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Permit CITY OF TIGARD BUILDING PERMIT PERMIT BUP2005 -00225 I I! DEVELOPMENT SERVICES DATE ISSUED: 6/29/2005 +�- All 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25101 BD -00105 SITE ADDRESS: 12805 SW 77TH PL ZONING: I -L SUBDIVISION: LOT: JURISDICTION: TIG Project Description: T.I. walls, stairs, bathrooms. 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: : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 0 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: Y 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: $ 30,000.00 Owner: Contractor: B R + G CO LLC SLADICK CONSTRUCTION CO PO BOX 23009 159 MENLO DR N TIGARD, OR 97223 KEIZER, OR 97303 Phone: Phone: 503 - 409 -6182 FEES Reg #: LIC 97570 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 6/29/2005 $320.80 [TAX] 8% State Surcharl 6/29/2005 $25.66 [FLS] FLS Pln Rv 6/29/2005 $128.32 [BUPPLN] Pln Rv 5/31/2005 $208.52 Total $683.30 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 r direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. / Issued By: /Cl.) Permittee Signature: 4 , V/L-' 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. i; 8-Qs s4c) 77 __ 1, 7�n 1 • Build I1 Permit Application FOR "OFFICE USE O NL Y „ f4 i" rt l � :' ,, City f �1 L� • Received �� ( '` m[[ No ' per y and g Date/By: �O �� —.A._/ i / j 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 "1p � / ry � lyOc yy /e�Q d dl�;�p'�Ii DateB : © ,g ;Iv DtherPermit: , 1 • n Inspection Line: 503.639.4175 l�I �+ U j � I j I Date Ready/By: C3 ee Attached C T kits[ for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: . iJ) LI Supplemental Infor ' ation 01 ttl mime= r IIiIfN \-\ \ -mod& C�� i , ,s. - .,N, 'i , g ,. ,� ;, x+�' � 'rte ^- . '�Sa ;� ' "}rs'�. . ^; .'. .5 .'e;N'4.�. i ;ca3� .*. : yr .... ., ' RIYFEz OF WOR K4 , ? r 1 4,6 .UIRI;D AT.4 1 ?�ND;2WFAMILXdDWELLING �, _?�° �":`.+�`'�A�5✓'.�, ,,, ��" , ;r.4_�,_.�w.a�.- v';�.:..sa.r�. ��ar.�. ,'3a,m..�t'�.,�'�.:.,,: �,', .- "�`�..t , A3.�z ..��~dk. �w,.��:_..,. - _��m„ 4zi..atC..W4,0rte: < RP. ". .. ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all a Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the Ia g z M : le m - t if ' OE d r ss , work indicated on this application. rte A ,:. fff',4 ;, a , �. xv C N ST 2`CICj .. ... ,, rAtomi , : Valuation: $ ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder 111 Other: Number of bathrooms: t JOBiITE IN OI i �ll I OCA IQN ' , 0 P M4 Total number of floors: Job site address: ( - 7 (',(� �� '�j� New dwelling area: square feet City/State /ZIP: —`�-� \\c60 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: ��J 1.V ' Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet zimaRE D0 , OMM RCI ffilgiirdi agf, ' . Subdivision: 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 the . . : �t l ' : , DD IOLiI O ORK� , e h work indicated on this application. (� } . \ � z � � ��, . Valuation: $ 'j r 6- e pia2p0Vtv.t‘ Existing building area: square feet �� New building area: square feet -. rA .P O `PRO RT � R' ",s „ W; p ,i tt_' w' TENA Tr I ,i r Number of stories: Name: 1a t ICI C r—de Type of construction: k/ Address: " T Occupancy groups: City/State /ZIP: Existing: 'Z - Phone: ( ) Fax: ( ) New: y P 'fig'. "a k nY.` P "° s �� rq* rc . e r «.' t ,, ,, g °`A4. 44 ' r $ .' d p g 1 ^. ,3 t' i? a r- v A PP TCANT 6 C ® Nfa`A T PIsRSON S .. __ .,��..r.� -, ., c.0 � b ; d�� � *d � . u� �.c-r ,�` -<,r frr� �rFa s 4 �� NO CE�'" Business name: Case- L ` r All contractors and subcontractors are required to be jJ licensed with the Oregon Construction Contractors Board Contact name: `�`"" C S under ORS 701 and may be required to be licensed in the Address: k i) — jurisdiction in which work is being performed. If the - City/State /ZIP: � ; QZ_ ' -1 applicant is exempt from licensing, the following reasons Phone: (> '3 65 Fax: (C�'y'z) '�4l^_ r. C / apply: ✓✓�` E- mail: --'' �I '2�� L r ftrl'4l's a "' r"r, a f ° '".,„ - "' N a ' a . =_. z' S.' ra#k ' '`" x - ,� •� �Wt i , r � ''r ` ` li RrA v w ,�,vs� . _ �. t ��. _ td_ . �..�:r ter_ �h� a.�: r�� .. � ,.ms,� .:� x � 3 ,. ,f; Business name: r rh r .� ;; < ,it . . .... r ,, . ,, . - ,��: B'CTILDIN G P , , ∎ , .IT ;FE Address: ES \ ,, t` `r J� Please refer to fee schedule City/State /ZIP: Fees due upon application Phone: ( ) �T / M CCB lic.: : ( ) Amount received �— Date received: Authorized signature: � �`� �_'�` This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Ca S9... Date: 4/ - %„:"4" * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \BUP- PermitApp.doc 12/03 440-4613T( I I/02/COM/WEB) wr t , ; �, Building Division w F PI d*Nti 1lu01l� Plan Submittal Requirement Matrix Commercial & Multi- Family - New, Additions or Alterations City of Tigard Type of Sub a o #�ofPlans_ ncludes additionsfanda terations) Re ultredat uor ..tz "� .:.x .. tz S,✓u 7 $ itt`[� 4 5 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* 2'I'd( t *'"� Fire Protection System JY. , '' i 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. i:\Building \Forms \COM- PlanSubReq.doc 12/24/03 CITE TIGARD .. BUILDING DIVISION PERMIT #: B11P2005 005 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 62�3l200 Phone: (503) 639 -4171 i aNpipifI 1t Inspection Requests (24 Hrs.): (503) 639 -4175 • INSPECTION WORKSHEET FOR DATE: 9121f ?005 TIME: 7 PAGE: 89 SITE ADDRESS: 12805 SW 77TH PL CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: TEREX UTILITIES WEST DESCRIPTION: T.I. walls, stairs, bathrooms. OWNER: S R G CO LLC, PHONE #: CONTRACTOR: SLADICK CONSTRUCTION CO. PHONE # : 503 -409 -6182 Inspection Request Scheduled For: Date: 9121/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 016211 -01 603 - 319~0520 Y Corrections /Comments/ Instructions: `1P1 _ WV -- �� hi P ASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED •, 1 Inspector: At Date: q (0 Phone #: (503) 718-