Permit cCi.ic= p rnt lMpr T r nm
PERMIT
CITY O F T I GARD DATE 12/26/95 —OJ"
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard. Oregon 97223.8199 (503) 839 -4171 PARCEL: 2S11 2DA -00400
SITE ADDRESS...: 06650 SW REDWOOD LN #150
SUBDIVISION • ZONING: I —P
BLOCK • LOT •
TENANT NAME •INS. CO. OF NORTH AMERICA
USA NO..........: FIXTURE UNITS...: 9
CLASS OF WORK...: ALT DWELLING UNITS..: 1
TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 s
Remarks: Tenant improvement.
Owner: FEES
PACIFIC REALTY ASSOCIATES type amount by date recpt
15350 SW SEQUOIA S -300 PRMT $ 2200.00 JSD 12/26/95 95- 274259
TIGARD OR 97224 •
Phone #: 503- 624 -6300
Contract or:
CONTRACTOR NOT ON FILE
Phone #: $ 2200.00 TOTAL
Reg #.. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not Guarantee the accuracy of the —
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tao and Side Sewer" Permit and the Agency '11 inst 1 a la�
Permitte - tre:
Issued By "
.
Call for inspection — 639 -4175
95-
•
• Commercial Building Permit Application " i�1, `
City of Tigard
13125 SW Hall Blvd. W1375
Tigard, OR 97223
(503) 639 -4171
Jobsite Address: 66 sz 51%
Z Office Use Only : :`: : : : . : :
/� L
Tenant: S N '` ' Suite # / 7
Valuation: Planck/Rec #
Permit #
Owner: Map & TL #
Address: Approvals Required
Planning
Phone: Engineering
Other
W //...oti'LA-41... ., Contractor: � fa. j ,
Address: / � arKr
t V Type of const:
2 3 , y/ Occupancy class:
Phone:
Sprinklered? Yes No
Contractor's License # c Z / 7= — '>/2j2 3/ 7
(attach copy of current Oregon license) Sq. ft. of project:
Contact name & phone: We il„. „ Story (1st, 2nd, etc.)
oZ �j�p - C / s,Z_ Proposed use:
Architect/Engineer:
Previous use:
Address:
Note: Plumbing & mechanical plans
must be submitted at time of
building permit application.
Phone:
A oe CA-k - 3 `
JOB DESCRIPTION:
Applicant Signature & Phone number
.
J
Received by: L -- Date Received: / C CS /
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)
Bldg:
Plumb:
Mech:
6 4,.}a95-- Sewer Connection (SWUSA) �C
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)
i1
Office TIF (TIF -0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: VE v
C enarit Name: AILS. U1• OF N. AM .IGA Accumulative Sewor Tally This SWR #: Salle 95 /5 22-
Address: h. 6O '' This PLM #: //-17/15 - O 373
REDWOOD LAAJE1 u(re ' I SO (PL-Dr Z4.0
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off valu added # added total #s total
Count off #s IJIA count 14 /A value values
Baptistry /Font 4
Bath - Tub /Shower 4 / i f 1 T
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4 2.. S 1 if 3 12--
- Domest 2
Drinking Fountain 1 3 _ 3 3 3
Eye Wash 1 /_
Floor Drain /sink - 2 inch 2 5 /0 1 Z 6. I?—
'
- 3 inch 5
- 4 inch 6
- Car Wash Drain 6
Garbage Disposal 16
- Dom (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind (over 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2
Sink - Bar /Lavatory 2 1 W 3 2.. 110 32
- Bradley 5
- Commercial 3 b l K I 3 4 e
- Service 3
Swimming Pool Filter 1
Washer, Clothes 6
Water Extractor 6 r
Water Closet, Toilet 6 1 C IO f!O dip L 9
Urinal 6 l0 3 ( 6 36
TOTALS ? 9 e/ (
Total fixture values: - 0/(0 divided by 16 = ./3i5 EDU = 14. N . ; 7 ED<c .
HISTORY
PLM# 95_A364EDU# 13 SWR# etS -OvR PLM# 55- 0046EDU# II SWR# els-. 0341g
PLM# 415 -0318 EDU# 13 SWR# 96 -04u, PLM #qq5. t EDU# Il SWR# q5- 034-7
PLM# 95 -0253 EDU# 17, SWR# 95 , •fie ?6390 PLM# 11 -tit1 EDU# it SWR# 95_ n34c,
PLM #15 -0 EDU# 12, SWR# 95-030 PLM# 14 O1s7EDU# ii SWR# q(`, 61401
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4. +
12• +
3. +
12• +
32• +
21• +
96• +
36• +
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216•
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14• *
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