Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00482
0i DEVELOPMENT SERVICES DATE ISSUED: 11/27/02
'� I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12750 SW 68TH AVE PARCEL: 2S101AD -01300
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 JURISDICTION: :JIG
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: $ 384,000.00
Remarks: Tenant Improvement
Owner: Contractor:
HAMPTON BUILDING, THE LLC NORWEST GENERAL CONTRACTORS
6803 SW WHEATLAND RUN INC
WILSONVILLE, OR 97070 PO BOX 25305
PORTLAND, OR 97298 -0305
Phone:
Phone: 291 -6986
Reg #: LIC 89425
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 10/31/02 $1,199.38 Electrical Permit Required
[BUILD] Permit Fee 11/27/02 $1,845.20 Sprinkler Permit Required
Plumbing Permit Required
[TAX] 8% State Tax 11/27/02 $147.62 Framing lnsp
[FLS] FLS Pln Rv 11/27/02 $738.08 Insulation Insp
Firewall Insp
Total
$3,930.28 Gyp Board Insp
Susp Ceilng lnsp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: / 4/6,k_.- C =_` 6
Perm ittee <
Signature: -
Cali 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application o ff F ICE USE ONLY
Y t J City of Tigard Date received: (a 3 (4— Permit 1, ea b01-.1)0 '
Project/appl. no.: Expire date:
City q/Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi - family 0 New construction 0 Demolition
0 Addition /alteration /replacement Tenant improvement ❑Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: f 2. 0 SW - % *$ PK. Bldg. no.: Suite no.:
Lot: 7 -11 Block: 33 Subdivision: W es" - , R ri pJ 0 Nem*T Tax map /tax lot/account no.:
Project name: • . c t ► IL 11 c •JTA L. i NI I T T.-
Description and location of work on premises /special conditions: _._ .. • • TR T
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
EMEI (Floodplain, septic capacity, solar, etc.)
Mailing address: , c , - 1 & 2 family dwelling:
- .. L l ZIP: ' Valuation of work $ _ , r J
Phone: 54 i - . - • :Fax: E -mail: No. of bedrooms/baths
Owner's representative: /' Total number of floors
Phone: 3. - (,q$ L IIMMIETVI E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
1111 Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial /multi- family:
CONTRACTOR Valuation of work $ 384 0 000
Business name: Existing bldg. area (sq. ft.) 42 6
New bldg. area (sq. ft.)
Address: •
• Number of stories
- ' . �c7 ZI - - • Type of construction V P4
Phone: - - -. IIMMITIVI E -mail:
Occupancy group(s): Existing: CtoIA l
CCB no.: - • New: me t] &soo.V,
Cr tt t 11 Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Address: C8 jurisdiction where work is being performed. If the applicant is
ZIP: - ; 40 2. exempt from licensing, the following reason applies:
Contact person: :c Plan no.:
Phone:25; -57 •aL06 Fax: E -mail:
IV ENGINEER OFFICE USE ONLY
a Contact person: 1 Fees due upon application $ •
Address: _ • . g Date received:
• , - � , t 1 ZIP: - '7'2,0 Amount received $
Phone: -. • Fax: E -mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards. please call jurisdiction for more information.
attached checklist. All provisions of . .: • t inances governing this 0 Visa 0 MasterCard
work will be complied a whet r sp =c' : •
ferein or not. Credit card number: / /
ll Expires
Authorized signature: , . Date: 1 D /2 S Z Name of cardholder as shown on credit card
$
Print name: . plAdt.t .) Rag aK4 Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. A 440 -4613 (6 /00 /COM)
1 2 I A) 11 x 9.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP D4f
Received (o ' „ ' Date Requested 6 �� AM PM BUP
Location t a' 79) 4 ' � Suite MEC
Contact Person J Ph ( ) .-t q— go ® 760z , O q 2_42
Contr. • Ph ( ) SWR
UILDIN Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain /� �—
Slab Inspection Notes i ` SIT
Post & Beam
Shear Anchors U (/
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL \�
• LUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan / j3�� 20C Z- 00 4'r
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: El Unable to inspect – no access
Fire Supply Line
ADA / /./� /
Approach/Sidewalk Date (J Inspector ' 7 r Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL