Permit CITY TIGARD SITE WORK PERMIT
l DEVELOPMENT SERVICES PERMIT # : SIT2001 - 00026
�� "' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 5/10/02
SITE ADDRESS: 15205 SW 74TH AVE PARCEL : 2S112DB -00600
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING : I -P
BLOCK: LOT: 014 JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: $98,848.00
EXCV VOLUME: 1,181 cy LANDSCAPING ?:
FILL VOLUME: 1,181 cy SITE PREP ?:
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 43,959 sf
Remarks: Site work for new 14,000 sq. ft. one - story metal building containing warehouse, office and manufacturing space.
Owner:
FEES
DENNY MEYER
7340 SW LANDMARK LANE Type By Date Amount Receipt
TIGARD, OR 97223 PRMT CTR 10/25/01 $738.83 27200100000
5PCT CTR 10/25/01 $59.54 27200100000
FIRE CTR 10/25/01 $295.53 27200100000
Phone: 503 - 620 -2086 PLCK CTR 10/25/01 $481.10 27200100000
Contractor: EROS CTR 5/10/02 $120.00 27200200000
SILCO CONSTRUCTION CO. ERPU CTR 5/10/02 $39.00 27200200000
ERPC CTR 5/10/02 $39.00 27200200000
PO BOX 83299 WQUN CTR 5/10/02 $4,581.50 27200200000
PORTLAND, OR 97283
Total $6,354.50
Phone:
Reg #: LIC 33578
Required Inspections
Erosion Control Insp 846 -8444
Excavation
Fill
Retaining Wall /Footing
Paving Insp
Strm Drain Insp
Culvert/Catch Basin
San Sewer Insp
Manhole /Cleanout - PVT
Domestic water line inspect.
Landscaping Insp
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Permittee Signature: _4 .,
Issued By: ��r� � � jee/,
Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day
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ti s o o e 1: T i 'tarty ,iii `4,r t at M` �e RR644 a 544
/ Building Permit AppieaLi m n .s=.: ` ,t t �, . �_.� �,? �; 4' .s � sp ` +;� .�
C7 } Date received: /0/2 / 0 / Permit no. ooI ��Qo' (0
. l « City of Tigard `/ ,-' I
..,;.7.,, r , . n J r i Project/app1. no.: Expire date:
Cit o Ti and Address: 13125 SW Hall Blvd, Tigard, OR 97223 —
y l Phone: (503) 639 -4171 • Date issued: By_ Receipt no.:
Fax: (503) 598 -1960 st Case file no.: Payment type:
18 95 - 0001-6
Land use approval: VAt2 1°111 0 0 D 22 l &2 family: Simple Complex: 1
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0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family '`0(New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 1Rrother: S
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Job address: 1 5"ZO 5 , u-,. " 14 112=- Bldg. no.: Suite no.:
' Lot: Block: Subdivision: Tax map /tax lot/account no.: 25 HI B F} t.eso
Project name: NEt,t4 EjU it) 1 t`k CA -folz - M a't' Si 6,14 &b. / _
Description and location of work on premises/special conditions: IMP 1LOVgItVbtTS Ai�tE_t.DGA - SC) AT T hE.. -
_re. f41) OP 6 ITO- — - -
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bss_l`� -� tZ yotaia etc. t,
Name: f 4' ' .•,s. z,n3�8R> > ttc .�.a s;_, .<t!.. Ei 7�„' g:; i' ,
h4ailing address: ?340 G. Li.). 1. r MA 12..... LAN P1 1 8 2 family dwelling:
City: -1 j k ma.t : , „ State: ZIP: aj') 2.2, Valuation of work $
L P11on50' _(,jt - gabioax: E -mail: No. of bedrooms/baths
Owner's representative: Jtt4 A,t4D -Ia' . t41C0L4 N ,,,, • Total number of floors
• Phot5b3 ,-2,01.,, , Fax:4, 30 E New dwelling area (sq. ft)
j;1„',.,. r pl .° t " li so t U . a4?n r}' r w h ' se AH ' Garage carport area (sq. ft.)
Name: 2E1,l µ.y____N -ts tL _ Covered porch area (sq. ft.)
Mailing address_ - a A9 6- E tZ Deck area (sq. ft.) S
- City: State: ZIP: Other structure area (sq. ft.)
Phone: ' Fax E-mail: Commercial /industrial /multi- fancily: �l
W t Y : sty t 1 t Valuation of work $ _91.) il
,�'t , wt r .. °w�''�,r���� Existing bldg. area (sq. ft.)
Business nary e: �G y1)5�
New bldg. area (sq. ft.) 14, Ob 1D
f�_
Address: Q I 39F
Number of stories t
City: drz,?- States' ZIP: ?7� ff3 v _ N - - -- i
Type e of constructi _ 11
! i'ltcnc: 281— 5 Fax: E -mail: - 1
__ B n o_ Occupancy group(s): Existing:
Ct�B —• New: _
tro lic. no.: , � �
City /me
Wit' ,„fit Notice: All contractors and subcontractors are required to be 7
•� ,�,, __ ,� Rf ,,, tr ,,,,�, �,,,,, � �� , M7rAi licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Addicss. jurisdiction where work is being performed. If the applicant is
I exempt from licensing, the following reason applies:
_ City: State: 1 ZIP:
Contact person: Plan no.: -
Phone: 1 Fax / E-mail: i
.. u ;f' , t3 t . � 1N r E n � s �L,.P 40 16x ., .r�, t "rt a I aV , , V „ 1
�E ..E ' 5� ° f ir m b, ate =� x a�.« M,.
Name: NI 1t,0(4 eN 1 r Contact person j lM At+ s.. _._: bees due upon application $
Address: ¶ l7 , .50 2 31 , 4 Date received:
City: 'rtGh ti;l'D Stateemz ZIP: oli 2 9 t Amount received $ / 5 "
Phon . 3 - w_2og,/ Fax: (o Please refer to fee schedul/
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with, whether specifi herein or not. credit card number. 1 /
Expires
Authorized signature:�a�r�u dl ate: 10 '24. 0 1 Name of cardholder as shown on credit card
Print name: Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6r00/COM)
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