Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2000 -00033
"� ��'� DEVELOPMENT SERVICES DATE ISSUED: 02/10/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -06502
SITE ADDRESS: 10925 SW 69TH AVE
SUBDIVISION: WAY LEE ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: 68 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: 20 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: $ 7,500.00
Remarks: Construction of a 20 ft freestanding pole sign.
Owner: Contractor:
WAY W LEE SECURITY SIGNS INC
GENERAL CONTRACTOR 436 SE 12TH AVE
52O1Ro a 0 SE 26TH PORTLAND, OR 97214 ORIGINAt PPh ND, OR 97202 Phone: 232 -4172
Reg #: LIC 00122809
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PRMT KJP 02/10/200C $105.50 HANDRECPT Foot/Found Insp
Final Inspection
5PCT KJP 02/10/200C $8.44 HANDRECPT
PLCK BON 02/01/ -1 $68.58 00- 321552
FIRE KJP 02/10/200C $42.20 HANDRECPT
Total $224.72
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Permitee i �
Signature: - _ _
Issued By: Ai - ,1
CaII 639 -4175 by 7 p.m. for an inspection the next business day
C Commercial Building Permit Application Fla "? =L
13125 SW FALL BLVD. New Constructipn and Additions Recd By /t>`'
Date Recd Z - 1 v
TIGARD, O� 97223 �
(503) 633'° 71 Date o Dm � �e /<2
Print or Type Permit # B, oar - Lo 33
• Incomplete or illegible applications will not be accepted Related SWR#
Called '1 - fa- lt'iV
Name of Development/Project -
Job Existing Building (EXNew Building 0
Address Street Address - Suite 'T �`
1( A ) w '4,i � Building
Bldg # City/State P Data
TIGA�j� Zj _ Existing Use of Building or Property:
Name
Property Pro a WA\4r Z_-.' � 5 -r 1 y --
Owner Malang Address Suite / Proposed Use of Building or Property:
City/State Zip Phone
3 1/0 R '17 No. Of Stories:
Occupant ame Sq. Ft. Of Project:
Occupancy Class(es)
Contractor � LV i,`r l �413
Prior to permit Mailing Address r Suit Types of Construction
issuance, a copy a/ SE L i LC 111.
of all licenses ,]lam
are required if City /State Zip Phone Will this project have a Fire Suppression System?
expired In C.o.T. Yes ❑ No M
database .. tv c'TDe- 172. 1 y Z.�2 y' 17 e_ Americans with Disabilities Act (ADA)
Oregon nst. Cont. Board Lic.# Exp. Date
Valuation X 25% = $ Participation
Z- 04°1 31),(0/0`)
Complete Accessibility Form
Name Project $
Architect Valuation ; �
Mailing Address Suite l ' .
Plans Required: See Matrix for number of sets to submit
City/State Zip Phone on back
Engineer Notr I hereby acknowledge that I have read this application, that the information
L 1C kl/V v given is correct, that I am the owner or authorized agent of the owner, and
MauinA Suite that plans submitted are in compliance with Oregon State. Laws.
2 "" 5 RAI Fl 5 r SAndr Date
City/State Zip Phone 6 Z , a 1 , 00 _ _
111q LAp x Vi L.tAr__ ‘87 69,1 , Contact (y
Person Name Phone t
Indicate type of work: New 0 Addition 0 Demolition 0 6�` G�` 1t 2jt 1?l�Qylly 2
23, 4177
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair O Other 0 FOR OFFICE USE ONLY
Description of work: MapfTL# r Land Use:
r t/ # , j •
Parks: Estl Notes:
# of Emplo `,'t`' , l , TIF:
J
11 the above figure is not supplied at the time of application, the city will
calculate the fee based upon the number of parking spaces. •
Note: Site Work Permit Application must precede or accompany Building r - c ",
Permit Application ��� t` ,L.' V Vi (( -) • id
1 is LVc
i. dsts\forms comnew.doc 5/10/99
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COMMERCIAL PLAN SUBMITTAL ,...-,
REQUIREMENT MATRIX
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1 :ldstslforms matnccom.doc 10/30/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
B - OC O33
Date Requested 3/P/03 AM PM BLD
•
Location 1 oq 5 artlev ' Suite ,�� MEC
Contact Person ✓� Ph — WS — ///r� ! � PLM
Contractor Ph SWR
UILDIN Tenant/Owner ELC
Retaining Wall ELR
-ootin • Access:
oundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: �l
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Misc:
■•. %��, ART FAIL
•`"' =ING
Post & Beam
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain Drains
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:
PASS PART FAIL
SITE
•
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for einspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date iI I U Inspector Ext
Other -
Final r
PASS PART FAIL DO N T REMOVE this inspection record from the job site.
1