11945 SW PACIFIC HIGHWAY STE 209-1 41 - 1 '
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equlpmcrtt is;;;pusc.i. 1984
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C►STRICT
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AUTOMATIC SPRIN KI.Eft F1 P'ECTCC�i
4000 S.W. HOCKEN AV'F,, BEAVERTON, OREGON 97WS
503-643.8551
VA I_ f I ! L L 1a (YE
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TITLE P-�civ v x T
11945 5W pacific Flwy
DATE a SCALE SHEET of
Suite 209
1 of 2 CONT. �4 ! DRWN. ___ SYSTEM of
-?SIP-o93- oia
If this notice a13pe:11•s cie:u•ei• than the
Jul- n 1998
docum;'ut, the docilmenl is of marginal quality. NUCIZ10 ILMEn
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11945 SW Pacific Hwy
Suite 209
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i^records\rrmicroflm\targets\builc.Iing.doc
DU{LDI . PERMIT
CITYSF TIGARD fERMIT . . : UP:
9 4 -w 104
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/r-_'0/94
13125 3W Aarl Blvd.T'jard,Oregon 97213.8199 (5M499-¢F17,17 1
PARCEL: 151.35DD-03301
SITE ADDRESS 11945 SW PACIFIC HWY #5. 102
SUBDIVISION. . . . : HOFFARBE=R TRACTS NO. 1 ZONING: C—G
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2
REISSUE: FLOUR AREAS----------- EXTERIOR WALL CONSTRUCTION—
LLASS OF WURK. : REF' FIRST. . . . : sf N: S: E: W:
TYPE OF USE. . . :COM SECOND. . . 7,f PROTECT OPEN I NGS?--•----------
TYF'E OF CONST. :5N THIRD. . . . : s f N: S: E: W:
OCCUPAN�,Y GRP'. :B2 TOTAL------ - : 0 s f ROOF CONST :B FIRE RET? :Y
OCCUPANCY LOAD: BASEMENT. : sf AREA SEF'. RATED:
STOR. : 1 HT. : 14 ft GARAGE. . . : s f OCCU SEPI. RATED:
BSMT? :N MEZZ? :ISI REOD SETBACKS-------- REQUIRED- -------------------
FLOOR LOAD. . . . : ps f LEFT : fit RCiHT: ft FIR SP,KL:N SMOK DET- - :N
DWELLIN, UNITS: FRNT: ft REAR: ft FIR ALRM:N HNDICF' ACC:Y
BEDRMS: BATHS, IMP SURFACE: F'RO C:ORR:N PARI;I NG:
VALUE. $ : 42000
Remarks : Re—roof bldg over si_tites 102, 104, 208, 201, and ='10 Cont inr-Cat ion of l '
work star^ted i.tnder- primary permit.
Owner: -- ------ -- ----- --- ------ ------------------------ FEES --------------
MILT BROWN type amol.tnt by date reept
115+45 SW PACIFIC HIGHWAY F,RMT f 247. 1Z Z, MAB 04/2'0/94 —
vF'CT $ 12-30 MAP 04/20/94 —
TICARD OR 97223
Contr-actor: --------------------------------
THOMAS DELANEY
u?522 SE DOYLE ROAD
ESTACADA OR 9702 ; --- --------------------------------
f-'hone #: 646-1156 t 259. 35 TOTAL
Reg #. . : 36881
------- REGOU I RED I NSF'EC-(I ON S -------
This perm-.t is issued subject to the regulations contained in the Final Inspection
7ioari 'iunicipal Code, State of Ore. Specialty Cedes and all other
appli_able laws. All work will be done in acr_ord3nce with
approved plans. This perait will expire if work is not started
h1hir. 1F� days of issuance, or if work is suspended for more
tha. 1P9 days.
Feer-mittee Si n t1_tr•e:
i s s 1-ted Py:
Call for inspection — 639-4175
PERMIT APPLICATION TIGARD OAT��,L� � ty Irl
BUILDING PE -
7HEUNDERSIGNED HEREBY APPLIES FORA PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOLI,PANYING PLANS AND SPECIFICATIONS. O VNER HONE ' p
�f1,111"Al ti LOT NO.
,C' �. JOB ADORESS 4/i'� .,7.,,• "M� i C+� r .Sly" e - - --
O'//NER�1 C --_- 1- ARCHITECT
ENGINEER
�� ��/� ADDRESS / OESiGNER
BUILDER
STRUCTURE (]/NEW REti OOEL O AOOITION �]_ REPAIR O RENEWAL Cl FIRE DAMAGE i ❑ DEIAOLITIO
❑ RESIDENCECOMA ❑ EDUCATIONAL ClGOV'T ❑ RELIGIOUS ❑ PATIO C] CARPORT ElGARAC _ G STORAGE ❑ SLAB❑ r-ENO
(! �— �i FIRE ZGNF "" PL/�N CHECK OY �_HEAT
OC CUPANCY �"�LAND USE ZONE SLOG.TYPE ,� —--
1 ->� _
4- e 6'i — -----
SEWER P ER P.I I T N
OCC.LOAD FLOOR LOAD HEIGHT
NO.STORIES AREA NO.BEOr4OOMS VF_LU%
BUILDING DEPARTMENT SET BACKS FRONT �� k'-F—R J+ f_- I-I~ IOE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO T REGULATIONS CONTAINED IN THE BUILDING CODE,ZOII!•I
c �., ; REGULATIONS AND ALL APPLICABLE C DES AND ORDINANCES, AND IT IS HERE21Y.AC' 'EEO TFAT T1.
�P1a�Check J.�-' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND 1 COMPU424C
WITH ALL APPLICABLE CODES AND OROIHANCES- THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
�SuSlolal 7 RESTRICTIVS COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITE BUSINE'
►ICENSF-SEPARATE PERMITS REQUIRED FOR SEVER.PLUTA@ING AND HEATING.
Stbu Tax(
-
Tota) (c-J C� APPt jr-ANT OR AGENT V-- �- `--
LPDCN Receipt No. P.00RESS - PRONE
,1pp�F i
SOC -
POC -
SEWER CONNECTION S
SEWER INSPECTION S
SEWER SURCHARGE S
.m'uln Fabrics 5326'��,
BUILDING PERMIT APPLICATION TIGARD DATE Apr6l 22 -&
THE UNDERSIGNED HEREBY APPLES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 234-3135
OR AS SHOWN AND APPROVED I,14 THE ACCOMPANYING PLANS AND S"CIFICATIONS. OWNER PHONE_ '. •"1%s2
LOT NO.----
OWNER
0. —_OWNER Fav Z<ittleS011 qtr?A_DDRESS 11945 S11 Ya'_ifiC iiigll"y Shits 209 & 210
` 1904 c::: I;lliatt. ARCHITECT
ENGINEER
BUILDER Chuck 13urrough0 ADDRESS Pot tlut.I■ LSH 97214 DESIGNER
STRUCTURE ❑ NEW Q REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE {COMM ❑ I.:)i.UCATIONAL ❑ GOV'T_ L PFLIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY {�"z—LAND USE ZONE C_'I' BLDG.TYPE _5 N _FIRE ZONE '""" PLAN CHECK BY N"W HEAT `--
Tennant modification aj 1*r approved plans b curie requirements
SEWER PERMIT# 1,oI.Iv --
OCC.LOAD FLOOR LOAD HEIGHT_ NO.STORIES AREA _ NO.BEDROOMS -- VALUE 1U.UUU
BUILDING DEPARTMEN T SET BACKS FRONT 6 REAR LEFT SIDE F IJHT SIDE
Permit _ y• ' _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN rHE BUILDING CODE, ZONIAG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TAE
Plan Check 52.3' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANi,E
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-totalI jl.• a RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPAR`TF^ERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4 w 3.22
Total
136.05 SDG -
PDC# APPLICANT 0.1 AGFNNT
By
Receipt No, —
Approved Msbja ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/ Cor tr r;.tor -
Per nril No.
Ruiigh•in
Fixture
.Final —..--
HLATING
- �lC•muartnr
�Fipn
Nns^r oil J-
Finnl
SEWER
DRIVEWAY
Final
I Storm Drelnage
IHnin Drrinl Fln;,l
Srdnvwlk
Curb&Street Final
, Approach
_
ElLOG. DEPT. FINAL TE,;i ORARY CEC•r PiCA-rE OrCLIPANCY -;nal
CERTIFICAZ:_OCCUPANC`'
I , Landscaping
..L.—..-.�._...._. iLlnronp F,nil
\. e
URK HUI HUME MINN
P 0 SOX 127 • TUALATIN, OREGON 97062 • PHONE 682.2601
.r
VAL_l1E VILLAGE :i/'tb
!1a y 11 , 1984
209 SW Tigard Plata _
g ---
Tigard, Oregon 97223 4139- 7
2510--093-012
hear M B Hinds Company,
3) This is a Fire and Life Safety Plan Review for the
automatic sp;-inkler protection system
installed in basement of Value Village.
This plan review is predicated on the
1980 edition of the National Fire
Protection Association Standard No 13
56) Call this office for inspection of installed equipment
while the installer is stili on the ,lob. Please notify
this office twenty-four (24) hours prior to anticipated
completion for field verification of romplianr.e of altered
equipment.
10) Approva'. of submitted plans is not an approval cf
omissions or over!,ights by this office or of non-
compliance with any applicijble ,egulations of local
government.
218) Normal office hours for Fire District Inspectors
are from 8. 00 to 9 00 a. M. and from 4: 30 to 5: 00 p. m.
Inspection requests and questions should be made by
phone during these hours only. Whenever possible
please ask for the inspector you wish to talk to,
by liame
If you desire a conference regarding this plan review or
if you have questions, please contact Gene Qirchill at
(503) 682-2601
Si e�� Cc
�✓ mac. Birc
Fire Prevention Burp,-u
CITY OF '
BUILDING PERMIT APPLICATION TIGARD DATE _ N° 0469
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER �''l f� ADDRESS �— BUILDER PHONE
.e I I ENGINEER
BUILDERr"�r� .f ARCHITECT DESIGNER
STRUCTURE KNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE r-]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE C1 DESIGN REVIEW [:]COUNCIL APPROVED 'L�SIGNS
OCCUPANCY---LAND USE ZONE —BLDG.TYPE FIRE ZONE_ PLAN CHECK BY_ HEAT_-
. r
OCC. LOAD _ FLOOR LOAD HEIGHT___ NO.STORIES _ AREA VALUE
BUILDING DEPARTMENT — SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit •� ` _- - ____ �—
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check -qcl REGULATIONS AND ALL APPLIJABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK W%I_L BE DONE IN ACCORDANCE WITH THI?PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording '�^ ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE., SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATINr3.
Total
I By APPLICANT OR AGENT
Approved Receipt No.
ADDRESS PHONE
DATE INSt, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rou h-in
Final
-- --------- SEWER
_ Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
%rb&Street Final
A roach
SLOG.DEPT. FINAI TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY _
Landscaping
`� �� Zoning Final
ti CV
all
to
*�,j ce
V) kki
tj
�.s J it
• Z • ? C W � 1- �\ �` '.l x ��` �1 o v'► � o O tL •� � v y�•. o
o� 40 ,� J
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G7 I I I i ' II
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f'I,'I11111�1�� i { r:
1-41 11 0
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1
CITY OF
BUILDING PERMIT APPLICATION TIGARD DA,E-c =J x. 19 N- 0 0 31
THE UNDERSIGNED HEREBY APPLIES FOR APER"iii t FOR THE WORK HEREIN INDICATEL
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE,—_____
// _ / /
UWNLR -i '/y�rr� _ ADDRESS �L c d ��
u ?,?�a. BUILDER PHONE
ENGINEER /
BUILDER _ Ot-n 1.`e ARCHITECT DESIGP ER _
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION _DREPAIR ❑RENEWAL ❑FIRELAMAGE ❑DEMOLITION
❑ RESIDENCE [:)COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND y❑MOV ING ❑�CCIN�DDITIONAL USE CI DESIGN REVIEW ❑COUNCIL APPROVED SIGNS
,gCCUPANCY� �-• LAND USE LONER-BLDG.TYPE-FIRE ZONE-1-7- PLAN CHECK BYHEAT —
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES _ AREA VALUE
r— BUILDING UEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit j
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS.AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State �,� LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
J
Total
By �C _ gee -
. .. AP" ' NT OR AGENT
Approved Receipt No,/0 "
�. �7
J'j ADDP) S5 PHONE '-
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE— 8-119 74 N° 0028
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN'. AND SPECIFICATIONS. OWNER PHONE
OWNER Wigwam Outdoor_atoreP ADDRESS Ti ai3 _P1a2a BUILDER PHONE
ENGINEER
BUIII- uminite Sign Co. ARCHITECT DESIGNER
STRUCTURE _❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
O RESIDENCE ❑COMM ❑EDOCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO []CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
0wOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW 000UNCIL APPROVED ®SIGNS
OCCUPANCY--LAND USE ZONE BLDG TYPE FIRE ZONE_ PLAN CHECK BY HEAT
10.00 for a, ian_permit
2.00 copy charge to change face from Wiewam _meq_ Pleld pan-ry___
4 OCC, LOAD V FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE _
Permit 10.00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
2.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT 1HE
WORK WILL !IE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HL.VE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS RE.OUIRED FOR SEWER, PLUMBING AND HEATI G.
Total fin Lygl.All1" '. Z Ai co
By —
APP' 'SANT OR AGENT
Approved Receipt No. 10(,O /(p ! . S C �J•iU , T1
ADDRESS PHdNF
EDLITLDI"JG PERMIT APPLICATTrN CITY Cr TIGARD da 1;R ' 9 7'1
7h w-dersigned hereby arn.i ic,n, Por a permit ror the work hereinindicated
n Z-07OWn. and approl. c.-4 : 'h,? ing plana ard operi fications,
lo
V
.A4&j=KjDqE
LNGINEER
91i I L n C() PHONE 63,7 -i�c7l ARCHITECT
DESIGNER
STRUCTURE IDNEW El REIMODE L 0 A D D 1 TI 0 N OREPAIR CIRENEWAL. OF IRE DAmAGER
ODEMOLITION
0P?SIDENCE OCOMM OEDUCATION 0GOVflT CRELIGIOUS 0PATIO QCAR PORT 0GARAGE
Q 5 10 R A G E 0 SL A BE C_NC E
BOND OMOV dG [J.r4L�Qr,�Q=D DESIGN �L�IEW QCOUNCj.L APPROVE SIGNS
N,_,USE OF_Q_ 7
OCCUPANCY LAND USE ZONE BLDG. TYPE EIRE ZONE
PLAN CHECK BY HEAT
rl 1 G,H 5 1 D E
r, T
P)�, T pr R 1T 1:3 155"IED SURICCT TO THE P.[-GUL.ATIOfJ5
ImE CODE, ZONING REGULATIONS
AND ;I'LL iQF.';,'1ABL(' COOE3 AND ORDINANCES AND IT 15
HERF.9, 'y PCRC. 6 1-.AAT r!- F WORK WILL BE DONE IN
ACrORWICC Q'IT14 THE PLANS AND SPCCTFIrATIOPJS AND IN
COMP.L. IANLF WITH ALL APPLICABLE CODES AND ORDINANCES,
IL' state THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE
ImEal COVENANTS. CONTRACTOR AND SUB-CONTRACTORS TO HAVE
h� CURRENT EITY BUSINESS LTrENSE . SEPARATE PERMITS
np.prowgrj REOUTRED FOR SEWER, PLUMBING, AND HEA IND.
FA�
Or ag
C,
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1
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xis(
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AL(. �lo FEXCFPt
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City of Tignrd
INSPECTION N REQUEST
for
SPECTION '`IME: _ . r PERMIT NO. : _ IN:
DATE.'
.,E Gr�/ %i DATE ISSUED : Z Z
/NERS NAME :9c GG, a; OM
ADDRESS: 7"
:NTRACTOR : _ I CC
'.ST : Air ❑, Woter❑ , Visual ❑ , Laboratory ❑ I TE
:SULT: Approved ❑ , Disapproved rl , Pending ❑ RE
.ETCH: SM
I
I
I
ru t .
IN PECTOR DATE I
B: Attach supplemental test data bereto] I Cpl
1
v�
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME:: J PERMIT NO. :_
DATE: 6 1 ? 7% DATE ISSUED :---L-L-. I
OWNERS NAME
ADDRESS: � �- ���'�
CONTRACTOR :
TEST : Air ❑, Water[] , Visual p , Laboratory p
RESULT: Approved Cl , Disapprov id 0 Pending p
SKETCH: y vPur f` �a 4
�•ayrvu�� �paf� 1�... /u�, �l.�J 11
I .
( t SPECTOR DATE
EWE: Attach supplemental tett data hereto
1
A
II+GCATI:::JOB # LOT
v�� �i!��!.1,.� _ _ C:•ii�k�ct ��� ��x:J.i.���...�ss.�.,.....�........
PLUMBER � � PERI±IT
SEWER F RNIr it
DATE BY
EXCAVATIOi� 'r " '•r;r
_ AIR CO.MI1 0 11'r
FOOT INGSt:lIl .-
�_ FORMS aPP.I".�'I. R :XP►1 ._.__._._�__.,._ I
iiElinxiCZf� STRrL_� y. :SE±I WRS/EXZM
STRUCTURAL STFIL _ CAEPV.F' f'! 9, •___...____. _.
PI.-IMMID R.I.
__ . I'tiff I'Ai?'CI;:y ......_ _ ....... ._..
5110
CITY OF TIGARD
12420 S. W. Main f —(
TIGARD, OREGON 97223
APPLICATION POP UJIT,I)ING PERMIT
11111111
New Construction ❑ Demolish ❑ Addition Remodel Move❑
ZONING DATE, ISSUED /� BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ No.
BY PLAN CHECK $ '7_JOTHER $ -
VALUATION $
TOTAL / • J%,-,$ RECEIPT No./O Q
Y
±F41
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNIGIIF.D WITH APPLICATION
LOT # MAP # CENSUS TRACT _ JOB #
Architect or Engineer
Address—
Owner—."-lJ
ddress_Owner—".aJ I Cr LU 4 M
Adr.resslt�.A V. SAND t_ /S'LuQ. .�eVyJ-41;N OG'<`e,,l hone
—7
Builder
Address ���•�'y�n���_rL�rl�'�e,vPhone
BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ® Industrial U
OCCUPAN ROUP _ No. of Stories Total Height--- Area of Lot_ T_-_
Typ Co rift, I II I'I IV V Floor Area B j_ 1 j•S/s� 2
Set Ba s: FrontZe�--,e-�ack L.Side` R.Side_
PrivateS ewe a 51ze �j�- Sewer_ L S' Septic Tank ❑
Water Service Pipe Si Storm Sewer ❑ Ditch ❑ Drywell❑
Street and Curb Requirements_ la /7
Driveway Width Jltm'c - z,-X S lege o. of Parking Spaces__________
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
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ADDRESS ASSIGNED ;ff--A-___fCLAQ1CQ,
FIELD CHECK BY DATE
PERI4IT APPROVED BY (1. .ev1 —`
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of occupancy has been issued by the City of
Tigard Building Inspector. _7
Signure of Applican7P