Permit BUILDING PERMIT V
�� � �& l w �"—.�� � � ����—^� "�� � � � ���� COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, O ou o1nn (503) 639-4171 PARCEL: 2S102CB-00100
SITE ADDRESS...: 128545bW GRANT ST
SUBDIVISION....: NORTH TIGARDVILLE ADDITION ZONING:R-12
BLOCK ^ LOT.............:41 '
__ ____ _
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK.:ALT FIRST....: 0 sf N: S: E: We
TYPE OF USE...:ED SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5N ...: 0 sf N: S: E: W:
OCCUPANCY GRP.:E1 TOTAL : 0 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 1 HT: Q ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS .REQUIRED ----
FLOOR LOAD....: 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:N SMOK DET..:Y
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC:Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR:Y PARKING: 0
VALUE.$: 850000
Remarks: Interior tenant improvement
Owner: . -- FEES • -----
TIGARD TUALATIN SCHOOL DIST. type amount by date recpt
13137 SW PACIFIC HWY. PLCK $ 1500.20 JH 03/20/96 96-277222
FIRE $ 923.20 JH 03/20/96 96-277222
TIGARD OR 97223 PRMT $ 2308.00 DST 07/09/96 96-281428
Phone #: 503-620-1620 5PCT $ 115.40 DST 07/09/96 96-281428
• Contractor: —
MICHAEL WATT
PO BOX 82374
3625 SE 17TH
PORTLAND OR 97282 — --------
Phone #: 238-0866 $ 4846.80 TOTAL
Reg #..: 64584
------- REQUIRED INSPECTIONS -------
This peroit is issued subject to the regulations contained in the Framing Insp ___ .
. Tigard Municipal Code, State of Ore. Specialty Codes and all other Insulation Insp .
applicable laws. All work will be done in accordance with Firewall Insp
approved plans. This peroit will expire if work is not started Gyp Board Insp ____
within 180 than 180 d days of issuance, or if work is suspended for core Susp Ceilng Insp
� Fire Al I
ay�. re arm Insp . _
Smoke detector i . .
Misc. Inspection
/ Final Inspection ______
^
Permittee Signature: '.4%
. _— ____—
' • Issued By: _� •',.. _ ____ _ -
Call for inspection — 639-4175
'
(61 -/61-etto
Commercial Building Per it Application
f Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 I 7 G
(503) 639 -4171 Z I
I�
Jobsite Address: 45O �,9 )7 �, : . • .
;Office.Use Only :::
Tenant: / % /,-fi -M Cr Suite #
Valuation: /ff� 0O7) 1O�,��6� PlarcklRec.. #` •
Owner: ' % b.A�O - // .c) Wooer � � fZ1c7
l -� 2 ;: #' : � : } ..�
Address: /0/7 4/4 9 i <" G s Requ ,'..:�
y . : A ppro v als Required :.:• �`'::�`:: `.....
Phone:
Engineering :.: ".,
Contractor: LI� ILL / Ili ;... :
/,)? / ® eC - PP 40 7/ t -- 2C l,e
Address: a ffp . y 4V)
Imiwi
Type of const: �v
Occupancy class:
Phone:
Sprinklered? Yes No
Contractor's License #
(attach copy of current Oregon license) Sq. ft. of project:
'Contact name & phone: Story (1st, 2nd, etc.)
Proposed use:
Architect/Engineer: Zile -y / 4/726.0 4 /7
�/ Previous use:
Address: / /J1 SGJ �/ ijFiG /9Yy
Note: Plumbing & mechanical plans
7 2 6 1 / € / 9 .016 1 must be submitted at time of
l �� - �«4 / e(G � T building permit application.
Phone: !4 /�/
JOB DESCRIPTION: /N,��,edyne, ,F.eucig T 76g7iee52044 uof mss? /Z;19A--
72a . 6,/,4,700 c � a urdj„ett6-7r✓ >`y a
—
App cant Signature & Phone umber
` 4
Received by: Y' � 1 , Date Received: 1 i°
Permit # Account Description • Amount Amt. Pd. Bal. Dc,.
Q �,,�`
VV (�� "DI LI ., Bldg. Permit (BUILD) 230c - - Zi0 °
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) / / 5 - fr' 5 ��
Bldg:
Plumb:
• Mech:
Plan Check (PLANCK) I 5OO r 29 /50 r)_46
Bldg:
Plumb:
Mech:
4,‘,02-‘110-b)11 Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
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 -0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire Life Safety (FLS) q7?%, 7.10 q..13,
20
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: t( f r a � Z � Li
1r E jA M2.ri - bcumulative Sewer Tally This SWR #: 6 16° - 1511 - 7
Ad .fa t ns --f'CcjJ1 This PLM #: 9 1tt"t,E) )
r-
Fixture Value Previous # Previous Credits Capped Fixtures Fixtures New New
Value Capped off value added # added total #s total
Count off #s count value values
Baptistry /Font 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 (over 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 t - 2- - _
Sink - Bar /Lavatory 2 Z b_ - 4 - 7 H-
- Bradley 5 5 H
- Commercial 3
- Service 3
Swimming Pool Filter 1
Washer, Clothes 6
Water Extractor 6
Water Closet, Toilet 6 I LI Z- 1 �r `7 ���g' Z l)
/ C I
Urinal 6 ' A ` 4 — 1
TOTALS
Total fixture values: 11 divided by 16 = /0 EDU
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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