Permit (3) CITY OF TIGARD BUILDING PERMIT
PERMIT #:
: ,,,4i DEVELOPMENT SERVICES DATE ISSUED: 41 2005 -00091
� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136CD-01600
SITE ADDRESS: 11674 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI wall
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 2 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: N SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 2,000.00
Owner: Contractor:
STANDARD APPLIANCE, INC. OWNER
TRUSTEE: JULIAN RITCHIE
5240 SE 82ND AVE. 72gF
PO eLAN D503- 77g7 -3377
Phone: 503 - 475 -3180
FEES Reg #:
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/9/2005 $62.50
[TAX] 8% State Surchari 3/9/2005 $5.00
[BUPPLN] Pln Rv 3/9/2005 $40.63
[FLS] FLS Pln Rv 3/9/2005 $25.00
Total $133.13
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 -246 ..99 or 1- 800 - 332 -2344.
"
Issued By: aft , _, /�, Permittee Signature: X: 1 �/
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• RECEIVED / / 1)-'6 ti .... ,
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r , - 1 L.4 4 Q. , IlQne4r
Building Permit Appliq ip 9 2005 FOR OFFICE USE ONLY
City of Tigard Received
g QTY OF TIG A DateB : 9 o,Ja.,•�, Permit N. , a o o v /
13125 SW Hall Blvd., Tigard, OR 9 2 I� Plan Revie r r�
Phone: 503.639.4171 Fax: 503 bqs " 4tis'' +� Date/B : Other Permit:
}' DIVI ti I i ��-, -
Inspection Line: 503.639.4175 E''L Date Ready/By: June: ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: 114" Supplemental Information
- • TYPE OF WORK - ' . REQUIRED DATA: 1- AND 2- FAMILY DWELLING. .
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
IR Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
- work indicated on this applicati
CATEGORY OF CONSTRUCTION
❑ and 2- family dwelling Commercial/industrial
Valuation:
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' . JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: + 1 61 y S w p c , t F t r. k� .. New dwelling area: square feet,
City/ State/ZIP: -r- , `.3 U r 1 O R. c -1 ".Z3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: S 4- a ,,, A a. a lDr ..„,k .- as - Covered porch area: square feet
Cross street/directions to job site: / Deck area: square feet
• Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CFIECKLISE:
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
' - DESCRIPTION OF WORK • work indicated on this applicatio
Fcnbr,. c. -V e - r.o1, Skr Vv, - o.1 wa1)S Ed Valuation: $ � ��
1- c o, b e. o.lc ro 4 c+-, O v 1 ' 0 ff e x 1 s 4 t r. o� s6'Qc e Existing building area: >,9� square feet
C .. le e•- a.
New building area: square feet
❑` PROPERTY OWNER K TENANT , • Number of stories: CQ
Name: C r, d c,, �. )., P 6' 4 t c r e o, 1 r+ Type of construction: N
Address: S ?•H O se_ B ,.,-..a x v e Occupancy groups: M
City/ State/ZIP: P O .. 1 a ,41 O ye... c 11 1 to to Existing: M t
Phone: (So1) 1 l -, '331 -1 Fax: (St's) S ►.(> o1• z3 New:
❑ APPLICANT' • • ) i r CONTACT PERSON N O T I C E ' , . . " • ? 1 i.., -
Business name: All contractors and subcontractors are required to be
Contact name: , v 1 . G n c...1 licensed with the Oregon Construction Contractors Board
2 under ORS 701 and may be required to be licensed in the
Address: S -. ► 1 o sr„... % Z" a t c jurisdiction in which work is being performed. If the
City/ State/ZIP: Po,.-4 1 O 91 ',1,04.1 apply: is exempt from licensing, the following reasons
apply: 6a -5
Phone: ( s d3) S a-1 Z 3S `-1 ( I Fax:: ( )
44/ • 6 4 : 7 7 ,7 1 1043
E-mail: 4- at.. , Q @s }-c,,., 4 k.,„ , ,k aL(l tonce , cow 7/ 5 :op
. CONTRACTOR
P16 a .hod ►mil 3
Business name f9/7 ���-. BUILDING PEttMI' 'FEES* •
Address: ∎ ,O/� J i `, , Please refer to fee schedule. '
City/State/ZIP: �"
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB lic.:
Date received:
Authorized signature: . ` J a_„., . This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 3, 1 , G,.-, 2 ;1- c , V , e Date: 3 I isl pS * Fee methodology set by Tri-County Building Industry
Service Board.
i:t Building \Peimits\BUP- PennitApp.doc 12/03 440.4613T(l1 /07JCOM/WEB)
•
• A
Building Division
�� j� Plan Submittal Requirement Matrix
---• Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal - i
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3 **
Mechanical 2
• Plumbing (building fixtures) 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans.
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue)
* For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: 20C)S DOO I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 t_ ; -,„ I I Ii l\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 't 7// .- / S TIME: PAGE:
SITE ADDRESS: H vl CLASS OF WORK: •
SUBDIVISION: (( LOT #: TYPE OF USE:
PROJECT NAME: 4 l J�E ��1 C� �'\ CC-
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: • PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code / Inspection Description Confirm # Contact # Message
(
Corrections /Comments/ Instructions:
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IX PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 ,761\ Inspector: ✓ Date: l / / phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION 4k , PERMIT #: BUP2005 00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005
Phone: (503) 639 -4171 47 4l 1 11
Inspection Requests (24 Hrs.): (503) 639 -4175 A-
INSPECTION WORKSHEET FOR DATE: 8/31 /2005 TIME: 7 :03AM PAGE: 66
SITE ADDRESS: 11674 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STANDARD TV & APPLIANCE
DESCRIPTION: TI wall
OWNER: STANDARD APPLIANCE, INC., PHONE #: 503-777 -3377
CONTRACTOR: OWNER PHONE #: 503475.3180
Inspection Request Scheduled For: Date: 8/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 014618 -01 503-347 -0377 N
Corrections /Comments /Instructions: /
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: " C1 / Phone #: (503) 718-
F T ;.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00091
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005
Phone: (503) 639 -4171 ,�1� l
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'!!+� --
INSPECTION WORKSHEET FOR DATE: . 8/26/2006 TIME: 7 :06AM PAGE: 90
SITE ADDRESS: 11674 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STANDARD TV & APPLIANCE
DESCRIPTION: 71 wall
OWNER: STANDARD APPLIANCE, INC., PHONE #: 503 -777 -3377
CONTRACTOR: OWNER PHONE #: 503
Inspection Request Scheduled For: Date: 8/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014306 -01 503 -347 -0377 N
Corrections/Comments/Instructions: e.e.i-ef L ___ 7- cso_s_i c0---L
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• 7 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C Date: 0 S Phone #: (503) 718-