C55?
Owner: ' KIJ 54"r: FraI3t~S
Map & TL. # — eSId F Cc 6
Address: /O 120c.}-1 131 IC .51-0 MAC_ufi J7e. Approvals Required:
G� ►� (l.C) CC. 9 72 i3 Planning Nee%
Phone: 519 - l 3'1 '70 nA ara
v Eng . . : : :
Other
Contractor: EAST—S--',i0t PAv"irJ6
Address: 17 O 2- N. w . EL Ev'
�P� ��� C- 3nc. -- ct 7s���' Type of const: � �ilt2 K i N 4 L.a
Occupancy class:
Phone: 4 - 7.5t3 (Jj_.' ta,ticr11 ,) 7/ -7.46 (a)
Sprinklered? Yes No
Contractor's License # 4'0896 Z. /�
(attach copy of current Oregon license) Sq. ft. of project: ZS00 -,f7',
Contact name & phone: d EZr3 L n! CLEVE. Story (1st, 2nd, etc.)
4672. - 156 -?
Proposed use:
Architect/Engineer:
Previous use:
Address:
Note: Plumbing & mechanical plans
must be submitted at time of
building permit application.
Phone:
JOB DESCRIPTION: CoNs lL k_r . P 41N4 L-01 Wrifi 10 PR K.1 s%
g
A•plicant Signature & umber -
0 6
Received by: Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due `'
Bldg. Permit (BUILD) G 2-;s .
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg: .3 Li_
Plumb:
Mech:
Plan Check (PLANCK) 110s "'
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) , I COU• 0tl
0 -65 Water Quantity (WQUANT) / p. a
Fire Life Safety (FLS) ,,//��
Erosion Cntrl Permit (ERPRMT) d'
Erosion Planck/USA (ERPLAN) / — 26. (P
P
Erosion Planck/COT (EROSN) 2 G 26- 6?)
Jo
(1)7 .
TOTALS: e).L-
kii
0, ►
\ CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: CO / — 9 k A.M. P.M. MST:
2
Location: ' y ) 5 5 ' .a'(4J (J' BUP:
Tenant: rl l� u / C5 7 .
Suite: Bldg: MEC:
Contractorj Phone: PLM:
Owner: - Phone: ELC:
� A.0t Ni-__. am
l + - - '
f �! � .'. _••�Ar � . — . , d -/ _ I ELR:
� . / —
l / lam
�" U 0 SIT: 0035
BUILDING BLDG (con't) ' LUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service NIISC.
Masonry Fire Sp Ceiling Rain Heat Low Drain Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt p6 ,
Approved Approved . Approved Approved ( ved )
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not A roved
FINAL FINAL FINAL FINAL FIN
/ I
A A 0 _ A .1! &_ /Li .' �.�i . . / // 1
1
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: 7762. Date: / Page of