12775 SW 69TH AVENUE ADDRESS:
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CITY OF TIGARD PERMIT :4. . . . . . . EAUPI)5 -tie
COMMUNITY DEVELOPMENT DEPARTMENT DnTE ISSUED: 04/06/95
13125 SW Hall Blvd.Tigard,Oregon 97223*819? (503)431041171
PARCEL: 2S101AD-03000
C.TTE ADDRESS. . .
SUBDIVISION— . - WEST PDRTLAND HEIGHTS ZONING: C-P
I'd-O-V
LOT. . . . . . . . . . . . . : 31 A^
- .7-9 .._.1)7 "'-- __-
PC I-11JUE: FLOOR EXTERIOR Wl-)L.L COI*,IS)TRUCTTO,1111
CLASS OF WORK. aALT FIRST. . . . . S f* N: S: E: W
TYP k'_ or usr, . . :coil SECOND. . . : s f PROTECT OPEN INGS;)---
TYPE OF Co.Nis,r. ;5N THI RD. . . . 5 f N: 5. E: W.
OCCUPANCY GRP. :R.3' TOTAL__..._..,_._._..__ S f POOP CONGT. rIFRE RET-.*
OCCUPAINIC-'Y LOAD:, B A 1-7*i E M E NT. : I 151 6 f AREA ;EP. RATED:
'i T 0 R. -, HT. : f-t ',-.0PAGC. . . .540 f OCCLJ SEPRATED.,
SSMT? : IYIEZ'7? ; REOD _C'ETBACRS------....... RCOUI RED----------------
rLOOR LOAD. . . P f1-TiFT.- ft RGHT: F t r-IR OPKL: IDMOK DET. .
DWELLING UNITS; 1 FRNT: ft REAR- ft F-IR ALRM- ' NDICP ACC.
BEDPMS: P.A T h 4 S. INV-", SJURFACE: PRO CORRt PARKING:
VALUE. 1; :
P,e m at-k s; : ,f a 1756 sad
q. ft. hol.ti�e nal 3417.1 5q. ft. garage. Septic, t
T)k tLLL��c.
IT11.1-nt LN pumped, fillod, And inspected.
OWn e-r: - - -- - - - -- - - .. -"-' - ----1-._-._.----- - - -:Ec; I
S'E'VEN KOLBERG type amol-trit by date
w` 131 F.)W TOW1*,I Cr,.NTr;-R LOOT., P RMT 1. 012) 10 04/05/':+
SPCT $ 1. 25 B 04/05/9VI
al. 00 S 13 5 15 -
W1!..-�3QNV1L.LE' OR CROS $
P`iclnc� #: ;2i14-164r'j CRPC 9i 8. 4' B 04,105/05 -
EPPI� P
1214/05/1)5
C0 T)tr-L4 C:t 7r~• _..., .... _.._
STANLEY
j1-
STANLEY KOLSERG
1`1114' 11ASI(ELL CT UNIT
PZIRTLAND Or', 972,,29 ......
6 i'l 3-45"-15 69 15- TO 0 L
3 A 17�5
-------- 115QUIRED INSPECTIONS
This persit is iSsied Sutiect to the regulations contained in the Pump/[!'ill septic:
Tigard Municipal Code, State of Dre. Specialty Codes and all other Mi Sc. InspectiLm
applicable laoos, All mcrP will Ws done in accordance with Final InEpection
approved —_._._ _.�_. _ - _._.._...._._..
plans. This pirvit will expire if wcrP is not started
within 18e days of issuance, cr if work is suspended for P-.re .......
than 18t days.
i-ispec,t ion 6:39-417'1
City of Tigard Commercial Buildin Permit Application
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
/?-77--S'
Jobsite Address: c^eRA)jZp_ ,itr r/h'/`1praiy
Office Use ani
Tenant: A�16 Ve= Suite#
Valuation: S S-O 0 Planck/Rec #
Permit# ( I
Owner: Map & TL #_
Address: 2g7S1 ,5W 7 ow,v Looe w Approvals Required
InJLS�vv�. O)C.L-G Olt Planning _
Phone: C 30� 6 FI__ 0 y A oEngineering
Other
Contractor: IQLr i� �, f�0L3L;W, -t 5ON5 Ca ti67112-Of Tr o y
Address: /.tomi� N►v //AS.& �� LT. U iv r i '7
Type of const:
Occupancy class:
Phone: (51031 G`r'3 5 3-b— 14 Z(, e 6 � 5
Sprinklered? Yes No
Contractor's License #
(attach copy of current Oregon license) Sq. ft. of project:
Contact name & phone:�-t4i_ 4 a X6,LSr_,4Ltw 6,Y3—y_5a ' Story (1st, 2nd, etc.)
Proposed use.
Architect/Engineer: _.TL--V[N JS f<6t_F3,L—
Previous use:
Address S tk, Ta w H CL=N72,P <_06F w,_
Note. Plumbing & mechanical plans
w4,5,y v t_ /►/P-r,e)m _ must be submitted at time of
building permit application.
N Phone:
J0B DESCRIPTION: UCILI d'4- 1_<.H Ot C%/..Elv s/� Nn�p ,�K rjgf & / �y �
L_ bv'/� r�� /�kf)o �. V Fh'Otj ` ' 'of t.srLy
X�eqq_�
App scant Signa & 15ho m`fier
1
Received by: ,f• ��I,IJC-�l„>r'l�k �`-- _ Date Revived:
Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg: L
Plumb:
Mech: �.
Plan Check (PLANCK) _
Bldg: _
Plumb:
Mech:
Sewer Connection (SWUSA) _
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mrss Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institut onal TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: