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Permit (179) " _r�� BUILDING PERMIT A CITY OF TIGARD PERMIT #: BUP2003 -00680 SSUED: 12/17/03 �1� DEVELOPMENT SERVICES DATE I � ' � " �� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15570 SW PACIFIC HY PARCEL: 2S110DC -02200 W SUBDIVISION: WILLOW BROOK FARM ZONING: C -G BLOCK: LOT: 011 JURISDICTION: TIG 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: 3N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,200.00 Remarks: Modifications to ATM area. (Wells Fargo area.) _Owner: Contractor: TIGARD, CENTER LP B J. CUMMINGS COMPANY 9777 WILSHIRE BLVD #609 2330 SE CLATSOP ST BEVERLY HILL, CA 90212 PORTLAND, OR 97202 Phone: Phone: 235 -1282 Reg #: LIC 23230 FEES MET REQOQIZE�IN SPECTIONS Description Date Amount Electrical Permit Required [BUILD] Permit Fee 12/9/03 $62.50 Framing lnsp [TAX] 8% State Surchart 12/9/03 $5.00 Gyp Board Insp Final Inspection [BUPPLN] Pln Rv 12/9/03 $40.63 [FLS] FLS Pln Rv 12/9/03 $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) 246-6699 or 1- 800 - 332 -2344. ri,!' i f � / Issued By: 1CJ(.(�t Q l�2b./0 Pe rm ittee " _ Signature: d)'1 0(.4:24) U Call 639-4175 by 7 p.m. for an inspection the next business day W Y 7v 5 1 rAo rlG Ilia i . . �. o' AgEIVED 4 Y o tl Building Permit Application,, OFFICE USE ONLY s't Date received: b_ Q Permit no.: �i(J d.op3— OO(v i� / �; j ' `' d CITY OF TIGARD 1:1.111MIMMIIIIIIIMIll /�/� 1900 SW 4th, Ste 5000, PO BoxglJQcgp a 1201 e /L✓LJ► Phone: (503) 823 -7363, Fax: (503) 823 -3018 I�P/��eP/�.50 /12 -/e-0) '�� TDD: (503) 823 -6868, Website: www.bds.ci.portland.or.us TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ommercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: /S5 O 5 ♦ '' G I C.i tf IV Bldg. no.: Suite no.: Lot: Block: Subdivision: Tax map /tax lot/account no.: Project name: E1.4,6 • L .-• - /v6 G ` N OAF SLR, Description and location of work on premises /special conditions: / /PGA 77O 7 TO A7714 A, &4Q • OWNER FOR SPECIAL INFORMATION, USE CHECKLIST (Floodplain, septic capacity, solar, etc.) Mailing address: ! D . tO 3(5/ 1 & 2 family dwelling: City: State: ZIP: 97 we, Valuation of work $ Phone: Fax: E -mail: No. of bedrooms/baths Owner's representative: Total number of floors _ Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage /carport area (sq. ft.) CM �� Covered porch area (sq. ft.) Mailing address: 0 5 CLA • — Deck area (sq. ft.) City: 70,0 • No State:Q,( ZIP: _I Other structure area (sq. ft.) Phone: JC- ZS Z., Fax: /35 0, ,z E -mail: Commercial /industrial /multi - family: CONTRACTOR Valuation of work $ /Zoo Existing bldg. area (sq. ft.) 3/80 Business name: a J , _ v , ` New bldg. area (sq. ft.) Address: 0 G G • Number of stories City: • ° • ( j State:QA' ZIP: 97292 j ► Phone: — �, E -mail: Type of construction • IT /y CCB no.: 2 Zap Occupancy group(s): Existing: 5 New: iv City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIII•l ECT /DP :SIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER OFFICE USE ONLY Contact person: Fees due upon application $ Address: Date received: City: State: ZIP: Amount received $ Phone: Fax: . E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the attached checklist. All provisions of laws and ordinances governing this work will be complied ' wh ether J specified herein or not. Authorized signature: � i ( Date: 129/03 Print name: (C../c, / T JAS ) for Cbiv k /sS,EA) Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. LT- famisWpp Building 0303.pmd CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP 'moo (p $O Received Date Requested 3 AM PM BUP Location /5 7 v Suite MEC Contact Person Ph ( ). ?/ R- / T PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner _ • / ' C Footing ■ / Foundation ELC Ftg Drain Ac . .i �� V �� ELR Crawl Drain U Coe Slab Inspection Notes: IT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: ■: PART FAIL PL U ' BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA �c c Approach/Sidewalk Data /2/� ! /v y Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL