Permit CITY � TIGARD
PERMIT
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DEVELOPMENT SERVICES m�m��u~m~��m o�om�o�u °�m~ou�m��w~~~ PERMIT # ~ SWR96-0511
.,�~ 131250W Hall Bl*� Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02/12/97
PARCEL: 2S101AA-09800
SITE ADDRESS...: 12570 SW 69TH AVE
SUBDIVISION ^ MLP95-0013 ZONING: MUE
BLOCK..........: LOT....... ...... :001
TENANT NAME ^COLONIAL PACIFIC LEASING
USA NO..........: FIXTURE UNITS...: 32
CLASS OF WORK...:NEW DWELLING UNITS..: 2
TYPE OF USE.....:COM NO. OF BUILDINGS: 0
INSTALL TYPE....:BUSWR IMPERV SURFACE: 14008 sf
Remarks: Construction of a new 8,217 sq ft two story professional office buildin
g
Owner: FEES
J T ROTH JR type amount by date recpt
12540 SW 68TH AVENUE #B _ PRMT $ 4400.00 B 02/12/97 97-290314
INSP $ 45.00 B 02/12/97 97-290314
TIGARD OR 97223
Phone #: 639-2639
Contractor: — — .
CONTRACTOR NOT ON FILE
Phone #: $ 4445.00 TOTAL
Reg #..:
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the .
side sewer laterals. If the sewer is not located at ths measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the : s a ler shall purchase
a "Tap and Side Sower" Permit and the Agescy wi' install a lateral.
Permittee S mat ur
4
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Issued By: �K^r~ r ' .w`�
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Call for inspection — 639-4175
(kkARt Vc ',-•• A ,
Commercial Building Permit Application
City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223
(503) 639.4171
Jobsite Address: 4-1-/ OFFICE USE ONLY ... •
. . • .. %
Tenant:kk/lAiVikiC f , t,c_ Suite # Planck/Rec. # • • •.i.•••••-. •••••,•:':',.. • •
Valuation: 60JKg10 ..
Permtt # • •-• • • •• z. •
• • :. • • : • • •••• ••:•••••-• • :•
• • • ••• • . . '' • • • •••• •••••:•••:.
• • • s ,
Owner: . •:•••
Pp:goy*. ReqU
Address: .z.
Plannrng
Engineering
.. ..............................................
•••••
Telephone:
, ' l et ct 7 9.
Si
C ontractor:
Address:
Type of constr:
Telephone: Occupancy Class:
Contractor's License # Sprinkler? Yes No
(attach copy of current Oregon license)
Sq. Ft. Of Project:
Contact name & telephone:
Story (1st, 2nd, etc.):
Architect & Engineer:
Proposed Use:
Address:
Previous use:
Note: Plumbing & mechanical plans must
Telephone: be submitted at time of building permit
application.
<
JOB DESCRIPTION: ( '2-M c ?c - C
(Applicant Signature & Telephone Number)
Received by: Date Received:
•
PERMIT# Account Description Amount Amt Pd. Balance Due
Building Permit (BUILD)
Plumbing Permit (PLUMB)
Mechanical Permit , (MECH)
State Tax (TAX)
Bldg.
Plumb.
Mech.
Plan Check (PLANCK)
Bldg.
Plumb.
Mech.
- j1 Sewer Connection (SWUSA) 0400 14400
Sewer Inspection (SWINSP) CAS -e 'y 5
Parks Dev Charge (PKSDC)
Residential TIF (TIF -R)
Mass Transit TIF (TIF -MT)
Commercial TIF (TIF -C)
Industrial TIF (TIF -I)
Institutional TIF (TIF -IS)
Office TIF (TIF -O)
Water Quality (WQUAL)
Water Quanity • (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT • (EROSN) - - -
TOTALS: y L S -o
4
. Tenant Name: I r'e o (CQ-
Accumulative Sewer Tally This swR #: (
Address. 17 tam This PLM#: - Z
Rxture Value Previous # Previous Credits Capped Rxtures Fixtures New New
Value Capped off value added # added total #s total
Count off #s count value values
Baptistry/Font 4 OeU 4
Bath - Tub /Shower 4
- Jacuz/Whpl 4
Car Wash - Each Stall 6
- Drive Through 16
Cuspidor/Water Aspirator 1
Dishwasher - Commer 4
- Domest 2
Drinking Fountain 1
Eye Wash 1
Floor Drain /sink - 2 inch 2
- 3 inch 5
- 4 inch 6
- Car Wash Drain 6
Garbage Disposal 16
- Dom . (to 3/4 HP)
- Comm (to 5 HP) 32
- Ind lover 5 HP) 48
Ice Machine /Refrigerator Drains 1
Oil Sep (Gas Station) 6
Recreational Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2 _
. Sink - Bar /Lavatory 2 V 1 7 1 9) 1-
- Bradley 5
- Commercial 3
- Service 3 ,
Swimming Pool Filter 1
Washer, Clothes 6
Water Extractor 6 1 •
Water Closet, Toilet 6 I 1+ 7-if i Z
Urinal 6
TOTALS • 3Z—
Total fixture values: '52- divided by 16 = Z EDU 2- DU' S C.lAtar- vA
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection L'i-• • •-417 Business Phone: 639 -4171
Footing Rain Drai
A lit
Cover /Service '1:
Foundation Water Line Ceiling -b.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post ` - -- - uct. Mech. Rough -in Gyp. Bd. -Bldg.
4 400 Gas Line Appr /Sdwlk Reins.
o Corn c / J,rn S a&
Date: 5fq(9 A.M. �/ P.M. " Entry:
Address: 12570 SU) ( TVI
Tenant: �! ? Ste: MST:
Con /Own:
63q -2k39 MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
.560P-q 05/ .'
51 .<4 eit,... ?
C..) ,v ".G /isl�f y . gc/ / � V1 17
iii
Inspector: v i _ Da7 /�
C - - ' OVED DISAPPROVED/CALL FOR REINSP. CF CO