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BUILDING PERMI1
CITY O F TIGARD PE R M IT #. . . . . . . : DUP911
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/20/94
13125 SW Hall Blvd.1*igard,Oregon 97223*8199 (51R?fS
7ill I
PARCEL: 2SIOIAB-01000
ie.) ,JW 721\1D A V E
SUEDI VISION. ZONING: R-25
BLOCK. . . . . . . . . . .
LOI.. . . . . . . . . . . . .
REIS13UE: FLOOR EXTERIOR WALL- CONSTRUCTION
CLASS OF WORE;. :DEM FIRST. . . . : s N: S: E: W:
TYPE OF USE. -, '-F
SECOND. . . : 5
TYPE OF CONST. :5N THIRD. . . . : s N: 5: E: W:
OCCUPANCY GRP. :R3 TOTAL----------: 0 4g f ROOF CJNST: FIRE RET?:
OCCUPANCY LOAD: BASEMENT. . 'L.f AREA 5EP. RATED:
S'T OR. : HT. : i�t GARAGE. . . : '.5 f OCCU SEP. RATED:
DSM'T? : MEZZ?: REUD SETBACKS—---
FLOOR LOAD. . . . : psf I-C.-FT: ft RGHT: ft FIR 5PKL- SMOK DET. . :
DWI:_J_LING UNITS: FRNT: ft REAR: ft FJt ALRM: F-INDICID ACC:
DEDRMS: BP71.1s: IMP SURF(ACE: PRO CORR: PARKING.
VALUE. $ : 0
Remarks : SEPTIC TANK TO BE REMOVED
Owner,: FEES
CRITERION EQUITIES t;ypj am 0'.1 Tit by date I-e C Pt
16225 SW BOONES FERRY RD, #LO---' PRMT $ 25. 00 JG 07/20/94
5PCT $ 1. 25 JG 07/20/94
LAKE OSWEGO OR 97035
Phor)p #:
MEGO PACIFIC'
3777 SE 21ST AVE
PORTLAND OR 97282
Phone #: 238.-3772 $ 26. 25 TOTAL.
Reg #. . .- 63108 REQUIRED INSPECTIONS
This permit IS Issued subject to the regulation; contained in the Pi.tmp/Fill Septi(2
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Irispectiun
applicable laws. All work will be done in accordance with
approved plans. This permit will ex'pi-e if work is not started
within 180 days of Issuance, or if work is suspended for more
than IN days.
,7- Ppi-mittee Sigriatui-e :
V
ISS1.1ed BY :
C—al—1f.a t- inspection 639--4175
Residential Sgilding Permit Application
City of Tigard w U Ig U v
13125 SW Hall Blvd.
Tigard, OR 97223 `
(503) 639-4171
Jobsite Address: /.2 ��/< �•/�. '�Z�!� /�L'E
Subdivision: Lot# Office Use Only
Planck/Rec #
Valuation:
Corner Lot? Y Permit #
Flag Lot? Y Reissue of� -`�--
Map & TL#
Owner. t;'R 1 TE21DrJ U►71�S Appruvals Required
Address: f"r-IZAy L?(S(, Planning
5u r rE ZO'3
L.AK ' O54,+/EG0, rR . 97035 Engineering
Phone: (e77- 9 ` 72 Other
Contractor: M 6,64A PAG I F IC,. C.O. Items Required
Address: -33 7 7 5 .E . 21 r Ay(r • Subcontractors
pc IZ r t-,tAN C)A 09 , 17 w2 — Truss Details
f=hone: _( -', ) 2�38 - 18 8 — Other
Contractor's License # L,- 3 I o p)
(attach copy of current Oregon license)
Contact Name & Phone: K1E IL.. 7NC Gi6Z5 'Z3&-377Z—
Subcontractors:
3&-377Z.Subcontractors: Architect/Engineer:
a Plumbing. — Address
v Mechanicals
(attach copy of current OR Contractor's License)
h
Phone:
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u JOB DESCRIPTION. DEMO H�ktL. —QFF L-:�7�15TlNCi iZVSI PFNCI:
Applic Signature 9 Phone number
Received by Date Received:
N WORM OMOF"ESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
_. Plumb. Pr—mit (PLUMB) _
_. Mech. I• mit (MECH)
State Tax (TAY.) _
Bldg:
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)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
V7 -- - - -
Fire District (FIRE) `
J
w Erosion Cntrl Permit (ERPRMT)
c.�
11' Erosion Planck/USA (ERPLAN)
J
Erosion Planck/COT (EROSN) _ - -- A
TOTALS: