Permit t ♦`4.i
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00107
A
DEVELOPMENT SERVICES DATE ISSUED: 3/28/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB 00800
SITE ADDRESS: 15995 SW 74TH AVE 150
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
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: 31 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: $ 20,000.00
Remarks: Tenant improvement
Owner: Contractor:
DUNCAN, JOHN A AND TIMBERRIDGE DEVELOPMENT
JANICE LEE 8321 NW RIDGETOP CT
7060 SW PALMER WAY PORTLAND, OR 97229 -8063
BEAVERTON, OR 97007
Phone:
Phone: 503 - 803 -9184
Reg #: LIC 153162
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 3/7/03 $152.95 Electrical Permit Required
Plumbing Permit Required
[FLS] FLS Pin Rv 3/7/03 $94.12 Framing Insp
[TAX] 8% State Tax 3/28/03 $18.82 Gyp Board Insp
[BUILD] Permit Fee 3/28/03 $235.30 Final Inspection
Total $501.19
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 -001Q through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling -("53) 246- 6699-or 1 -800- 332 -2344.
A
lss d By: ,.... , Q A h9 t L' /
Pe rm ittee •-- _ ,
Signature: ` j►
,� -w
Call 639 -4175 by 7 p.m. for an inspection the next business day
---'"" FOR OFFICE USE 'ONLY ` . `
Building Per fi plication - "
R ece i ve d D /L B
r Date /B (� % Permit No.: / lav 5.. o/c 7
City of Tigar • /1 qp o F0 Planning Approval Other
ry Date /By: Permit No.:
13125 SW Hall • iTY / ? Plan Review Other
Tigard, Oregon 9 =3t/ OF T, X83 Date /By: Permit No.:
. //q ii
Phone: 503-639-4171 �� i 1 . 1960
/ � / ♦ �� e ,' I Post- Review Land Use • � Date /By: Case No.
Internet: www,ci,tigard.or,us S / A` � � Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503-6S Name /Method: Supplemental Information
a " t TYPE,, OF'WORKe' $;,, �... t z ` 2 �' a REQ,UIRED r r°"'�t' 7,
❑ New construction ` a1 & 2 FAMILY DWELT iING x
❑ Demolition k 4 . , emu^ _„ .. 1 , . Wssw i .. ; ",a - ti ,:',
n Additio alteratio eplacement ❑ Other:
t , ri , _ ., ORY OF CONSTRUCTTON o q,i. Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling 1 Commercial /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 $
' ,_ r inifi J;OBISITE_INFORlVIATION an'd[LOCATION 'INV& t No, of bedrooms: No, of baths:
Job site address:(s q 5 `5' 'L;l. .74-11;i1— Total number of floors
New dwelling area (sq. ft.)
Suite #: /50 l ` Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: w ee . t Ort hoio.r, /ucs Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
kE f ' i " REQUIRED, DATA - i 4 ` ' r ,, w
.. ; COMM , USE CHE KLISTI t ' 6; ,
Subdivision: Lot #:
Tax map /parcel #: • Note: Permit fees* are based on the total value of the work performed. Indicate
`,,, -1 x , Wiz, ;DESCRIP, TION ®F WORIZ „ . „;:` the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application. �/�
CI; l' (a ri :] tl.c ti do 'L; ; t'. ' ,,,,v ' •tun �+,n4 Q�O CJ �L/
( I V a l uation $ f d}.017 / Existing building area (sq. ft.)
13 c e- e. it t. IN 6 t...)44.--e: New building area (sq. ft.)
Number of stories
PROPERTYOWNERr Mi?, / `iTENAI T,` a _` "' ( Type of construction
Name: - �c c. ..t'' ( Or - 4 a j c, nt ee •y Occupancy group(s): Existing:
C/ New:
Address: V 7 v z 3 v L `s 5t4 • - r A
City /State /Zip: ra;,r la,,,a ep It c 7 2 i il
Phone _co �l �2 C 5'1 Fax NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
..APPLICANT! ` rr ., ; "NTACTlPRSON " ' 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: 4 f?re P'eus,J je from licensing, the following reason applies:
d
Address:
City /State /Zip:
Phone: SO - 3 .y/ 2.. q 9 3 L Fax o r s ,, [ Ram o .,: }T , a a 1 ;
d „ � ', ,�, BUILDING PERMITsF � ,, �:
E mal Please refer to fee schedul''e. `
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�..r � �� 4CCtNT� ' � �- �� �, ..,
"z , k . � .,. , • .: �.. .. tzF. ». `- tee.. ,_,�.�.�.,, .. • ._.. _ _
Business Name: ill pa c Fees due upon application $
Address:
City /State /Zip: Amount received $
Phone: Fax: Date received:
CCB Lic. #:
Authorized I Notice: This permit application expires if a permit is not obtained within
Signature: — I L L �/ ' Date: 4s �� 180 days after it has been accepted as complete.
. J /1? • e 1 D)c,.) c k. , *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
41'15 a1 T �'' 4 a /� �7 , d 7
is \Dsts \Permit Forms\BldgPermitApp.doc 01/03 $ 91, A [
A� ��p Commercial Plan Submittal
L vi
� Requirement Matrix
City of Tigard
�
# o b+ Eu
TYPEOF'SUBMITTAL f ;,Plans
(Includes New Additions or Alterations) R at"
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 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.
is \dsts \forms \COM- matrix.doc 9/24/01
TC Y OF Ti G RD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION p Business Line: (503) 639 -4171 ` MST
BUP 3 OO l b 7
Received Date Requested S '� AM PM BUP
? Location / S ! 7 q - Suite /S 2 MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ` SIT
Post & Beam /
Shear Anchors ..2 O O 3 ^ ea, `l� 6
Ext Sheath/Shear
Int Sheath/Shear _
Framing
Insulation
Drywall Nailing S U /`
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot.- :
(OAP PART FAIL
BING
•.st & 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Li Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA 7 Z /O 3 Inspector / Ext
Approach /Sidewalk Date
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 Li e: (503 -639 -4171 . MST
`{auP 3 -dotes
Received Date Requested AM PM .p UP
Location / - V' 4 Suite / MEC
Contact Person �e. e O w Ph ( ) 3/ — 9 9 PLM
Co r artc g - Ph ( ) SWR
( - UILDI G Tenant/Owner ELC
Footing
ELC
Foundation
Ac ss:
Ftg Drain A -,GwGe ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Insu a ion v /4 y / Q Cout /L A tZe /_
Drywall Nailing 1,
Firewall Fire Sprinkler LG /C ott C G / N S� 6 /7d o /�iu
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fines
ASS.,BART 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for rei pection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL