Permit f
r _ ? J•
CIT OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00428
" 'Jl DEVELOPMENT i
Br SERVICES o -639 -4171 DATE ISSUED: 10/21/2005
PARCEL: 2S101 DB -00617
SITE ADDRESS: 13360 SW 76TH AVE ZONING: R -3.5
SUBDIVISION: ROLLING HILLS LOT: 025 JURISDICTION: TIG
Project Description: Adding (2) windows & (1) door to shop.
REISSUE: �Q _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK:S � tl— FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 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: $ 500.00
Owner: Contractor:
BRUCE & LIN WILKINSON OWNER
13360 SW 76TH AVE
TIGARD, OR 97223
Phone: 503 - 443 -3996 Phone:
Reg #:
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 8/26/2005 $40.63
[BUILD] Permit Fee 10/21/200E $62.50
[TAX] 8% State Surcharl 10/21/200E. $5.00
Total $108.13
Th is 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 -6 9 or 1- 800 - 332 -2344.
Issued By: , ,,, �/i Permittee Signature: ,., � „i, Iy )
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business 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.
Building Permit Application FOR OFFICE USE ON LY°
� /j
City of Tigard D Date /By: Received.^— . j Permit No.:, i j ii .
1125 SW Hall Blvd., Tigard, OIZ \F1 � �� \�u ` �`% tt�� Plan Review
gone: 503.639.4171 Fax: 503.5 8. 0 ^ 'I Date /B : � A v C OS Other Permit ---
Ins AU' 200 yell =I� Date Ready /By: S See Attached Checklist for -
ection Line: 503.639.4175
Internet: www.ci.tigard.or.us Notified /Method: Supplementallnformation a
an
` AliFPE ire °4 k l e 3 REQUIRED DATA 1 AND 2 F DWEELIN s
AdWE154kAtitaAINVMAANNrigt: ,- ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. 0
Indicate the value (rounded to the nearest dollar) of all
21 Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the v
' y � work indicat o n thi app
�� CATEGORY OF f CONSTRUCTj h -
Valuation: s p) 00 CV I- and 2- fancily dwelling III Commercial /industrial 5
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
40 W SI 1 E INFORMATION AND LOCATION y Total number of floors:
Job site address: 13 O. Svj n ka - k . we _ New dwelling area: square feet Z.
City /State /ZIP:n"k D0 011 - -a3 Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet `.
i' ANGC l�n41 , \ < 1 - 1-' c r. F r\ J �, d S•G an Other structure area square feet
' \O • n>R 4OSIS St,. � •f51 1 \�cC* IS ')Coot - iN , REQUIIREDDA7A OMMERCIAL= USACH ECKLIST'
Subdivision: fk okki tAiktS Lot no.: Permit fees* are based on the value of the work performed.
L 1 Indicate the value (rounded to the nearest dollar) of all
Tat map /parcel no
To x LA. � ti o \ a5 tc 511 08.3 equipment, materials, labor, overhead, and the profit for the
''_' I f work indicated on this application.
DESCRIPTION OE W ORK' , y
r\r \f\o c�^ 1t,) c0. , rxrl One `( r, - �
t, Valuation: $
J Yl i 5•..V.�
Existing building area: square feet
., • - ' >• a • - ar.Imaa vasIMIlea a ma c a.■ .
New building area: square feet
1 `� PROPER CY OWNER ., ❑ TENANT `` Number of stories: -
Name: 9.1ekkcc a,-( Lvf - yiIO ; 1 \SIP1 ,,,r Type of construction:
Address: \ c0 - - ic, 1�? 3j Occupancy groups:
City /State /ZIP "- \--\ ,fa Oil c1�a3 Existing:
Phone (5o3) L N t 3 (P Fax (5 3) j'3 -3Ci9(4 New: IAW - p( 11Y1
. ?' }' ? .: A Par - 7 i U7 t 3 31 3 y N '
.. ,.,,. ,. �F " PERSON :: t
Business name: .' „',, .3 --, L.,ka, A4 Fp, \..% di All contractors and subcontractors are required to be
Contact name: L\ r uak; licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: \3-d S r)b- Q0� jurisdiction in which work is being performed. lithe
City /State /ZIP: applicant is exempt from licensing, the following reasons
�i Ca k c . `1 as a ppl y :
Phone: (5t 3) q L Fax: : (S33) qqa., 37 7 c
E- mail: Lk e, C s't, i\
ear t CONTRACTOR
E 5
3.usi nessname: L
t OAP t`∎t a ',Ckl(i, 03 I ..415'�) ,
BUILDING PFRMiT� FEES � '^ �4� ;::
1 - E#Cr�. X:O�..d•:T , �
"jam „t ,..oF
Address:
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
cone: ( ) Fax: ( )
Amount received
1 GCB lic.:
$..uthorized Date received:
signature: \ ( This permit application expires if a permit is not obtained
�j 1' within 180 days after it has been accepted as complete.
Print name: V. 0n (3, 1 \<• Date: g' * Fee methodology set by Tri- County Building Industry
Service Board.
is \Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T(1 I /02/COM/WEB)
OIT`A OF TIGARD _
BUILDING DIVISION PERMIT #: BUP,XO5 ,° ° ��g.
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 , � ' �iN p� i i w � � �� 1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TINE: PAGE:
SITE ADDRESS: / 336 7(0 Av e ' CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE(Q3) 443_3
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 3/ D C Pour Time:
Code # Inspection Description Confirm # Contact # Messa•.- --
Corrections/Comments/Instructions:
411111111
III-ViaillitLrIM '
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PASS PARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL CAL FOR I PECTION n ADDITION L FEE ASSESSED
Inspector: 4WIL . Date: 5( - 6 4one #: (503) 718- S `""-0