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Permit x-1.7_ Sir -ra SST S Ae-gA--O [Of t vODAe1 Tr 726 [ g Z 12 7,4 tS DU 6 W i - F- V Commercial Building Permit Application 4 4t) Cy of rgaro 731 :5 SW Mau elva. Nara. oR 97223 (503) 639 -1171 Jobsite Address: 224-c. SN(C N pi 1 Y er, OFFICE USE ONLY Tenant:_ j'T•E_ ►fl Suite # Planck/Rec. # Valuation: 4 4'I ©CDC Pernik* 1 t w ,.M e) • • K S • Owner: .-460 ecnatmT ADorovals Required Address: ? lshy S \V t 4 L hiltIP ST ( . Planning • ( CD? 2 Z3 Engineering 'elephone: GDR, --1 Q.1 i ? Other . . • Contractor 't ' IS!,( 157 /09-3e0 1 46C Address: Type of constr•, V N Sf+RA4 Cc• -rip Telephone: Occupancy Class: Contractor's License # Sprinkler? No G''4° (attach copy of current Oregon license) � e�' �./ Sq. Ft. Of Project 1 044- A Contact name & telephone: 3 (rats S G,44 — ■e2 2 Story (1st, 2nd, etc.): ( Architect & Engineer: .,A A ec.s4 irw.,trs Proposed Use: l L. Address: C ?7 S S\\ I t ITS+ A AL. 1 1 v Tree i �Q ' 00$ Previous use: '�'etiL Note: Plumbing & mechanical plans must Telephone: 44- --- 4 -2ZE be s bmitted at time of building permit application. JOB DESCRIPTION: e - .��.�. Co 4-4- (Applicant Signature elephone Number) eived by: Date Received: U Q — 11'/ e 2 '.1Tt.CCC kcsr 'Q�o 'ERMITX g Account Description Amount Amt Pd. Balance Due CB uilding Permit (BUILD) V — Plumbing Permit (PLUMB) Mechanical Permit (MECH) State Tax (TAX) 7b � V lb art) Bldg. Plumb. Mech. 240 v Plan Check (PLANCK) c('(5.- 9(5. Bldg. f Plumb. Mech. Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential T1F (T1F -R) Mass Transit T1F (TIF -AMT) Commercial T1F (T1F -C) Industrial T1F (TIF -I) Institutional T1F (T1F -IS) Office T1F (T1F -O) Water Quality (WQUAL) Water Quanity (WQUANT) Fire Life Safety (FLS) 1 a/ 3, 40 • Erosion Cntri Permit (ERPRMT) Erosion Planck/USA (ERPLAN) ./ Erosion Planck/COT (EROSN) 77-C3 1 r TOTALS. �X ! 1 • I:'CCMTf.CCC (CS7) 1Ci5