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Permit
4 ^. CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2000 -00362 Ili DEVELOPMENT SERVICES DATE ISSUED: 8/29/00 461- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AC -02500 SITE ADDRESS: 10890 SW 95TH AVE SUBDIVISION: ASHBROOK FARM ZONING: R -12 BLOCK: LOT: 019 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM 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: 0.00 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: $ 2,000.00 Remarks: Demolition permit for single family residence of approximately 800 square feet, includes both house and garage. All demolition debris to be removed and sewer is to be capped. Upon final inspection SDC credits will be available Owner: Contractor: ABRAMS, DAVID A & M PACIFIC INC 6205 SW CARMAN DR PO BOX 19184 LAKE OSWEGO, OR 97035 PORTLAND, OR 97219 Phone: Phone: 892 -5388 Reg #: LIC 138423 • FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Final Inspection PRMT CTR 8/29/00 $50.00 27200000000 5PCT CTR 8/29/00 $4.00 27200000000 EROS CTR 8/29/00 $26.00 27200000000 ERPC CTR 8/29/00 $8.45 27200000000 (additional fees not listed here) Total $96.90 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987. • Pe nn itee / Signature- A 01 / Issue By: /�� _ � , A � � M I / �, l Call 639 -4175 by 7 p.m. for an inspection the next business day CIGARD Commercial Building Permit Application Plan Ch 13125 SW HALL BLVD. Tenant Improvement Recd I y D R _ ' /}9 TIGARD, OR 97 Date to P.E. (503) 639 -4171 Date to DST Print or Type Permit # j Ji -0O 2 Related SWR # Incomplete or illegible applications will not be accepted Called Name of Devygpm Existing Building New Building CI Job Si✓i� j�_ „ 7 kS ,./.4- �-- . Address Street Address Suite Building logy:, S(il ,sr Data Bldg # City /State Zip Existing Use of Building or Property: Name Property 1) fi v / 0 /g 6 r 7 Proposed Use of Building or Property: Owner Mailing Address Suite n.o. IL o v /91C(1-( No. Of Stories: / City /State Zip Phone P J / ..7 1 Sq. Ft. Of Project gvv Occupant Name f`V C4/1/1 Occupancy Class(es) Name / ` Contractor 19 144 /sac, c Co1,- (-._,.. f("`_'_"/ Type(s) of Construction Prior to permit Mailing Address Suite issuance, a copy Will this project have a Fire Suppression System? of all licenses G' DJI ( / Yes ❑ No are required if Ci /Stat Zip Phone Americans with Disabilities Act (ADA) expired in C.O.T. ®� CV 7 7 Z1 5 database � / Valuation X 25% _ $ Participation Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form 2 8 y) 3 Project $ �^0�� • Name V Valuation J Architect Plans Required: See Matrix for number of sets to submit Mailing Address Suite on back _. City /State Zip Phone I hereby acknowledge that I have read this application, that the information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with Oregon State Laws. Engineer Name Si. ur= of Owner /■ sen Date Mailing Address Suite S/ l7 oUa ontact Person Name Phone City /State Zip Phone 3 (2t (9 re ((c 6, 5 -6, ' — FOR OFFICE USE ONLY Indicate type of work: New 0 Addition 0 Demolition Map/TL_ #' - :Land - Use Accessory Structure 0 Foundation Only 0 Alteration 0 = _` Repair 0 Other O •Notes: , ;: - '• Description of work: A , 1jy� 7 , J y� a TIF. ��r 1> 0/162 .)e C / 't Note: Site Work Permit Application must precede or accompany Building ( Ov Permit Application ,,. , e 6 9 ( f I: \COMNETI.DOC (DST) 5/98 � � � W c 7 1- i COMMERCIAL PLAN SUBMITTAL REQUIREMENT MATRIX application For n eIethca! submittal, the application must contain the sgnature of the supervisin e1ectrican before plan review wIl be conducted 4f1,0(plOnij* ddthon1 plan sets for dtstributton purposes (Copy for Cantracter City, Washington County. Tualatin Valley Fire & Rescue) Total # Of TYPE...................... ,.......................... KEY: Submitted .................... S (Private) 1 S = Site Work B (New or Add) 1 B = Building F (New or Add Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building -- E (New, Add, or Alt) 2 Add = Addition B & F & M & P & E 3 Alt = Alternation to Existing (New , Add) Building • NOTES:. I:\dsts\forms\matrxcom.doc 10/30/98 i 18" WALNUT , 6 F „ R /i U /A IT_ PL : , E6:_ r---__ _ , G --- \ , . , `' ,.. , 1-.4 ,, E , 1 1 6 8" m F A l U L I E T s 4, / • 22 "4 ET:nly, '''-'----::::::\- N., • ' ' A '--.......,. I il ,,,''"*"--- dii I,I / f It - .' . A: - -----_,,,kl i BIB 4O ' ,01, PIPES 4 FOR 44" STUMP . .., l' , / \28 STUMP • rn •••-----"-* X ... ''''''.... ..".-------- ...(2-- - rt. c i 0 ewta". " ' k 612.4„..C : i \ \ \ --11 1\ ,1 -----, IA i 1 1 / • ' 1111*: 1 ' 4.:P3. LE-m i • • - n „foRDABLE 7- • . _-••• , • • - - S EPTIC ....„ : • -,....,:,posijx;00 v.; - :VVILSOltfitig, OR 97070 031€82029 -FAx-( 5704779 , • r. '4” Pt •-:- • • ..!• CUSTOWER OPIOER 1'40. PHONE OATS SCI a ct? (0( 5s / - (42 C NAME • Z.— j ( • ADOFT.:83 0;59 0 5_ 1/1./ • t, AN SOLE BY CASH C.O. U. CHARGE ON ACCT. MDSE. RET'O. PAW OUT e4- QT DESCRIPTION PRICE AMOUNT aroorki4 phI as0 co • - n • sun • • • • !- Rai - z 0 C cn N N N • cs) • TAX 1:1 RECEIVE° EP:r& TOTAL . . --; • - All claims ard recurred gads MIA b6 W:::oriigaliiecl by th:s bill. .• • - • • • - • • THANK YOU CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24Nour Inspection Line: 639 -4175 Business Line: 639 -4171 //-, ii BUP 2e - v -eio 3C- 2— Date Requested AM ) 2 4 PM BLD Location /0 990 51.1 9y Suite MEC Contact Person Ph j /.5 zoy -Cfk PLM Contractor � Q e3 0 SWR • Tenant/Owner "AA v ELC Retaining Wall ELR Footing Access: c �'�/ ( j Q FPS Foundation 13.1 c/1 Cf /Od Ftg Drain C SGN Crawl Drain Inspection Notes: a 'Z� Slab SIT Post & Beam �y Q (.\\C. �� Ext Sheath /Shear � d��t.��- � Int Sheath /Shear Framing I Insulation — fit, Drywall Nailing C:37 )2A Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof I V 6 �.� i...o. 1 Misc: ©eha v - Am/PART FAIL 'PL'UMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final (trisr- 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 PASS PART FAIL SITE Backfill /Grading - Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach/Sidewalk Date 1A, /4/ 0 a Inspector " �i Exrc Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. ' CITY OF TIGARD BUILDING INSPECTION DIVISION s 24 -Hour Inspection Line: 639 -4175 Business Line: 639-4 BUP. 6 ,20°1 1 aav Date Requested 1-/ AM PM )4 t I ,�1 BLD Location /(1 �s9 ° SA/ 9) " 4"? Suite MEC Contact Person Ph PLM Contractor �� Ph SWR BUILDING : `e Tenant/Owner 12/e �- � �4 �'� - 6 , ) ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear 1/ \id C AC-- - _/‘Thr\ Framing / W t Insulation Drywall Nailing Firewall 6 Fire Sprinkler Fire Alarm 'o _ / , Susp'd Ceiling u� Roof Fin Final nal 9 Ce -:t om -- PASS PART FAIL UMBII Po t & Beam Under Slab Top Out Water Service L ain I rains 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 PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA /� • Approach /Sidewalk Date 9/ l " ) ^� Inspecto r (' Ext I Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. r � y � -BUP-- Building Permit ELC - Electrical Permit , 4 Inspection Description Date Passed By - 4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line • Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final Structural observation Final inspection t l /Le /o U PLM - Plumbing Permit 4 Inspection Description Date Passed By BUP — Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP PLM, SWR, ELC, ELR, MEC SIT PERMITS CITY TIGARD BUILDING PERMIT PERMIT #: BUP2000- 00362 DE / VE H I O BMEN°T 6 ZAP 3 9 -4171 DATE ISSUED: 08/29/2000 Blvd., r g ( PARCEL: 1S135AC -02500 SITE ADDRESS: 10890 SW 95TH AVE SUBDIVISION: ASHBROOK FARM ZONING: R -12 BLOCK: LOT: 019 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM 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: 0.00 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: $ 2,000.00 Remarks: Demolition permit for single family residence of approximately 800 square feet, includes both house and garage. All demolition debris to be removed and sewer is to be capped. Upon final inspection SDC credits will be available for future development. • Owner: Contractor: ABRAMS, DAVID A & M PACIFIC INC 6205 SW CARMAN DR PO BOX 19184 LAKE OSWEGO, OR 97035 PORTLAND, OR 97219 Phone: Phone: 892 -5388 Reg #: LIC 138423 FEES REQUIRED INSPECTIONS Cill Type By Date Amount Receipt Final Inspection PRMT CTR 08/29/200 $50.00 27200000000 5PCT CTR 08/29/200 $4.00 27200000000 • EROS CTR 08/29/200 $26.00 27200000000 ERPC CTR 08/29/200 $8.45 27200000000 (additional fees not listed here) ; L Total $96.90 MNI 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 tit 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 I 952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987. 0 Permitee 0 Signature: Issued By: Call 639 -4175 by 7 p.m. for an inspection the next business day G 1 9/12/00 Activities for Case #: BU P2000 -00362 4:59:08 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date . 3 To Done By Disp. Level By Updated Notes r BUPA005 Application received 8/29/00 DEB DONE No Hold BLD 8/29/00 BUPA010 Permit created 8/29/00 DEB DONE No Hold BLD 8/29/00 BUPA870 Final Inspection No Hold BLD 8/29/00 BUPA085 (F) Issue building permit 8/29/00 DEB DONE No Hold BLD 8/29/00 • BUPA090 (F) Reprint Permit ZZZ DONE No Hold ZZZ 9/12/00 • T Page 1 of 1