Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2003 -00164
14 DEVELOPMENT SERVICES DATE ISSUED: 4/29/03
`` '' 1 3125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15205 SW 74TH AVE PARCEL: 2S112DB 00600
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 014 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: UFEW D 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: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY 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: $ 3,800.00
Remarks: 20' high free standing sign.
Owner: Contractor:
MEYER, DENNY G + NANCY L MEYER SIGN CO OF OREGON INC
7340 SW LANDMARK LN 15205 SW 74TH
TIGARD, OR 97223 TIGARD, OR 97223 . .
Phone:
Phone: 620 -8200
Reg #: MET 00001899
FEES LIC REQ - a b , a p 1 e i SPECTIONS
Description Date Amount Foot/Found Insp
[BUPPLN] Pln Rv 4/8/03 $53.11 Final Inspection
[FLS] FLS Pln Rv 4/8/03 $32.68
[BUILD] Permit Fee 4/29/03 $81.70
[TAX] 8% State Tax 4/29/03 $6.54
Total $174.03
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you_ta. ollow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 1=0010 throu h.QAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
ca • g (503) 246 -6699 oN1- 800 - 332 -2344.
Is ued By: G /
Pe mi ittee /
Signature: T -__
I
Cali 639 -4175 by 7 m- far- aniaspection the next business day
/slog j 1 -7- ,
FOR OFFICE USE ONLY
Building Permit Application
Received Building �1,� /,/
Date/By: ii--q 3 Permit No.:? •" OD/ ('i`J
City of Tigard EC 1 - i Planning Approval Other f
Y g i_ Date /By: Permit No.:
13125 SW'Hall Blvd. Plan Review Other
Tigard, Oregon 97223 (p� (() Date/By: Z$ol / Permit No.:
Phone: 503-639-4171 Fax: 503-59-f66' / � eh'' N 9! f ") " Post- Review Land Use
� ,I j ( Date/By: Case No.
Internet: www.ci.tigard.or.us CITY OF T '" Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 50353..M. 1MG DIVISION Name/Method: Supplemental Information
A E A it e. �T.YPE WORK' „' „ '' ,., .., rs t` � rRE UIRED DTA K Iz ` z s t
it t f 'fie ° � �y � A
6 z `3�- -� 5§ `� 4 t R � � r '' 1 & 2 FAMIL � Y DWEELLIN , ,,
111 New construction 111 Demolition w Act �._ ,
❑ Addition/alteration/replacement ❑ Other:
F ” r .,a,vr� . =,fit. �
r "CATEGOR.YOF CONSTRUCTION „,'z Note: Permit fees* are based on the total value o the work performed. Indicate
❑ 1 & 2- Family dwelling ,.JCommercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
l ; ' °°°� '� °�' JOB, SI ;TaE;INF ORl 1IA TIONandLOCA �� � TION �, A No of bedrooms: No of baths:
E
-�� � Total number of floors
Job site address: '/ ��� 14,077" New dwelling area (sq. ft.)
Suite #: 1 Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: /22 F �1 5 S' /, /Y Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
I, alive RED DATA ; e�, �., w p r i
t CO MMERCIAL ` US E "IC HECIQ;IST
Subdivision: Lot #:
Tax map /parcel # Note: Permit fees* are based on the total value of the work performed. Indicate
m PTIONU T FWO t RK w "..:: max:,. ::: the value (rounded to the nearest dollar) of all equipment, materials, labor,
�, , .: .A 1 t t x 4 '�' + ;T
SCRI
K
.... ,., M .<....v�DE
overhead and profit for the work indicated on this application.
_ — N57flt -A /OW (t) �Pi EESA - 9l t N
s / 61s). /4_16 ,�i - p� 7 /F6 _ Valuation $ 3 g00. 00
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories 1
aPR®EERTY QWNER,; , I, 5TENANT , .,';, i „ fi r,:': " r fl Type of construction
Name: /�2�/ER Si 6/1/ co . Occupancy group(s): Existing: u
New:
Address: /,S O 5() ; 7
City /State /Zip: 1&,q -en J - g 7 Z
Phone 5U3 b'app NOTICE: All contractors and subcontractors are required to be
LICAN FaX licensed with the Oregon Construction Contractors Board under
ii-A40101007 ,,,- ,, CONT3ACT PERS .._ provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: S.-I /fl tt4 y from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: x � i mmi> 4-
ax BU ILDING P ERMIT FEES
Emall ilt r _ lease re er tto fee schedule ' ° +� r
, ... _� " ., , '. g i C TRACTOR u < ,. .. r.. , �� ,: ,., , :.. m �. , ; ' ian ._� �: ±, _ w .
Business Name: /g/ / S tGiffe Fees due upon application $
Address: 15ao5 s(,t) '74 J
City /State /Zip: T/ G7 A�21 1 Ok 97( ,7 Amount received $
Phone3 - QQ „LIDO Fax: Date received:
Authorized „ 'I �� Notice: This permit application expires if a permit is not obtained within
Signature: — -- ' Date: 3 180 days after it has been accepted as complete.
61 €4
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) 1
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 ` 1 R .
BLS � /
40� Commercial Plan Submittal
�
J s Requirement Matrix
City of Tigard
' = TYPE OF SUBMITT # � o f P lan$
(Includes New Add bons or � Alteration > 't
Required at
Sk q . 1 C
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review 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.
is \dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3-061(9(4
Received Date Requested _ AM PM BUP
Location /500.5 Suite MEC
Contact Person Ph ( ) 6 2 b - 0 0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
'' : ation
ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Ins ction otes 1 a _ 3 SIT
Post & Beam m
Sr Anchors
Sheath/Shear
Ext eah/hear
Int Sheath /Shear
.Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler •
Fire Alarm
Susp'd Ceiling
Roof
Other:
� d
12 PART FAIL
PLUMBING
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 n Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line /' /
ADA Date _ / / / d� Inspector (
Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL