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CU O F TI GARD BUILDING PERM. �'
COMMUNITY DEVELOPMENT DEPARTMENT PiJAIT
13126 SW Hall Blvd.Tigard,Oregon 97223*8199 (603)539-4171
EXPIRED
PTL ISSUED. 0 5;/21
s•su SW 9:j T i,i A V PE'JICEL.
V i�Zj' 0. PORN ZONING: R
IS ULt"LUOP (A". TXTERIOR WI -L LL_W;
.-Ass OF WORK. :A'- FIRS7 . . . . . Sf S: L:
' L Lj I S f PROTECT ZPENINGS'�j
"T' L!7iE. . . :S�
'r,P E CIF CJI'45T. -.5;\( TH I Rb. . . . 5 f N moi 5 E
T b TAL Ill sf ROOF LWIIZi RL ki- I
:CUF'i-_4NCY LOAD: Sf AREA SEP. RAILD.
ft bbl" S
Wr'*' N 0 4' Z RLUD SLTPACv�Z� REQUIRED---
00R LOW). ps f` LEFT. L kcif A I f:'-'. F 1"R 5f=KL IJK OL T. . I
,LLL NG W,41-1 b; FRNT: ft REAF: ft FIR AL.RM: t-ti,IDICP GAG'is
0015: LA IMP SURF!'410E.: PRO GC'`R: Pi-'tfir.1 Nc,1
type amour-A cy date 1-ccp,
`440 SW 95'4H 4-CL PRMT 313. 50 JH OSIL6/93 X
!: . 0.1 BMR ut 4 6:_1 141/�1.
GJ-Rij 1. C13 JH 05i E8/9-
une #
RLWUIRL." 1 1,obt-Lt, .4 i.)N:.i
issurc to luie rqljieaions contsined in the Foot/found x,
-,.Wd L"Alt, Etit'ii Of G"t, 3piCialty Ctde% MCI all Othl ' Final Inspection
p,-;::,:,:;�j 'A A," imrl io:'i be dunp in accordance wiV
app,ayc; ;,it `t,it pu,s:-1- will impire if work is ut stak",eu
issuance. or if iic;0 is su�ptndpd fore sort,
..........
1.0
it)#. Ltioii E39-4175
r
I .r T A PLNCK/RECT # LEC 1ry-AOF T1�L�11D ,3�u sw
Tram Orcaon 97W PERMIT #
COMMUr.ITY DEVELOPMENT DEPARTMENT
(507)63"171 DATE ISSUED
Boa ADDRESS: \c7 � (�. TAX MAP/Lor
SUB: LOT: LAND USE:
VALUATION:
OWNER tt SPECIAL. NOTES
NAME: tel, h i 65Aer- REISSUE OF:
ADDRESS: 20 2/ Q -s,t,V 1; Ayr LAST REISSUE:
'j"_� r1,�V_ -7 FLOOD PLAIN/
PHONE: �;� -to-z>-7 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: _-- OTHER: -
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS:
MECH: "-- _ BUS TAX.
ARCH ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS: _-
APPLICANT SIGNATUR
Rc-ceived Ely: U Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. S.A DUE
10-432 00 Building Permit Fees ���o k
10-431 00 Plumbing Permit Fees _
10-431 01 Mechanical Permit Fees
10- 230 01 State Building Tax (5%) __ f
Building
Plumbing
Mechanical
I0-433 00 Plans Check Fee
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) _
31-450 00 Storm Drainage Syst Dev Chrg
F--
(SSDC) -
24-445-01 Water Quality (Fee in lieu of) _
24-445-02 Water Quantity (Fee in lieu of)
Cn
1.
w TOTAL _ 2 U
nm/3587P.WPF