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Permit BUILDING PERMIT CITY' I` OF TIGARD PERMIT #: BUP2004-00054 ��141. DEVELOPMENT SERVICES DATE ISSUED: 2/12/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S133AD 02200 SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE SUBDIVISION: ZONING: R - 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: El TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 80 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 105,000.00 Remarks: TI: 1st. floor (South) classrooms and offices Owner: Contractor: WESTGATE BAPTIST CHURCH BRIAN DUTTON 12930 SW SCHOLLS FERRY RD 16775 SW LAKE FOREST BLVD TIGARD, OR 97223 LAKE OSWEGO, OR 97035 Phone: Phone: 503 - 407 -1627 Reg #: LIC 111999 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 2/12/04 $763.80 Electrical Permit Required [TAX] 8% State Surchart 2/12/04 $61.10 F P Required Fire Alarm P Per ermit Requirec [BUPPLN] Phi Rv 2/12/04 $496.47 Plumbing Permit Required [FLS] FLS Pln Rv 2/12/04 • $305.52 Framing Insp Total Gyp Board Insp otal $1,626.89 Susp Ceilng Insp Final Inspection 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 or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Issued By: ��c � C���C. 46( . C�7 Perm it tee n Signature: Th /j� r Call 639 -4175 by 7 p.m. for an inspection the next business day • • 'Building Pex Received mit Application FOR OFFICE USE ONLY , � City a>rd 22 QQ BuilOther din _ / Date /B /2 _p�� ti 2 U Permit No. () ? 9o' -pO05/ Ap proval of Ti g Date/By: Planning Permit No 13125 SW Hall Blvd. Plan Review Other - Tigard, Oregon 97223 Date /By: {t 4 1 0 1 /5 Permit No.: Phone: 503- 639 -4171 Fax 503-598-1960 -144110i14:` 1l �1' P o st- Review Land Use Internet: www.ci.ti ar d.or.us - . e. Date /By: Case No. g Contact s'�./� ® See Page 2 for . 24 -hour Inspection Request: 503- 639 -4175 Name /Method: / Supplemental Information a2 '`"i "^ ; , �s#+'`'';" r'R W t' R . ,g. R',' .r t :'A ar�. =?:: ..'s . ywy [ B 4 r? N � ' °ta .�. e� ��� : � � TYPE OF,.. O __ �.� �.°.: �� ' s��� �f,., . ��� �� �� REQU �D TA �'� � � New construction ❑ Demolition ' ' A A = -I -& 2W - ' r t . Addition/alteration/replacement 111 Other: �� '� _ ������ � - ;' �? >°c ":: l4 - w.;r ...- „�3.;�.CAT;EGQRY= :O 0 F;�CSTRTICTIOIV:::� ,E r} ,.., `'c it» ; ";€ Note: Permit fees* are based on the total value of the work performed. Indicate ter_ vim , ._ �'. ,.,� u.���.. �.�k, ❑ 1 & 2- Family dwelling 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 $ RX 9 k. T;O&SITE INFO ®Nand,` "L®CATION No of bedrooms: No of baths: Total number of floors Job site address: ..(0'1, o A.Y..1..1:0( ti K ; z J New dwelling area (sq. ft.) Suite #: I Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: i., sst fclsfL c'j «r Cr{vict1 Covered porch area (sq. ft.) Cross street/Directions to job site: t.0-r-tn Deck area (sq. ft.) Other structure area (sq. ft.) N -M U Ep DATA° .� �r s E COMIVIERCIAI� USECHECKLIS �� Subdivision: Lot #: � �`�' .. .: ....u�N- .�`� °. �. ,� � _�, -.. , �a � b : Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate mate °' 'T" a n } the value (rounded to the nearest dollar of all equipment na s, a or, �`��� �wDE � �� �� ,� �~„,�. ( ) overhead and profit for the work indicated on this application. 171 Valuation $ /6.5; ° Existing building area (sq. ft.) New building area (sq. ft.) - Number of stories Ngfottinguitost R .y 4 E l I nNotranymagni Type of construction - • Occupancy group(s): Existing: Name: 1,3 es C A--cv Pren-ST C 000- :14 New: Address: 10730 s ..3 13:P, L F= 4- -4,gy : -.� . City/State/Zip: —, 6-ka b arc g7z23 3 S � 5 � NOTICE: All contractors and subcontractors are required to be Phone: U 5 2u 35 Fax: j© . licensed with the Oregon Construction Contractors Board under VA-00-001,-U, _ �. , .. CONTACT P�ERSOIV provisions of ORS 701 and may be required to be licensed in the Business Name: ( 6 -k4 c'rP T lS i C chl@Git jurisdiction where work is being performed. If the applicant is exempt Contact Name: V 8,1)03 — from licensing, the following reason applies: Address: , 0 `7 3o 5. i T5O +K - City/State/Zip: 7 0 e. tr 1'7 Z z 3 Phone: So3 .52 i i 35r Fax: 1 �t . p l� t £� e s E - mail: s nzrr sc �� G R F m E UlL E � EES* l ' , 1 S . .ei efer o :fee > h u �n,.�. , ,._ ,: t yt ` CONTR�AC' .� 4P lea t l .�. <.�. �,�.. ��.�� tee, .,. ., ,.W� �� �_� � a s. Business Name: b / L,-,b tcL r X Fees due upon application $ Address: 14,17S 5 t. r,-K o s ec t •-r Z LV 0 City /State /Zip: L,1-Kc 0501fZ - 0 d4- -- Amount received $ Phone: 3 S 7Z 73S?.., Fax: 50,3 67 S 0Z G d Date received: CCB Lic. #: Sys 1 Authorized - /� Notice: This permit application expires if a permit is not obtained within Signature: i. % Date: .4 — ��' Oy 180 days after it has been accepted as complete. 4 ■Vern) / l'u r (Ok) *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 Plan Submittal Requirement Matrix - �I Commercial & Multi- Family City of Tigard New, Additions or Alterations F 7 2 E ; M1S v P 4 'tom' �'j T TYPE OF SUBMITTAL k,. #' of Planst. O (Includes New, Addit■ or�Alterations) a # Required at ons Submittal 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. i:\Building\Forms\PlanSubMatrix.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 INSPECTION DIVISION Busi p--ss Line: (503) 639 -4171 MST r BUP Received ;Ate Requested t AM PM BUP ( Location 7 E w ( Suite 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 Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 1 1) XIMLI.OW PAIIIL •���','_ =1NGRT FAIL 1 �_ /.� Post & Beam Or I '4111M1 Under Slab '•� Rough -In Water Service Sanitary Sewer s 1 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 Anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: ❑ 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