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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.9199 (603)039-4171
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.6199 (503)639.4171
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CITY OF TIGARD 1 � .. i..
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 07223*11M (603)6394171 is i=; , ,:. a 3 ( L) ,
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13125 SW h V DM4 PLNCK/RECT Yrte-
CI rY OF TIG.A.RD ToptA0-jon972U PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT
(503)634A'71 OATS ISSUED
JOB ADDRESS: fyS3L acv x-v,�:f64t , TAX MAP/LOI _ � r 1 Z 6h 0,11
SUB: // /yl�sw, SLI = LOT: z 7 _ LAND USE:
VALUATION: �.Z' 4/5" T-
OWNER --TT�� SPECIAL NOTES
NAME. :0&)/,) REISSUE OF:
ADDRESS: dF 9-3yse/ _ LAST REISSUE:
_�- G2t• 97223 FLOOD PLAIN/
PHONE: _� _.���_ SENSITIVE LAND:
CONI RACTOR APPROVALS REQI;I REO
NAME: ��W '� - _ PLANNING: FL/!-y'_�
ADDRESS: ENGINEERING: —
FIRE DEPT: _
PHONE: _ 3 � OTHER:
CONTR. BOARD #: _ 411,V'513 _ EXP D
ITEMS REQUIRED
SUBCONIRACTORS: PLUMB: i' ��su� _ LIST/SUBCONTRACTORS:
MECH: ` BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: — TRUSS DETAILS:
ADDRESS: OTiI%rR:
PHONE: _ — ----- ---
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATURE
Received By: _� Ji Date Received: Z/
r
PERMIT k ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees )t
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State building Tax (5%)
Building "
Plumbing
Mechanical .2
10-433 00 Plans Check fee 33,j3 93`33
Building2Z.G�
Plumbing
Mechanical
10-230 06 Fire
`>caXR'�3 r./• 'Z 30-202 00 Sewer Connection GU
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees _T
25-448--06 Institutional TIF Fees
25. 448-03 Office TIF Fees
25-448-01 Residenti::l traffic Fees /-3-50
25-448-05 Mass Transit TIF fees /( U
52-449 00 Parks System Dev Charge (PDC) oc'
31-450 00 Stnrm Drainage Syst Dev Chrg
(SSDC) - ! y
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (fee in lieu of)
TOTAL S ,' , �.-�SS, ✓ 1st�1 y
nm/3581P.WPF
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE OF
13125 SW Hall Blvd Tgard,Oregon 97223.8199 (503)639.4171 OCCUPANCY
VICRMIT #. . . ,. . . . 1 MST'..'.3 .1,1
PAPCEL.;
`311E ADDRE55. . . ' 1483�" SM 80TH c;VE
RAZE ME.(-#D0W,,", NO. 2 --,'t]N I NG i R-4. 5
lK JC K. . . . . . . . . . . LOT. . . . . . . . . . . . . Oo-'7
C,LfISS OF WOR'K. 2NEW
TYPE OF USE. . . .SF
".11CCUPANCY GRID. IR3
OCCUPANCY LOADir,'25 14
NAML. . . 4
Fier ivarkc,:
t,d D CONST. INC
P 0 BOX 23454
FYGARD OR 97223
Phonp #l: 639-6881
Contractors
DWI) CONTROCTURS, INC
P 0 BOX 23454
-1,1(3ARD OR 17L,281
PI.-lunw #- 639-6801
Fie q #. . 1 411:,03
Occupmocy of the above r ef erell-iced Lmj. Idiril;j is hereby giver, and C'ert if ip-H
i I-te f-,ompi iance with the St,at-e Of Oregon Specialty Codes f ,," the gral-IP,
W.cupancy, and use 1-mder which the reforetirod pe -Mit was i 6 T,"I CA
I LD I Nt-'Pi LTOR
R PL. ,.DI" orr IC,
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P0'137 IN CONST'TCUOUG PLOCE
xm—m I' RN NOT:C6
City of Tigard Building Du part.uo ���i /
13125 SR Ha`.1 Blvd. Tigard, Oregon 97223
Inspection Line fRec-O-Phone): 639-4175 Bunineee Phone: 539-4171
Inspection:
Footing P)-'-)q. Underslab Hoch. Rough-in \PP r/Bdwlk
Found. Plbg. Top out Cas Line
siNAL� ,,
Port/Beam Strvct. San. Sewer .- `
Framing dq.
Post "Beam Nech. C
Rain Drain Ineulnllon 1umb /
Plbg. tinderflooc Water Une
Gyp. Bd. 4900h.
VeCe Pn< •9atn�i:____�-���j
�}-� TIno sAN pN
Address:_ ! yj I
Permit
Bui ldor.
TyE FULI.JWIVG CORRE(TIONS A" RISQUIRED:
C'c- /v 'p T / t�U s T mi
_vim.►-/T f'G,�, �cam/�'`c- � .�
In.Pactcre_ C-3
Date$ 's
APPAOVgp DIBAPPRCPM APPRMD gUS,JRC! Tp
A1o11I
��all For Reinsp.
INSPE__TION "TICS
City of Tigard Building Department k: 639'-4171
13125 SW Hall Blvd. Tigard, Oregon 9722Inspection Line (Rec-O--Phone): 639-4175 Business Ph
Inspections
Footing Plbg. Unleralab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line INAL
Poet/Beam Struct. San. Sewer Framing Bld
Poet/Beam Mach. Rain Drain Insulation
kNlbq. Underfloor Water Line Gyp. Bd. ech.
--��
Date _ —A
—AM_ � Times AM _ PN
Address:lVtf3.2 � Permit f
Bu)lder;
__w_ (J�✓p
THE FOLLOWING CORRECTIONS ARE REQUIREDr
Inapector r Dates
APPROVED DISAPPROVED APPROVED SUB.IRCT TO ABOVE
_Call For ReinAp.