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Permit , .i. CITY OF T BUILDING PERMIT PERMIT #: BUP2003 -00493 *���; DEVELOPMENT SERVICES DATE ISSUED: 8/14/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB -00600 SITE ADDRESS: 16195 SW 72ND AVE BLD.D SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : 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: $ 38,500.00 Remarks: Re -roof Owner: Contractor: PACIFIC REALTY ASSOCIATES PACIFIC ROOFING COMPANY INC 15350 SW SEQUOIA PKWY #300 -WMI PO BX 1728 PORTLAND, OR 97224 BEAVERTON, OR 97075 Phone: Phone: 640 -3163 Reg #: LIC 41571 FEES REQUIRED INSPECTIONS d. Description Date Amount M t sc . Fo&. P2oQeES5 ' [BUILD] Permit Fee 8/14/03 $388.30 Final Inspection [TAX] 8% State Tax 8/14/03 $31.06 Total $419.36 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Issued By: _ZCue2�.eiC__ Pe rm ittee Signature: a 3 6 Q -IC— Call 639 -4175 by 7 p.m. for an inspection the next business day Building Permit Application OFFICE USE ONLY t ��Ji' City of Tigard C l e �D Date receive /o3� Permit no.:/ �J� �9j ��`� " Projectlappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd Tigar 97223 C Phone: (503) 639 -4171 Date issued: BYZIg Receipt no.: Fax: (503) 598 -1960 'AUG 14 2003 Case file no.: Payment type: Land use approval: CITY OF TIGARD 1 &2 family: Simple Complex: .. TYPE OF PERMIT O 1 & 2 family dwelling or accessory ($,Commercial /industrial 0 Multi - family 0 New construction 0 Demolition 0 Addition/alteration /replacement O Tenant improvement 0 Fire sprinkler /alarm 0 Other: JOB SITE INFORMATION Job address: 1 NA — 5 w 7) rd 4,,e.- Bldg. no.: 1 Suite no.: Lot: I • Block: 'Subdivision: 'Tax map /tax lot/account no.: Project name: V O r Description and location of work on premises /special conditions: w c-re. / G -ccr e- CCSC�t- c rv OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: i � ;c_ \ \,-,' 4`�i ctcok.1 L p (Floodplain, septic capacity, solar, etc.) Mailing address: 15 35-0 sc.,), 5 I e v o Ic4 a ' . w ,. $.�. . 306 1 & 2 family dwelling: City: Qarka,,,.1 a/ l State:0 r ZIP: ' j ,.) 4 Valuation of work $ Phone: I,yy - &got IFax: 6a9- 17Z1E -mail: No. of bedrooms/baths Owner's representative: ,off,,, U jj.i. y Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage /carport area (sq. ft.) Name: PI�.z.n,z. ,,,I Covered porch area (sq. ft.) Mailing address: p c„,. 1-7a4 Deck area (sq. ft.) City: g r%. I State: Q r I ZIP: 91015 Other structure area (sq. ft.) Phone: (,y,ct- 1 t Fax:(Jt - • E -mail: Commercial/industrial /multi - family: CONTRACTOR Valuation of work $ 31s, ctc.• - gcyc Existing bldg. area (sq. ft.) as(, p0 Business name: T " ,f New bldg. area (sq. ft.) @- Address: QA ( 1-1).% Number of stories 1 City: 6 rla lcr A 'State: 0 r I ZIP: 9101 S Type of construction TA 1r-- 0 4 Phone: yis3 -o.w. t1 11 316 I Fax f,• - 31 E -mail: CCB no.: 1-11 s-i Occupancy group(s): Existing: X New: City/metro lie. no.: Notice: All contractors and subcontractors are required to be ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: I State: I ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER _. OFFICE USE ONLY Name: Contact person: Fees due upon application $ Address: Date received: City: IState: `ZIP: Amount received $ Phone: 1 Fax: E -mail: Please refer to fee schedule. I hereby certify I 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 laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied with whether spec ed herein or not. Credit card number: / / D Expires Authorized signature: B Date: V)3/65 Name of cardholder as shown on credit card Print name: (fit, 3 g e l s Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -46l3 (6 /OO /COM) ? t c-//c>.?-1. - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received . /lam/ 95 , Date Requested -- / L i AM ✓ PM BUP Location's / '' r %: -= Suite MEC Contact Person Ph ( )' ` / i PLM Contractor Ph ( ) - 0 ° i - ` - % ' L SWR BUILDING • Tenant/Owner ELC Footing Foundation .� ��. }.�;, .�� �...: ELC Ftg Drain ELR .'`°_, �k: ; ,�, � Y, ;': t a ,oJ �' '� t � 1 ► � : ,.• i•/ Crawl Drain "= _`� - -�J� ^1 P : ° �� ?,,�..r- t.s•h.n.c•- 'z�� ?ct �:�; r _ �� :, }�.f 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 Roof Otheri t' - Final 6 PASS. ART FAIL . ` Prown3ING Post & Beam Under Slab Rough -In 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 SITE Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line `� / +, ADA Approach/Sidewalk Date f ! 7 1 C) Inspect Ext • Other: / Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST /61 c7,5— BUP 6 O ce9) Received Date Requested ? AM PM BUP Location Suite MEC Contact Person .1.1- Ph ( ) Co tie - 3163 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ,,...---- ti _... Insulation Drywall Nailing Firewall gi,k Fire Sprinkler Fire Alarm , S� Ceiling ! S / 17 0 0, S c Gt/ i r ` 1__ PART FAIL PL 1 '' BING - Post & Beam P o e t {J r- 6 w 1-- -7 fi. 72 Under Slab > Water /� -P4c/ m C/? - 4 i.c.:1 s-!' ' k Water Service Sanitary Sewer i Rain Drains (.../ e-- � 0 /2� 4f S ��h e.� Catch Basin / Manhole / Storm Drain / 4 t- / U , , µ [ / f w / // Shower Pan G� q c/-C ( ,, / Cc c 7' , / G �T Other: Final S T72 / / 6- L4�' o` 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: 0 Unable to inspect — no access Fire Supply Line C� / / ADA Date ! �y/ v 3 Inspector ( Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL