11875 SW 79TH AVENUE ADDRESS:
IIS75 SW 79""*" AVEN,t1"A:
n
tea.
.J
CA
111
J
1:Vecord;VnicrofIrn\targets buiiding.doc
CITY GF TIGARD BUILDING I . _
F ERM 1 T #. . . . . . .. : HIJFUP, s 0074
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: WiV*i94
13125 SW Hell Blvd.Tigard,Oregon 97223.8199
PANCEL: 1 S 1.36CD-03400
SITE ADDRESS. . . : 1. 1 87 5 SW 79TH (0E
5UBDI.VISION. . . . : TWIN OAKS LANE ZONING: C^-G
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :8
-----------------------------------------
REISSUE: FLOOR AREAS-------•----- EXTERIOR WALL-CONSTRUC i ION-_.
CLASS OF WORK. :LEM F I RST. . . . : s f N: S: E: W.
TYPE OF USE. . . : =-)F SECOND. . . : sf PROTECT OPENINGS';)----------------
TYPE OF CONST. :501 THIRD. . . . : sf N: 5: E: W:
OCCUPANCY GRP. :R3 TOTAL----: 0 s f ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: BASEMENT. : s f AREA SEP. h,7TE:D:
STOR. : HT. . ft GARAGE. . . : s f OCCU SEP. RATED:
BSM 1 ?: ME Z Z? : REOD SETBACKS-- ------- REQUIRED---------------------..
FLOOR? LOAD. . . . : ps f LEFT : ft RGHT: ft FIR SF'KL: SMOK DET. . :
OWE1_LING UNITS: FRNT: ft REP.;t: ft FIR ALRM: HNDICP ACC:
BE.I?R2MS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE. $: 0
Remarks : SEPTIC: TO BE PUMPED, FILLED R INSPECTF_D. SEWER MUST BE CAPPED OFF AND
INSPECTED
I
Commercial/Planned
?tevelopmertt; ) . (WCTM 161 .:,BCD, tax lots 2200, 2300, 2400, c 00, `600, 2700, X800,
L9009 3000, 3100, 5200, 3300, '400, ?,500, 3600, 37O0, 3800, 3900, 4000, 4100,
1
IBA, tax lot 200 and 261 IBB, tax lot 1201.
Owner: FEES ._---_--------__
COSTCO WHOLESALE type amount by date rtecpt
10809 120TH AVENUE. NE. PRINT $ E5. 00 JH 03/OB/94 -
SPC;T t 1. 25 JH 03/08/94 -
K I RKLAND WA 98033
Phone #: 2OE�-8: Ei-81ON
Contractor
E. I-EL ROBINSON+CSI/PUCTION
73,20 SW 14UNZI..ER ST. SUITE 300
T I GNRD OR 97223 _-----.-----_ ----_.__-._-_____-..-______ ..
Pho -Ie #: 643-8531 f 26. 25 TOTAL.
Reg ft. . : 63147
REQUIRED INSPECTIONS --- -- -
This persit is issued subject to the regulations contained to ti.,- Pump/F i. l l Septic
Tigard Municipal Code, State of Ore. Specialty Codes and all other Cap sewer line _^
applicable laws. All world will be done in accordance with Final Inspection _ �-
,` approved plans. This pet-sit will expire if worli is not started ~�
within 181? days of issuance, or if work is suspended for sore
than 180 days.
�^Permittee Signature :
lied By . 1
Call for inspection - 639-4175
i w
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobslte Address: Ps, C
Office Use a Only
Subdivision: _ Lot t! 2 �l l'.�
PlancldRec#
Valuation:
u Pergut# --
r ' 1 ll _
Owner. c r' �,D�T c U .Reissue of
Address: I d 0 cL_ Al L Map'&TL#
Approvals Required
Phone: _S�O 6 - ;� ,�X- ,K I U 0 �— ---
1'I,inning
Contractor: )�n 0'_r1SQiL ,n, s r=use e,, �,« Engineering
Address: 60 N 1ti' (arc 1 I -Ed ___ Other
fid, ►► , o
Items Required
Phone: ��U � - 6 ys - k S ,3..J _
Subcontractors
Contractor's License #
(attach copy of current Oregon licens,-,) Truss oetails
Subcontractors: Other
Plumbing:
Mechanical: _
(attach copy of current OR Contractor's License)
a.
Architect/Engineer: —
V)
Address: _
J
LD
Phone:
COMMENTS: _—
Applicartt bi�at-hr 8 Phone number