Permit ., `.CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00276
COMMUNITY DEVELOPMENT DATE ISSUED: 5/24/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 11 AC -02700
SITE ADDRESS: 14650 SW 97TH AVE ZONING: R -4.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 037 JURISDICTION: TIG
PROJECT: TWALITY
Project Description: Epoxy anchors.
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: 5 -1 HR sf N: 5: E: W:
OCCUPANCY GRP: El 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: $ 1,500.00
Owner: Contractor:
WACO SCHOOL DIST 23J TRIPLETT WELLMAN INC
6960 SW SANDBURG ST PO BOX 160
TIGARD, OR 97223 WOODBURN, OR 97071
Contact #: PRI 503 982 - 4188
Phone: FAX 503 - 982 -0390
Reg #: LIC 43496
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/24/2007 $62.50
[TAX] 8% State Surcha 5/24/2007 $5.00
[BUPPLN] Pln Rv 5/24/2007 $40.63
[FLS] FLS Pln Rv 5/24/2007 $25.00
Total $133.13
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 B r / / i „ _ t Permittee Signature
i Lith. rx ,,, , ....
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Call 503.639.4175 by 7:00 a.m. for an inspection that business day
is
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.
Buildin'F'ermit Application - FOR OFFICE USE ONLY .
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City of Tigard a o 7 • PermitNo30 �A0 7. O d7
�' g � DateBv: Rece ived ,
- 13125 SW Hall Blvd., Tigard, OR 97 9 E C EVEP _ Plan Revie.o mi -
' • Phone: 503.639.4171 Fax: 503.598.19 DateBv: [f
BRAY 2 if 2007 Ready /By: iurs: ® See Attached Checklist for
TIGARD Inspection Line: 503.639.4175 Date Read B
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITY OF s IGARD
A lfl rimstri rift' a cstrlbt
W _ RE t TJIRED DATA `1-AND.2 `FANIILY4DWEI LINGa=
CI New construction � ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Igt Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
za _ Cr>3E _ RY OFCON =— STRUCTTO ott Utr �_ work indicated on this application.
N
Valuation: $
❑ 1- and 2- family dwelling [Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- °_'� Total number of floors:
° B=S=INORMA;T -ION D UCAT_-IO_ Nom= r_
Job site address: ii-k 34 17m .-ve • New dwelling area: square feet
City/State /ZIP: 77074 v i , , D/ .nC� 1 `f C Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name:7(/'-L /r V
y MS (51Qb eistmc Covered porch area: square feet
roc
Cross street/directions s to job site: '{ / "/ ^ �/ Deck area: square feet
€ S(/U g7/ 1 r V 0/ P (o'cl _ Other structure area: square feet
— _ rIVI � IVI —.N,= =ms=s *_
M
EQ tHRED_ATA:=GOERCIAI -USE CHECKLIST=
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: _ equipment, materials, labor, overhead, and the profit for the
•*—' e -tee-
_ _T-.-- _ DESCRIPTION O FWORK _ - work indicated on this application. It rre o : co nc yf e Ls he7� f/ // /d' 0/46. Valuation: $ / ere
/,ua /I conhecf /ar? f a ,nee/ Ls/raa _ i 7/2Z/ Existing building area: square feet • L 56/6m/ G re. £//€ f New building area: square feet
Ar _- _ -°;
z' PRUP.ERTTl'° R m y �
El -= Number of stories:
Name: 7 /g4k / c, �� 4 , h /'kV / ,�,evi / Type of construction: V— l�/� 1 .
Address: / � 5 , q7bpO (5 ( and C/tiro 5f. Occupancy groups: .42. (
Cit ! 4 ( O!) 97 ?2 Existing:
Phone: (*Oa ! r� 1 7 1 6€50 Fax: (_ /s /- 'J °t7 New:
®IAP -P rek∎IT _ A rOON aril ERS9N NOTICE
Business name: .:
.ha /! Q /.SD17 fi e J S JT ien/ l ec All contractors and subcontractors are required to be
Contact name: ,er /G>f/ / 5(ee, -odood licensed with the Oregon Construction Contractors Board
�
/ / under ORS 701 and may be required to be licensed in the
3/T Address: 'T SW GUa sh /n f4v L_51 . (Ste'. 2ti jurisdiction in which work is being performed. If the
City/State /ZIP: et/f /4r/1 0 T2 applicant is exempt from licensing, the following reasons
p / ( app
Phone: (563) 22�• (p' I, Fax: : (S 273 -•q/92.-
E-mail: brie clouier com
CONTRACTOR , - . ..
s Business name: 7 ' L 7 W tt---M /V Czn/ /G[C7 I B DING ERMIT FEES _-
A lei,.. fer ii fkiiche7ule „s.
Address: 7/ , / M f J e ersQ/�f e Structural. plan review fee (or deposit):
City/State /ZIP: PDX /barn c3 , 707/
Phone: ( ) . 82 - �/[ 8 Fax: (503 76 0 0.370 FLS plan review fee (if applicable):
CCB lic.: / co Gy/- C / Total fees due upon application:
�; , / OP� Amount received:
Authorized signature: "' , `1I / i
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: / � / ew . 6 19 k, i , Date: o 5 / ma y / c:e * Fee methodology set by Tri- County Building Industry
Service Board.
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