Permit CITY OF TI BUILDING PERMIT
PE RMIT #: BUP2004 -00507
,i DEVELOPMENT OP Tigard, ICES 639 -4171 DATE ISSUED: 11/15/2004
SITE ADDRESS: 13332 SW BENCHVIEW TERR PARCEL: 2S104DC 00200
SUBDIVISION: BENCHVIEW ESTATES ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 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: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: 20 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 8,300.00
Remarks: Extension of existing deck.
Owner: Contractor:
JOHNSON, BONNIE CASCADE CONTRACTING
13332 SW BENCHVIEW TERR 6045 SW OLD SCHOLLS FRY RD
TIGARD, OR 97223 PORTLAND, OR 97223
Phone: 503 - 521 -9119
Phone: 503 - 209 -4449
Reg #: LIC 146324
FEES REQUIRED INSPECTIONS
Description Date Amount Footing Insp
[BUILD] Permit Fee 11/15/2004 $129.70 Framing Insp
[TAX] 8% State Surcharl 11/15/2004 $10.38 Final Inspection
[BUPPLN] Pin Rv 11/15/2004 $84.31
[CDCPLN] CDC Pln Rel 11/15/2004 $42.00
Total $266.39
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.
Issued By: _
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
"ir ,
Building Permit Application .. FOR OFFICE USE ONLY `
y /
Received ��
City of Tigard ""°4Q7 B Date G� Permit No.: ♦ M y 0 /
13125 SW Hall Blvd., Tigard, OR 97223 R EC '� IVF" Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ol � hf W � Date/By: Other Pemut:
Inspection Line: 503.639.4175 , a Date Ready/By: El See Attached Checklist for
Internet: www.ci.tigard.or.us OCT 2 5 1 1 Notified/Method: Supplemental Information
TYP REQUIRED DATA: 1' AND:2- F 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
%Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the •
1 -and 2-family dwelling CATEGORY OF CON CoRION work indicated on this application. �� �-
Valuation: $ 000
y g ❑ Commercial/industrial /
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE v INFORMAATION _ ,:ANDn \v;c. LOCATION Total number of floors:
Job site address: 1-s33Z 5 W +'dAo 1 `•L rt- New dwelling area: square feet
City/State/ZIP: — "c; v..2:51 0 Nt. 47 LZ3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: 5100 square feet
Other structure area: square feet
REQUIREDDATA 'C OMMER(IAL - 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:- '__ CA- .WORK work indicated on this application.
E)C 4 V■Siat\ 6J- Q4 1Sti •1<, Valuation: $
Existing building area: square feet
New building area: square feet
❑ TENANT Number of stories:
PROPERTY OWNER ,, '° r' '
Name: 'S a ^ - 49\9sKSN\. Type of construction:
Address:
i'S 3 3 2 S t...) 3. Q.., 14.. r t- Occupancy groups:
City/ State/ZIP: 1.-; q Gr€K n'SZ. 9'727— Existing:
Phone: ($.. 33) 511 c j , 9 Fax: ( ) New:
C AN T = - s£ -' CO NTACT PER t o
PLI ` `, NOTICE
Business name: C /' �n All contractors and subcontractors are required to be
Contact name: W' licensed with the Oregon Construction Contractors Board
AC.r.•wn._ •-C--C under ORS 701 and may be required to be licensed in the
Address: Go y S w o of . 5c I s f F� jurisdiction in which work is being performed. If the
City/State/ZIP: ‘.-..post.. f' a. en. 9 1 zz = Y applicant pp is exempt from licensing, the following reasons
Phone: (503) Z o 9 y y y q Fax:: ( )
E -mail:
_ F CONTRACTOR
Business name: ' csc,cd• CjAsft r1/4I� BUILDING PERMIT FEES*
Address:
Please refer to fee schedule
City/State /ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
CCB lic.:
II& 3.z 4 An/?-7 / Amount received
A Date received:
Authorized signature: (� A This permit application expires if a permit is not obtained
// �� w �� --"�� within 180 days after it has been accepted as complete.
Print name: At4✓,,, -- 4 , ,L. Date: 1drz,5 * Fee methodology set by Tri- County Building Industry
Service Board.
i\ Building \Permits \BUP- PemutApp.doc 12/03 440- 4613T(11/02 /COM/WEB)
4 111
Building Division
A 101# Plan Submittal Requirement Matrix
II
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:\ Bui ldingWorms \COM- PlanSubReq.doc 12/24/03
11/03/04 16:06 FAX 5036813603 CLEAN {PATER SERVICES 0001
L /03/2004 17;06 FAX 5035981960 CIT3t OF TI GARD
2001
-- 00 I.7 Zc - 605 ■
. NOV 0 3 2004 i '' I F ile Number q 4Q3
J
C1eanWaLe r - • ,Services
Q .., ce/Anti hrccnt it) sI�- - S ensttiverAregr caning Site Assessment
W •
�, - sdiotlon Date 1 1 -.9 _ Oy
o r�I► :p & Tax Lot O 00,2c) Owner Owner '�.�.. ��... d_ ___act,
•c S@ e Address 3 S
' .rte .e,, , -- ) -- -0.fy i Contact -Ca "
co ; • • posed Activity '7�..s �� tac es...3 \ a \--___. Address �J
Phone - - ‘21.. - Y_______
�— -
elficial use only below U11s Ana
Y N NA Y N NA
ri ❑ ❑ Sensitive Area Cornposite Map E ❑ ra aS r�mwater Infrastructure maps
Map #
Locally adopted studies or maps Other
El Specify ❑ ❑ Specify A ce.Z a,•.. -;.../
Based on a review of the above information and the requirements of Clean Water
Services Design and Construction Standards Resolution and Order No 04-9:
Sensitive areas potentially exist on site or within 200' of the site. THE APPLICANT
MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE
PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. If Sensitive Areas
exist on the site' or within 200 feat on adjacent properties, a Natural Resources
Assessment Report may also be required. •
I/ /:l Sensitive areas do not appear to exist on site or within 200' of the site. This pre-
screening site assessment does NOT eliminate the need to evaluate and protect
water quality sensitive areas if they are subsequently discovered on your
property. NO FURTHER SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS
- - REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A
STORMWATER CONNECTION PERMIT.
1:1 The proposed activity does not meetthe definition of development. NO SITE
ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED.
Comments:
___,Z345 eI ap f. ..J u T Si 7e p/4. Qatrro,�
pi.ef,G/ D /or W. // rrii : -w. •'t4M i -ear b. , T t ' .vc - r.
Reviewed By: _"' Date: . ) e y
- Returned to Applicant
&Tail J�( Far Counter
' Date I io a BY-245-
2550 SW Hillsboro Highway • HIIlabaro, Oregon 5/712A
Phone: (503) sa1 -3805 • FaX (603) 881 -4439 6 www otm IZAS _ s_orr
CITY OF TIGARD 24 -Hour
BUILDING Inspection Li (503) 639 -4175
INSPECTION DIVISION Business Line (503) 639 -4171 MST
Received Date Requested - — i AM PM BUP
Location _ _ — A.idA ' I if . - . Suite MEC
Contact Person Ph ( .. ) �7 — PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Q SIT
Post & Beam • / f /' '�
Shear Anchors
Ext Sheath/Shear 'Le 1 4
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
i n t; ;P PART FAIL
• MBING
Post & Beam
Under Slab -
Water he
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 El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL r - SITE Please call for reinspection RE: _ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date / / Inspector Ext
Other:
Final DO NOT REMOVE this inspection reco from the job site.
PASS PART FAIL
•