Permit •
- 7 a CITY OF TI CARD BUILDING PERMIT
•
PERMIT #: BUP2005 -00272
-- 13125 SW i, I DEVEL R9 ICES -639 -4171 DATE ISSUED: 7/8/2005
PARCEL: 2 S 101 AB -01608
SITE ADDRESS: 07455 SW BEVELAND RD ZONING: MUE
SUBDIVISION: HERMOSO PARK LOT: 019 JURISDICTION: TIG
Project Description: TI: Addition /alteration.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 10 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 55,000.00
Owner.: Contractor:
KOBERLEIN, PATRICIA LYNN PHIL ROSE CONSTRUCTION
7455 SW BEVELAND RD 17430 SW VIKING ST
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: Phone: 503 - 649 -9559
FEES Reg #: LIC 156441
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 6/28/2005 $323.80
[FLS] FLS Pln Rv 6/28/2005 $199.26
[BUILD] Permit Fee 7/8/2005 $498.15
[TAX] 8% State Surcharl 7/8/2005 $39.85
Total . $1,061.06
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 ' t questions to OUNC by
calling 503-246 or 1 - 800 - 332 • 4.
Issued By: 46 ,41111/_ ` _, ` . _All' _ ,L Permittee Signature
• 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.
1 �CEIVE®
Building Permit App ication ' ,• . - FOR OFFICE USE ONLY' - . '
City of Tigard JUN 2 8 2005 D c/By. (. 2- 05 d Permit No.: ._ �y-7
13125 SW Hall Blvd., Tigard, OR 9722TT Plan Review
Phone: 503.639.4171 Fax: 503.598�1•960 OF TIG A RD /,, �.l..;,, Date/B Other Permit:
Inspection Line: 503.639.4175 BUILDING DIVISIO U'_'_I!, Date Ready/By: 0 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: t, Supplemental Information
TYPE OF WORK ' REQUIRED DATA: I= AND - 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
94, Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF. CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ['Commercial /industrial
❑ Accessory building 12 Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7 Li S S 5 Ij g el/ El. AiAO New dwelling area: square feet
• City /State /ZIP: TIC lAi- Ua, e. Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ( c i .n T% AL d lvulr•, S Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
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
DESCRIPTION OF WORK , . work indicated on this application.
Wt 041 a to l l k.-1.-, n Valuation: $ 5E 044-
Existing building area: 24,-p ( square feet
New building area: 45-7 square feet
iJ PROPERTY OWNER ❑ TENANT Number of stories: ( 5,1-041 B)
Name: Pt *rim rim n & Aksta AP Lit t.%9 s r L L C Type of construction: V B v
Address: '2,0 0 %1 S I 41-6,1,4 itpi, Occupancy groups:
L krum o,FP -I,t
City /State /ZIP: \S e /,f < .1/b d t4- y /A-E . 4 70 67 Existing: ' 0 /D,1
Phone: 9� 3 2g —$L O b Fax: ( ) ,. New: D 1
. ❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work' is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
. .. CONTRACTOR
Business name: P p )4 ., (O f1 - - - Si& c. BUILDING PERMIT FEES'
Address: 17 '( 3 6 S w II k 11.4.9 s' h Please refer to fee schedule.
City /State /ZIP: g C4vFlLCptn O/t(: , g 1 o O
• Phone: (51b ?) G ((0 _ ( s i ' Fax: ( 3) / 9 93 C� Fees due upon application
l0 Amount received
CCB lic.: / 4--4, yYl f ?— LI _07
C Date received:
Authorized signature: \ This permit application expires if a permit is not obtained
n i'' `— 0//15
within 180 days after it has been accepted as complete.
Print name: r 1. 1 Date: * Fee methodology set by Tri County Building Industry
. Service Board.
is \ Building \Perm its\BUP -TI- PermitApp.doc 12/03 440- 4613T(11/02ICOM/WEB) P 'ev n(1t -- $ - lv cirYP ` g ij bQ- we
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Building Division
! Plan Submittal Requirement Matrix
�'1' i� '� 1 = Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal - # of Plans—
. - (Includes new, additions and alterations.)' Required at
Submittal '.
•
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*
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 �f 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 \Permits\BUP- TI- PennitApp.doc 12/03 440-4613T(I1 /02/COM/WEB)
\
CITY OF TIGARD
• BUILDING DIVISION PERMIT #:
BUP2005-00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
7/6/2005
Phone: (503) 639-4171 /*
7/veol
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/23/2005 7:07AM 83
SITE ADDRESS: CLASS OF WORK:
07455 SW BEVELAND RD
SUBDIVISION:
HERMOSO PARK LOT #: 019 TYPE OF USE:
PROJECT NAME: WESTERN TIGARD HOLDINGS
DESCRIPTION:
TI: Addition/alteration.
OWNER: PHONE #:
WESTERN TIGARD HOLDINGS, LLC, 503-628-8508
CONTRACTOR: PHONE #:
PHIL ROSE CONSTRUCTION 503-649-9559
Inspection Request Scheduled For: Date: Pour Time:
9/23/2005
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 016410-02 503-793-1010 Y pi-M_L
Corrections/Comments/Instructions:
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ASS 0 PARTIAL APPROVAL fl CANCEL I I NO ACCESS
I I FAIL fl CALL FOFVNSPECT1ON i ADDITIONAL FEES ASSESSED
Inspector:
j' ILI_
Date: 1 5 a- Phone #: (503) 718-