Permit ` BUILDING PERMIT
' CITY OF CITYOFTIGARD #: BUP2004 -00182
-�+L :.it. , DEVE Tigard, DATE ISSUED: 5/25/2004
(503) 639 -4171
SITE ADDRESS: 12703 SW 67TH AVE PARCEL: 2S101AD -01000
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 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: 8 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: $ 34,650.00
Remarks: TI, ground floor only.
Owner: Contractor:
SPECTRUM DEVELOPMENT BEACON HOMES NORTHWEST (151251)
25117 SW PARKWAY AVE PO BOX 407
WILSONVILLE, OR 97209 WILSONVILLE, OR 97070
Phone: 503 - 570 -8828
Phone: 503 - 570 -8828
Reg #: LIC 151251
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pin Rv 4/22/2004 $232.90 Electrical Permit Required
FLS FLS Pin Rv 4 /22/2004 $143.32
Plumbing Permit Required
[FLS] Framing Imp
[BUILD] Permit Fee 5/25/2004 $358.30 Gyp Board Imp
[TAX] 8% State Surchari 5/25/2004 $28.66 Susp Ceilng lnsp
Total Final Inspection
$763.18
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 (51 -• or 1- 800 - 332 -2344.
�
Iss ed By: ; _
Per - - ��� / : J L _ �
/ . 7
Signature: i �`
O r .39 -4175 by 7 p.m. for an inspection the next business day
/Z 05 SW 4
Building Per * t' : tion FOR OFFICE USE ONLY
b ' Received / Building 4�/ 41 / Q
7r t& SF tP t ` ., ` O Q y t DateB : �� / Permit No.: 0' // — C4.4- 0 r
C ity of Tigard i' C+ K D Planning Approva Other
Perm
13125 SW Hall Blvd. pr 1\C 1510 Plan Review Other
No.:
Tigard, Oregon 97223 GO nn , �G, Div DateB : S - i 5 Permit No.: \
Phone: 503 - 639 -4171 Fax: @,;t`� 8 -1960 "�
.^ " i1 Yjl Post - Review Land Use
Internet: www.ci.tigard.or.us ' ' r j 'i I Contact Case No.
See Page 2 for Q
24 -hour Inspection Request: 503 -639 -4175 Name/Method: / ® Su • • • • lemental Information
:,! ;TYPEOF; ; -'. �l
�/ ; REQUIRED DATA: ; .� , . °
IN d New construction ❑ Demolition 1 & 2 FAMIL,Y'DWELLING '
/ ❑` Addition/alteration /replacement ❑ Other:
CATEGORY OF:CO TRUCTION ` , . Note: ' -rmit fees* are based on the total value of the work performed. Indicate C
❑ 1 & 2- Family dwelling Commercial/Industrial the value .. • ded to the nearest dollar) of all equipment, materials, labor,
overhead and pro or the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
,:JOB:SLTE�INFORMATION and'LOCATION :Y:4 No. of bedrooms: No. o •:•I;
Job site address: )27O2 .,..._)k.1 rp7-� Avg • Total number of floors �!
New dwelling area (sq. ft.)
Suite #: - ---. Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: c. )M (Ge, � Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
` t i a � - L 4 ' � N Other structure area (sq. ft.)
. ; t . 0, ED'DATA. r ' . -
COMMERCLAL :USE CHECKLIST
Subdivision: _LR
Tax map /parcel #: ,2G 1 1 AD/ I coo Note: Permit fees* are based on the total value of the work performed. Indicate
'` '";DESCRIPTION WORK. the value (rounded to the nearest dollar) of all equipment, materials, labor,
`� ® overhead and profit for the work indicated on this application. �`
. ND S - Valuation $ 34(49SO '
Existing building area (sq. ft.) � 1 t) �1=k.
esp.. ' S uc ru AL • 0 - r/• 1-•/ - New building area (sq. ft.) M.'Fs
13::1 Ka END • PI � 614 4!..ALIG• LL Number of stories L
PROPERTY OWNER '-, ..r , ja`TEN'ANT . ., _ Type of construction
Occu group(s). Existing:
Name: S - 6VV‘, iVl:Lp�1'�/�,}°(' New:
Address: =,J 17 Z J ?4NN1
City /State /Zip: N( Le e . 917_6 9
P nej Cj7 p�j2$F 576 NOTICE: All contractors and subcontractors are required to be
P9 licensed with the Oregon Construction Contractors Board under
LA PPLI(CANT -.; y 4 „CONTACT PE C/N, provisions of ORS 701 and may be required to be licensed in the
Business Name: t'AV 1,p >g51 ' V r .Ai556�. jurisdiction where work is being performed. If the applicant is exempt
Contact Name: 'pF�.\f, p illf from licensing, the following reason applies:
Address: 2 )2 K c ,- } AV1; . 4 30
City /State /Zip: p jp:I M7 1 ()(z . r7 2oc
Phone: 503 • ZZ4, • 6 Fax: - 2 31 1 I' a r 1^ ,, —
BUILDINGTERMIT FEES* ,.
Email: �p 1 S e{ L r e GtJN/1 , `. 4Please•refer to`fee sched'ale. ; 4 y�
a , i ; : ., CONTRACT_ORa '' . , - .._ . > ,, ... ...... , , . .
Business Name: $_, .H 1Al Fees due upon application $
Address: 2 i 1'7 sw �f�cP•4G A A' . AVM •
City /State /Zip: W1Lslyi / 0R. 976'7n Amount received $
Phone: ;13. 570 . e Fax: j • X-7 ezei Date received:
CCB Lic. iti
Authorized S r _ �J Notice: This permit application expires if a permit is not obtained within
Signature' / J � .L / �. a e: �• r _ 9 / � 180 days after it has been accepted as complete.
i
i/ l / i 11.1AFAI *Fee methodology set by Tri -County Building Industry Service Board.
.11116111P• . ( . lease print name) .
i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
6 B13/37
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received
17 �/ Date Requested ` tea" AM PM BUP a0 ,P.-
Location /€7 70 3 5w 6 7 /' Suite mosigotpichmegaldgetall
Contact Person .A1(dy' Ph ( 1 -0 7 -- OS PLM
Contractor Ph ( ) SWR
UIL Tenant/Owner ELC
oF' offing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling f
Roof w r
Other: - ='
in
PART FAIL
•
B ING
.
Post & Beam
Under Slab F . c
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: .
Final
_Fags PB — FAIL
ECHANI )
Post & Beam
Rough -In . .
Gas Line
Smoke Dampers
a
PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl 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 1 �� /O t
ADA Approach /Sidewalk Date I nspec t or v ■ (^ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART,, FAIL