Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00263
. �i�l DEVELOPMENT SERVICES DATE ISSUED: 8/7/03
` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC 01500
SITE ADDRESS: 15757 SW 74TH AVE BLD D
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 006 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: NONE 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: $ 7,500.00
Remarks: Unisex Restroom addition serving the site complex.
Owner: Contractor:
74TH AVENUE INDUSTRIAL PARK LL DAVE COX
8100 SW DURHAM RD 12115 SW SPRINGHILL RD.
TIGARD, OR 97224 GASTON, OR 97119
Phone:
Phone: 620 -2086
Reg #: 603- 475 - 3189661
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUPPLN] Pln Rv 7/3/02 $78.07 Plumbing Permit Required
FLS FLS Pln Rv 7 /3/02 $48.04
Foot/Found
ramin Insp
Insp
[FLS] Framing Insp
[BUILD] Permit Fee 8/7/03 $120.10 Shear Wall Insp
[TAX] 8% State Tax 8/7/03 $9.61 Gyp Board Insp
Total Final Inspection
$255.82
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
callin• 13) 24. -.099 or 1- 800 - 332 -2344.
Issued e / 4.0-144_4-ki
Sn ittee ature:
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Call 639 -4175 by 7 p.m. for an inspection the next business day
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Date received: 7 - 542— Permitno :,� ...,3___3 f .. of -, - ,
, j,,�+i i , f 1 1 \ � , Pro j ecdappl. no.: p date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard O 9,7.223, I,; .: t = —
u D ate issued: y• Recei no.:
Phone: (503) 639-4171 ��
Fax: (503) 598 -1960 .j' , Case file no.: Paytnent type:
Land use Approval 6101 ��f�( �, t 1 &2 family Simple Complex
y rL l d. ''',: .r1r , rv,M4 �Yl�i
t& v:IISgs:; ;§�prryka �7 z ^'� i w ''' ; , 4 h ,,fir[ s 7gn p ,. yi y ki' * 7�Fyr.�,, ; �,Y..� y x �' lF.7Y A{++ +'� ;tX 1. t l } ' 4 C t S r F . „f,x ;',"'G` : s y a:ai �. .'
' . ". � A 0 3 .a. r"�a c e ; t' t*,...A..I1 *' 0 A . , -it "f„ — .+r.. 't1�. 4" 6Ct.. e,ttr.'t, '�?'_�.n:3 m ..P it . �7 , 1 0.44K
,� � y ' , -� s �
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
D Addition/alteration/replacement
Tenant improvement 0 Fire sprinkler /alarm 0 Other:
94 , 0 , fZ k R S E`INFARA , 'Wt r
; g q T O 4 z' 4
Iob address: I S" 51 5t W , 1.4' A\t Bldg. no.: Suite no.: N1/4.
Lot: Block: Subdivision: 14 I N U ( . i i . 1 - ; A ` L ,4.11— Tax map/tax lot/account no.: r,.e- 1 12 pro 1 5 op , alin
Project name: 'r r..7? - ' O'- , 1D1,T - F TO e: � ILCDFi -4/%t "Win-- -7
Description and location of work on premises/special conditions: _. �... t i rr: V'. i : �' "" t % t L 1 N f D
fa a ,, r , y _ .,, a w BIZ Sor titii a tior� �e r . ;
Name: �'� `/�� 'II 4... ,, 4 . . t. i. a , y � .. „ 4 S 0l rmti o . f a , .
Mailing address: G.;.,1 7') S -1 OL 2 -HAM 4 -' 1 & 2 family dwelling:
_City: j j b:; /,1.2') State: 02 'ZIP: c- 7 - 7.4 Valuation of work $
f Phone:( ;p 31 - 3�{Z 0 Fax: I E -mail: No. of bedrooms/baths !_
Owner's representative: j~j.i(,;�' a E 1`1 G (f-{ p m. ; '4(. — Total number of floors 1
k ------, • Phou X03 „ 9.AS Fax E-mail New dwelling area (sq. ft.) ----- ' g t° r , Atitttiak 'gip i � s ' Garage/carport area (sq. ft)
,u T 1, .. ...ii, ..a.< . 4 , . .,w 3. M� � .. „ ,
N l(., I� N 6 l M (- Covered porch area (sq. ft.)
Mailing address: 1.1 {,„ tA KL Deck area (sq. ft)
Cif : J State: I ZIP: Other structure area (sq. ft.) __
i°f on Fax: E-mail: t> ommercial/industrial / multi- family:
y� D p ,» t o - ky+ s r of Valuation of work $ t , ; /,,1,.r
_ '' y C0 1' ' TRA G T OR' _ 5'., „. , ,, Existing bldg. area (sq. ft.) l0. 6 r%
[ddress: ty: usiness name: (� 1,4 N ' . 1
New bldg. area (sq. ft.) � .�
Number of stories 1
{ State: I ZIP: Type of constriction � /—t` � hone: Fax: E-mail: n-
Occupancy group(s): Existing: ✓ .
CCB no.: New:
City/metro tic no T „ Notice: All contractors and subcontractors are required to be
T i e r,&;` E 4 i J �,'I� GP1EIf gla t !! iii `.' licensed with the Oregon Construction Contractors Board under
1 Name: provisions of ORS 701 and may be required to be licensed in the
�Addcess. jurisdiction where work is being performed. If the applicant is
I
ZIP: exempt from licensing „the following reason applies:
State:
I City: 1
1 Contact person: Plan no.:
Phone: Fax E-mail:
¢'v x ,, n+ S t i Cr m n a g "� s d r zv r sm x( 4 a '# r '
s ^5� ' . �0„, EhGi11EERv' A `4 4� a is , , f§ , �.1�r. `� .,�. ' t � fr o ,, ,
g
Name: ; U j.; ( 1.4 5 R. i' j N (r I Contact person t ", J24' Fees due upon application $
Address: p, p, sox 3'j t r} t Date received:
City: 1-16,,A x-172 (State: t 'ZIP:. of i Z 9,1 Amount received $
Phone:(yg ?) /4p- Lq P&-(pl Fax: ‘0,0,4..34,3(.,1E-mail: Please refer to fee schedule.
[hereby certify I have read and examined this application and the Not all jurisdictions neaps 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 specified herein or not To g rd F6,1" credit ca numbs- / /
O Z nk4L.E y Expire
A t t h on z _ ) y signatures„__ -&`1 .I)/yY�'f'e.t;)41)ate: ' 1 ' b 2, Name of cardholder as drown oo credit card $
Print name: U I M A f-o 21 - LAt �`j Cardholder signature Amount
Notice:: This permit application expires if a permit is not obtained within I80 days after it has b accepted as co mplete. 4.40-4613 (603"CoM)