Permit ..,-,k
a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00545
°' COMMUNITY DEVELOPMENT DATE ISSUED: 11/8/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AA - 09800
SITE ADDRESS: 12570 SW 69TH AVE ZONING: MUE
SUBDIVISION: PP1996 - 024 LOT: 002 JURISDICTION: TIG
Project Description: TI - walls (4,000 sq ft)
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: 89 BASEMENT: sf AREA SEP. RATED:
STOR: 2 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: $ 50,000.00
Owner: Contractor:
JT ROTH DEVELOPMENT JT ROTH CONSTRUCTION INC
12600 SW 72ND AVE, STE 200 12600 SW 72ND AVE STE 200
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 - 639 -2639 Contact #: PRI 503 - 639 -2639
FAX 503 - 624 -0239
. Reg #: LIC 31700
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/8/2006 $470.80
[TAX] 8% State Surchari 11/8/2006 $37.66
[BUPPLN] Pin Rv 11/8/2006 $306.02
[FLS] FLS Pin Rv 11/8/2006 $188.32
•
Total $1,002.80
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 dired questions
to OU NC by calling 503.246.6699 or 1.800.332.2344.
I ----. / Z
Issu d By: k ;L� Permittee Signature: __.ate' _
Call 503.639.4175 by 7:00 a.m. for an inspection that busines - day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 . Commercial Tenant Improvement
Building Permit Application Folz oFFlcl: psi.: ONLY
City of Tigard DDa B / eANOI 11
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi idliMpillil
111 Phone: 503.639.4171 Fax: 503.598.1960 p Other Permit:
T I G R D Inspection Line: 503.639.4175 Date Re: Z IP ' ® See Paget for
Internet: www.tigard- or.gov Notified/Met od Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ w 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
CATEGORY OF CONDUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
• ❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /AOD S New dwelling area: square feet
City /State/ZIP: 76 .gote arfi- ,'21-,2,/ J Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: a t jy( L/ I/ mst %/ Covered porch area: square feet
Cross street/directions to job site: 6-? ' 4 /7 ,/it ✓ Deck area: square feet
/ Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
• equipment, materials, labor, overhead, and the profit for t
DESCRIPTION OF WORK work indicated on this application.
7gy4101 4 C1,•)We /'V Valuation: $ 5" 6F9 0
CWIAg /j tiruh• /l/i.e Srnucr4nAt6 Existing building area: SO OD square feet
�
i.44.- New building area: square feet
PROPERTY OWNER I ❑ TENANT Number of stories: z,
Name: j (. 4 , 0779 4„,,, f f _ Type of construction:h /,� f
Address: / j ,/ 7z Occupancy groups:
�DL�
City /State/ZIP: i , g Existing:
Phone: (03 ) (39', f3 I Fax: (P-7 ) Agg - O2 : ! New: /
❑ APPLICANT ❑ CONTACT PERSON NOTICE J
Business name: d: R . �- oi All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City / State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: pi ) kW a:0 L. Fax: : f)j ) 6-4237
E -mail: Wenv i i & /rdI,
CONTRACTOR
Business name: (7).7. Aflf! (✓f 4<1t BUILDING PERMIT FEES*
Address: 'AlaO S� 7aZ_ (Please refer to fee schedule)
�• to Structural plan review fee (or deposit):
City / State/ZIP:
Phone: ( G3 ) 6 / 3 p I Fax: 03) 6Ay 0,Z,,� FLS plan review fee (if applicable):
CCB lic.: t - ? d (� Total fees due upon application:
Amount received:
Authorized signatur This permit application expires if a permit is not obtained
J� ea( within 180 days after it has been accepted as complete.
I Print name: lill'� (i� �Iv / I Date: / • Fee methodology set by Tri-County Building Industry
Service Board.
1:\ Building \Permits\BUP- TI- PermitApp.doc 03/23/06 440 -4613T(11 /02 /COM/WEB)
CITY OF TIGARD - - -
BUILDING DIVISION PERMIT #: BUP2005-005546
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � At
INSPECTION WORKSHEET FOR DATE: 12/28/2006 TIME: 7:01AM PAGE: 49
SITE ADDRESS: 12570 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: pP1996 - 024 LOT #: 002 TYPE OF USE:
PROJECT NAME: GEORGE FOX UNIVERSITY
DESCRIPTION: TI - walls (4,000 sq ft)
OWNER: JT ROTH DEVELOPMENT, PHONE #: 503 - 639.2639
CONTRACTOR: ,,IT ROTH CONSTRUCTION INC PHONE #: 503-639-2639
Inspection Request Scheduled For: Date: 12/2812006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 041546-01 503-806 -0602 N
Corrections /Comments/ Instructions: / 4 -,
, . i
-, . , t _
, ,, s
6 / I o w, 1
PASS • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
q..X(PI Date: 1 Phone #: (503) 718- 21W_
1
•
Building Division
• Plan Submittal Requirement Matrix
T 1 G n R ID Commercial & Multi-Family - New, Additions or Alterations
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 2 **
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 \Permits \BUP -TI- PermitApp.doc 03/23/06
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: BUP2006 OOE45
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/812006
Phone: (503) 639 -4171 a
Inspection Requests (24 Hrs.): (503) 639 -4175 F:_..
INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7 :O0AM PAGE: 6
SITE ADDRESS: 125 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: PP199 &024 LOT #: 002 TYPE OF USE:
PROJECT NAME: GEORGE FOX UNIVERSITY
DESCRIPTION: TI - walls (4,000 sq ft)
OWNER: ff ROTH DEVELOPMENT, PHONE #: 503- 639 -2639
CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639
Inspection Request Scheduled For: Date: 12/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 04 503-806-0602 Y
Corrections/Comments/Instructions:
i \ "ce -40 / ' T P--- ST" r '. LE_.
t -( PP.
- (k)ST A ap,
1 -.A-A 1 (k) 0 - i C-Cj
1 I 6C-- Lt 0 ---
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
y ❑ CALL FI' INSPECTION ❑ ADDITI AL F ES ASSESSED
I nspector: 1 1111 Date: t 4 46 Phone #: (503) 718 -�3
CITY -:OF TIGARD ;
BUILDING DIVISION PERMIT #: BUP2006.00545
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/13/2006
Phone: (503) 639 -4171 � '" ard ll F '(I l
Inspection Requests (24 Hrs.): (503) 639 -4175 _ ..
INSPECTION WORKSHEET FOR DATE: 12/5/2006 TIME: 7 :00AM PAGE: i5
SITE ADDRESS: 12570 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: PP1996 -024 LOT #: Q02 TYPE OF USE:
PROJECT NAME: GEORGE FOX UNIVERSITY
DESCRIPTION: TI - walls (4,000 sq ft)
OWNER: JT ROTH DEVELOPMENT, PHONE #: 503-639-2639
CONTRACTOR: JT ROTH CONSTRUCTION INC PHONE #: 503 - 6332639
Inspection Request Scheduled For: Date: 12/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
205 Drywall nailing 040667 -01 503.806.0602 N
Corrections/Comments/Instructions:
14 . ' .
7
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAI • RI ALL Fir INSPECTION ❑ ADDITIO AL FES ASSESSED .
Inspector: P 1 Date: tZ b (J� Phone #: (503) 718 -
CITY OR TIGARD 5.
BUILDING DIVISION PERMIT #: BUP2000.00545
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2006
Phone: (503) 639- 4171up
Inspection Requests (24 Hrs.): (503) 639 -4175 —i1110- "'L.
INSPECTION WORKSHEET FOR DATE: 11/27/2006 TIME: 7 :05AM PAGE: 16
SITE ADDRESS: 12570 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: PP1996 -024 LOT #: 002 TYPE OF USE:
PROJECT NAME: GEORGE FOX UNIVERSITY
DESCRIPTION: TI - walls (4,000 sq ft)
OWNER: .lT ROTH DEVELOPMENT, PHONE #: 503 -63 -2639
CONTRACTOR: „IT ROTH CONSTRUCTION INC PHONE #: 503 - 639.2639
Inspection Request Scheduled For: Date: 11/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message pevi
275 Framing 040249-01 503 - 806.0602 Y
Corrections /Comments /Instructions:
..
atOWII
PASS ID PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ • - INSPECTION ❑ ADDITIO AL F S ASSESSED
Inspector: �( Date: t / v� Phone #: (503) 718- 4.22.