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10435 SSV GREENLEAF TERR
CITY OF TIG •w�RD BUILDING PERMIT
J � PERMIT #: BUP1999-00229
DEVELOPMENT SERVICES DATE ISSUED: 6!7/99
13125 SW Hall Blvd., Tiqard, OR (67223 (503) 639-4171 PARCEL: 2S110DD-07700
SITE ADDRESS: 10435 SW GREENLEAF TERR
SUBDIVISION- ISUMMERFIELD NO.5 ZONING: R-12
BLOCK: LOT: 241 JURISDICTION: TIG
REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: sf N. S: E: W:
TYPE OF USE: MF SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: N'
OCCUPANCY GRP: R; TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCLI SEP. RATED:
BSMT?: MEZZ"?: _ REQD SETBACKS _ REQUIRED _
I FLOUR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
IBEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,000.00
airs.Remarks: Exterior structural re Permit fees cover two individual ins
p ,.vi ib. n�dlf;onal inspections subject to
re-inspection fec of 50.00 each No C of O required.
Owner: Contractor:
FORBES, CAROL L TRUSTEE K CONSTRUCTION INC
10435 SW GREENLEAF T`R PO BOX 34
TIGARD, OR 97224 NEWPORT, OR 97365
Phone: Phone: 541-764-3858
Reg #: LIC 97820
_ FEES _ REQUIRED INSPECTION 3
Type By Date Amount Receipt Misc. lnspection �
PRM BON 6/7/99 $100 00 99-315933 Final Inspection
Total $100.00
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specia'ty Codes and all other applicable iav,. All work will be done in accordance with appreved plans.
This permit will expira if work is not started within 18') days of issuance, or if work is suspendel for rnore
than 180 days. ATTENTION Oregon law requir&, you to follow the rules adopted by the Oregon Utility
Notification Center. Those rules are set forth i-I GAR 952-001-0010 through OAR 952-001-1587. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 2.46-1987.
Pennitee �� f
Signature: _-----------
Ml �
Issued 8Y: L`�1.tit�t�' �l�. ���.V-�--.�
Call 639-4175 by 7 p m. for an inspection the nert business day
CITY OF TIGAPD Commercial Building Permit Application Recd By
_
13125 SW HALL 3LVD. Tenant Improvement Date Rec'dData t�P.E.
I iGA,F`' OR 972;23 Date,o DST _
(503) C 4171 Pe jitit*�T' tZ2°�
Print or Type r<elated SWR N
Incomplete or illegible applications will not be accepted Called__
�— Name of DevelooppmentiPmiect — Existing Buildino X New Building (l
Job
Address Street Address �,� r"�«,. sidle Building
/ C, 17, < T ---- Data _
Bldg N — city/slate Zip Existing Use of Building or Property:
t 2-
Name
Property Proposed Use of Building or Property.
Owner Mailing Address,2tt p- Ai Suite
o y"', S 7-)6'K _ — No. Of Stories:
City/State Zlpr hone
i_ /i 'I. �'�7 6'�; "/ 2 � Sq. Ft. Of Project: _ ------
Occupant Name
1 f�, Occupancy Class(es)
Name _ _ "�" I
Contractor Kc" ��- S j Q'� c j/o,4C Type(s)of Construction✓N
Prlor to permit Mailing Address— Suite _
Issisnce,a copy , Will this F roject have a Fire Suppression System?
o'all licenses C�, 0>Uk �,�— _ Yes _No
ere required if City/State Zip Phone s. --- —�— —
Americans with D;sabilities Act ADA
expired ire C.O T (ADA)
database NEt,.-Oe%PI c>x 9 S 3k Valuation X 25% = $� _ Participation
Oregon Const.Cont.Board L.ic.* Fxp Date -- Complete Accessibili Form _
--_-- e7 7 �rf,jZ H lel/ Project $
Name r Valuation
Architect Plans Required: See Matrix for number of sets,'o submit
Mailing Address _ Sulte LA on back
Gity/Slate Zlp —� Phone I hereby acknowledge Coat I he,e read this application,that the information
given Is correct,that I am the owner or authorized agent of the owner,and
�{ Name that plans submitted are in corr, fiance with Oregon State Laws
Engineer I
Il
Signiturp of UwMr/Ag§A Uate/Mailing Address Suite b
Contact Person Name 'shone
CitvlState Zip Phone i rso4,:�X T "�< L 7
—� �— FOR OFFICE USE ONLY _
Indicate type of work: New O Addition O Demolition O Map/TLN Land Use.
Accessory Structure O Foundalicn On'y O Alteration O
Repair O O!ner O Notes:
Descrlptlon of work:
TIF: •--- ------- — -- —
Note: Site Work Permit Application must precede or accompany Building
Permit Application
I1COMNEWTLDUC (DS
t) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal. the application must contain the
signature of the supervising electrician before plan review will be conducted.
,'after plain review approval, Plans Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy for Contractor, City,
Washington County, Tualatin Valley Fire & Rescue)
Total# of --
TYPE OF SUBMITrAL flans KEY-6
Submitted
f (Private) 1 S = Site Work
1W-04—ew or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M k.:ew or Add or Alt) 1 M = Mechanical
B & M (New or Add—) - --- — 1 - P = Plumbing
P (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) 2 New = New Building
E (New, Add, or Alt) � � 2� Add = Addition
Alt = Alternation to Existing
(New , Add) Building
*B or B & M (Alt) 1
*B & M & P (A It) 3
*B & M & P & E(Alt) 3
*B & M & P & E & FkAlt) 3�y
N01 ES:
*Shaded areas designate ALT submittals only.
I Wsts\forms\matrxi:om doc 10/30/98
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