Permit I tt li f
r
'' BUILDING PERMIT
� C F T PERMIT #: BUP2004 -00502
. +1I1i`'� DEVELOPMENT H BMENT Tigard, 639 -4171 DATE ISSUED: 10/27/2004
SITE ADDRESS: 11565 SW HALL BLVD PARCEL: 1S135DD-01800
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -P
BLOCK: LOT: 026 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: 5N : 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: $ 10,000.00
Remarks: Attach shed to house compressor.
Owner: Contractor:
PANG, KEIKO TR GENIE ELECTRIC CONSTRUCTION INC
46 -442 HOLOLIO ST 8701 SE 156TH AVE
KANEOHE, HI 96744 PORTLAND, OR 97236
Phone:
Phone: 503 - 762 -9296
Reg #: LIC 56639
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 10/27/2004 $139.30 Electrical Permit Required
[TAX] 8% State Surcharl 10/27/2004 $11.14 F Insp
Framing I In nsp
[BUPPLN] Pin Rv 10/27/2004 $90.55 Final Inspection
[FLS] FLS Pln Rv 10/27/2004 $55.72
Total $296.71
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 wilt 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 (50 46 -6.'•- or 1- 800 - 332 -2344.
Issued B :� ti�.7∎ 1 _ _diA. !.-‘2.10
Permittee
Signature: / _ ir C ---<
Call 639 -4175 by 7 p.m. for an inspection the next business day
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Building Permit S
OR
Annlientw
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.. •- . . F, OFFICE USE ONLY , ': .. '.,•.' .!-,' . ' :- , '' --.:,., ,..,
, . ., . . . , .. .. , ..„ - • 1, . ..
Received A . ifif ,
ri Permit No. Ifj '
City of Tigard
Date/B : ta:Ize - , 0 — 00 4 - -
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 our 2, 'J 20 47
. O. „ / Date/B : Other Penult:
Inspection Line: 503.639.4175 _AM,. o Date Ready/By: iil See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: MO Supplemental Information
CITY OF TIGARD
.,.: . ' ,:,,,,,., ,..-.,,::.. ,, .'• ----,.. -;, -TY 1 I)1Y-- 191(: `!---' '' ': --',- ',• , ‘ -•", . ". - --,: - ' . REQUIRED DATA: I- ANtr24AMILY DWELLING
0 New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY _ OF CONSTRUCTION , • - -- . • - , , ,: - „ • . - '•,' . --- .-- ; work indicated on this application.
' --'-- --, • ' '' • . ': -,r- '-' ', ,
Valuation: $
El 1- and 2-family dwelling at<mmercial/industrial
' of bedrooms:
0 Accessory building 0 Multi-family Number
of bathrooms:
0 Master builder 0 Other: Number
. .4, • -, , . , . . . 4 , ,...., ... . .., „ .,_ . _
'':-' - '- • ', -,. :-.:.-.C- 'JOB' SITE INFORMATION AND LOCATION, 1:-: ,, , ..,.., Total number of floors:
Job site address: /75-6 5 ..(1 1/41 1 _ 46 L - V Ar New dwelling area: square feet
City/State/ZIP: 7.1 613 .b 012 f7 2 z 3 Garage/carport area: square feet
/
Suite/bldg./apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: 2 g 1 0 ce4s iv e 9,e..47-y 0 c Deck area: square feet
HALL _ BLI/lb, Other structure area: square feet
REQUIRED DATAI:COMMERCIAL-USE,CHECKLIST '
: ... . . . - '. • •• - .. - . ,
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
equipment, materials, labor, overhead, and the profit for the
'-- ' °-,' "-/ '''- :-'':.; '. .,- r :' t .'",--' :, ':-:''',- '. -'-'• DESCRIPTION oF'■voRic-; ,-.T.':-::.,-.,;,,..„--,:- , ' t,"7•, , ' -, ' .i work indicated on this application.
Valuation: $ /9 0
CO _ _::: ---
ro/v 57,eve-4-, a" 6 /4- I \ o 6.- #ay....
Existing building area: square feet
e rr - O p e j_FAi 7 51/Cr7 6 ‘7
PV /€
p New building area: square feet
4 ROJERTY OWNER .. - D TENANT Number of stories:
Name: A/ AP gi E _i77-FTS&—/Y-c Type of construction:
Address: 6' Z.(' . 1 4,1../ t2/€ 69,V ,$ ??.. Occupancy groups:
City/State/ZIP: Pae7 . L9 X Existing:
Phone: (SO ' 5) 2, 5 — 31 7 I Fax: ( ) New:
• APPLICANT ',-':-,::;,' ' . ;'' ;: , 0 ::6oNtAoriiiigi*::::',
Business name: No . 5 0; ,: -----V6--/v_s All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: /9•6/// /v t Fc92 f C._ under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
C applicant is exempt from licensing, the following reasons
ity/State/ZIP:
apply:
Phone: (503 ) ZZ -3/7 / Fax: : ( )
E-mail:
- CONTRACTOR
, ...
Business name: r—C-N s E Et-C AA C cle6Lc7ei/07 ON
:.:''.------. - - .--', RI)ILDING PERMIT FEES*
Address: /' 41 1
gl 0 i 5 r / 5v &VC: Please refer to fee schedule. •
City/State/ZIP: PO grt-, 0 ia i ' 'Z
— 5 Fees due upon application
e
Phone XS_ .1 762- /2 7 Fax: ( ) 767 --ene g
Amount received
CCB lic.: 1/45 . ei
Authorized signature: '" ---..„......,....___ Date received:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /9.1..,VI AL F net C.— Date: /0-.ZO -0 I I * Fee methodology set by Tri-County Building Industry
Service Board.
i•\13uilding \Permits \ BUP-PermitApp doc 12/03 440-4613T(11/02/COM/WEB)
Building Division
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
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 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested // oZ I 7 L AM PM BUP
Location / / S 0 0 Suite f` MEC
Contact Person ��!/�t � Ph ( ) � e gP37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ,/ �
Insulation IL) ta- b F *e4t{ ( F Drywall Nailing
Firewall ( "2034-- e.23igee P J4
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•
(ASS PART FAIL
PLUM n ING 1
• Beam ;��
Under Slab � .
Rough -In
Water Service
Sanitary Sewer \) V
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 bef ire next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call or reinsp:- tion RE: Unable to inspect — no access
Fire Supply Line
ADA
1r*
' " ��
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspe ' ion record from the Job site.
PASS PART FAIL