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Permit 01, . CITY OF TIGARTI-9 BUILDING PERMIT PE RMIT #: BUP2005 -00262 -elk DEVELOPMENT SERVICES . DATE ISSUED: 6/22/2005 `- '�J I" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639-41 PARCEL: 1S136AD-06502 SITE ADDRESS: 10935 SW 68TH PKWY ZONING: C -G SUBDIVISION: WAY LEE LOT: 001 JURISDICTION: TIG Project Description: Modify cell tower. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FIRST: sf N: S: E: W: TYPE OF USE: g SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 10,000.00 Owner: Contractor: WAY W LEE OREGON ELECTIC CONSTRUCTION GENERAL CONTRACTOR 1010 SE 11TH 5210 SE 26TH PORTLAND, OR 97214 P OR 97202 Phone: 503 - 234 -9900 FEES Reg #: LIC 203 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 6/17/2005 $139.30 [TAX] 8% State Surchari 6/17/2005 $11.14 [BUPPLN] Pin Rv 6/17/2005 $90.55 Total $240.99 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1-800- 332 -2344. Issued Bydi r ZS Permittee Signature: - Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. iorgs so- 6 i + - 4 REC VbD �• Building Permit Application O �� � FUR ()I 11( :1: 1) ON I.1 City of Tigard " 7 Date/ . T � /�� � / Permit No.: ' , 1 �� 13125 SW HaII Blvd., Tigard, OR 97 y L E. 1 iLi.1 B Plan Zip Phone: 503.639.4171 Fax: 503.598 ( S IO ` i�"*' T)'s ^ I " Daz : 20 QS Other Permit: Inspection Line: 503.639.4175 f. ljr1,1 IU. ���, , i_ _� Date Ready " ®See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: — ,..., Supplemental Information • TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING Permit fees* are based on the value of the work ❑ New construction ❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ,Commercial/industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: , () q . S (� (8 New dwelling area: square feet City/ State/ZIP: f i ( A ILD ©k ' 7 3'A Garage/carport area: square feet Suite/bldg. /apt. no.: 1 Project name: ) T 77 Tt G ADD NE Covered porch area: square feet Cross street/directions to job site: TAB s_.5 S . OR- ?9 Av Deck area: square feet (El. i r A fij • iligiu Le O N -f-O SW e ? Other structure area: square feet • fKw y, k3/J) 47 i a 9_5 SG/ G �'E f4tltC . . REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. HAIIVI RfANC.E W DIG K Zvg ex t STTN G (/N%rA oven TAM Valuation: $ /�, WO . -2-2' 1 f it LL I T-p Z.LrtiLAc e d ex 1371 n! Cr AN �slvN� S Existing building area: square fee /N Le_t�vG a mew A N my S rT ENANT Ix 6XI7 G 4. ,. New building area: 0A square feet Number of stories: ,i /A Name: OLDcr N „S-7-43n-Ls- 'T'C(, E S (j c Type of construction: 7 o,r ,y,¢.r r Address: Q . 3p y` `` �- o'4 a(, Occupancy groups: �T City/State/ZIP: A. ..bum () a '-4 - 4.- 41 Existing: Phone: (9,24) 7 g f(4 0 Fax: ( ) New: APPLICANT `CONTACT PERSON NOTICE Business name: c.>~ 4¢ A c.... _ rt ni 4 T NC , All contractors and subcontractors are required to be Contact name: -r M - .Y I Tt'62 lc licensed with the Oregon Construction Contractors Board K under ORS 701 and may be required to be licensed in the Address: q g a % - us 1:1x: , _S-r- a /_ 1 jurisdiction in which work is being performed. If the City/State/ZIP: ?Oa - rt.A' , OR 1 i (o applicant is exempt from licensing, the following reasons apply: Phone: ( ),p17 97oo Fax:: 6.03 ) ,p s7 97 o E -mail: CONTRACTOR t - C' CC — Business name: T —.e 6, (?� A. 7 s 1 ' 1 , 6 0‘,01 4.4o BUILDING PERMIT FEES* Address: 2.4/ ,y6. ,9i4 AGe2) Please refer to fee schedule City /State/ZIP: .{c -n j i n , , Ciiq 9 7a // Fees due upon application Phone: 6 ) 535 ,9.-E po I Fax: ((o3) a 4 e t o - — Amount received CCB lic.: �.a3 D✓e& F --__ Date received: Authorized signature: Thi permit application expires if a permit is not obtained � - within 180 days after it has been accepted as complete. -p rint n ame: j�j� g h /gc� Date: �. ((7 6 O C • Fee methodology set by Tri-County Building Industry ` Service Board. !ding\Permits\Bl1P -Pe mitApp.doe 12/03 440.4613T(11/07/COM/WEB)