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Report M_s 7-,?--0 / 9 -00 ,,) 3 7 ,3 515' S -Li 1---)"---/9-f.----/----4.E- s--7:- A ,,, _ . , li' 2 S 2ON If ul * 0 - --'-- cidydreofTsigsard A and Commercial Suite Application TIGARD Addresses and suite numbers are assigned by the City of Tigard. Once a new address/suite is issued, the city noties fi 911, USPS,Washington County and various utility providers.This does not change any account information or replace a"change of address" form. Directions To Submit Form I Fill in form I Via email:OscarC@tigard-or.goy I Attach Site Map or Suite Layout Map(see below) I In person: Permit Center Building Counter I Fees will be charged when new address is assigned (p3125 SF 1 lull 131Ni.,Toni.OR) 0 Per address$50 Oscar Contreras,Public Works Department I Per suite $50 OscarC@tigard-or.gov 0 Suite or address to be retired—no charge 503-718-.2687 0 Re-activating suites in our system—no charge REQUIRED Attach Site Map or Suite Layout Map I For Site Maps—show location of building on lot, front entrance and location of driveway along street. I For Suite Maps—show the locations of current active suites,new suites and suites to be retired. , Site Information q 55 siA) Parcel Number Number or Current Address: , Residential Property –OR– 0 Commercial Property Number of New Addresses: ?-- afir -4 404 Building Name(if applicable): Is this property currently in the land use process (i.e.partition,site development review)? 0 Yes ANNo Contact Information *Please sketch the building layout with address Property Management Company (if applicable): locations: Contact Person: 3en vvilo (6,--6,acc. SE---,---- /9-7-i-d)-,(74,----2, Phone: 7)) 5 6C--,5 47..,nail: ) ,t i Yv161 1 1 IrD&CrPublc Works/MOM Approcatroo Form For mom iOrmation,please mit umr.ligairborsor i (