Permit lyi CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00340
COMMUNITY DEVELOPMENT DATE ISSUED: 6/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S127DD-00100
SITE ADDRESS: 09730 SW CASCADE AVE ZONING: C - G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: SHANE COMPANY
Project Description: TI
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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 275,000.00
Owner: Contractor:
SHANE COMPANY LORENTZ BRUUN CO INC
9730 SW CASCADE AVE 3636 SE 20TH AVE
TIGARD, OR 97223 PORTLAND, OR 97242
Contact #: PRI 503- 232 -7106
Phone: FAX 503 - 232 -5609
Reg #: LIC 33
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 6/28/2007 $114.04
[BUPPLN] Pln Rv 6/28/2007 $926.61
[FLS] FLS Pln Rv 6/28/2007 $570.22
[METCET] Metro Const 6/28/2007 $330.00
(additional fees not listed here)
Total $3,366.42
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.
lir
_L____
Issued By: Permittee Signature:A
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.
06/20/2007 10:07 FAX 5035981960 CITY OF TIGARD Z002
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Buildin . Permit A • dieation
Commercial T 4 i r''4 p�r+ I EJ FOR OFFICE USE ONLY
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City of Tigard Da
tc e :�ca4s' 1/7 3 ' CI_ ',Apo r1�.390
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;: c 131 . E55 03.639.4!71 Hall Blvd.,T!g •: 2007 �*" PlaaRcviewt . , i V Other Permit.
Atom 0 E t ' ^.3. 6 'B : � � .►s � � kris: MI seeFage
inspection Line: 503.639.4175. Dart Re"dyBy'
'r r C �L'R'1? p Notified/Method: Supplemental Information
Internet www.t fir. 4 t �' 1 No
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: ' � . ) °@ AT 1' a WV 1 . r ItEQTJII?,ED AATA: -AND i-FAMIT.'Y AWELLING ' .
❑ D emolition Permit fees* arc based on the value of the work performed,
construction New consction Indicate the value (rounded to the nearest dollar) of all
X Addition/alteratioti/replaccment ❑ Other- equipment, materials, labor, overhead, and the profit or the
. ::.: . .
to rhead, an
CATEGORY' Q1P' , .' ,:_ . ..: .....: .... ,.
work indicated on this application
Valuation: $
❑ 1,- and 2- family dwelling %Commercial /industrial
—
Number of bedrooms:
❑ Accessory building ❑ Multi - family
❑ Master builder ❑ Other_ Number of bathrooms: _
o of floors:
.. .... Total number
;. ,YO SITE I1VlrQRMATION ''ill'rT1':IACATIO ;
Job site address: ,: c . ' C E '4vavue New dwelling area: square feet
City /State /ZIP: 1"t GD 1 OF-- - Garage/carport area: square feet
Suite/bldg - /apt. no.: Project name: Covered porch area: square feet
Cross street/directions to job site: £ f1 p f SW faz 1 f27 Deck area: square feet
C',W C,AE 1 Sum' taJ e, F 1. 2.17 Other structure area: square feet
— `REQUI UID DATA: COMMERCIAL -USE C'Y>IECKLY+ST : .
Subdivision: I Lot no.: permit fees* are based on the value of the work performed
Tax map /parcel no.: c j �j�b Z Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
• indicated on this ;.:': :: > 0ESCRIOtIOx'� WORK :r '..: , ::
work in n is app t ton_
not piNr..n OIa Clrf ' i L.Ditu &: fit:.. Valuation: $ 2 7' ,c0C7
op e Existing building area: square feet
14a ry, j (N 9r ri oF P rivsicAr e e • New building area: .. -" square feet
PROPERTY: owsta : : .: 0, TENANT: :. ' Number of stories: 2
Name: g524aeN1 C \ 2 - N,ti BVT, Iir. Type of construction: V & A
Address: 710 .+� _.C.6043 FL -0C1 Occupancy groups: 8 y., Ci
Cit /state/Z IP: Q l 012 ., • 'r 720°1 Existing: M / V
Phone: (503) 861� .FID ¢- ax: ( ) New: G.ri
Business n w 7 G`Y�� ' 1�`� - -cy CONTACT'; PERSflN : 1r1Q X ICIa
name: A All contractors and subcontractors are required to be
Contact name: " , I --ftti- z-i LA} A-4A licensed with the Oregon Construction Contractors Board
r under ORS 701 and may be required to be licensed in the
Address: I t 1 R-v I Cj' '. S01' %..0 jurisdiction in which work is being performed. if the
City /State/ZIP: a NTLA I C42' . ' 721rf2— applicant is exempt from licensing, the following reasons
apply:
Phone: 0072.0 • 40:7'1 Fax:: (50uj) clt4 • 631e
E -mail: ek ( a..1 --a . Com
Business name: 12 7 F4.J e f 5 ,W Criet B1JILII G:PERMTT FEE$'
/r �� laaasa rtldMfte
Address: � (p 1 '1 �V S • 7JCE) Structural plan review fee (or deposit):
City /state/ZlP: > 2--\--•t,it 02-. Q7 - FLS plan review fee (if applicable);
Phone: ( ) VA. • • I t C(p Fax' (9.7) 232• . f
CCB lit.: 0(2.
Total fees due upon application:
Amount received:
Authorized si azure: This permit application expires if a permit is not obtained
,�^ within 184 days after It has been accepted as complete.
Print name: - ______:_is - Date: Cam(!/• fg, .07 * Fee methodology set by Tri-County Building Industry
Service Board.
l: 11 3uildinglPermits 161.IP-TI-Perniitapp.doc 12 /27/06 440- 4613T(11 /02 /CQM/WIi8)
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: BUP2fl07 flf-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/28/2007 Phone: (503) 639 -4171 ��" 1i "� +�
Inspection Requests (24 Hrs.): (503) 639 -4175 jL.
INSPECTION WORKSHEET FOR DATE: :�i5f2007 TIME: 7:00A1 PAGE:
SITE ADDRESS: 09730 SW CASCADE AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SHANE COMPANY
DESCRIPTION: Ti
OWNER: SHANE COMPANY, PHONE #:
CONTRACTOR: LORENTZ BRUUN CO INC PHONE #: 50. - 232 7106
Inspection Request Scheduled For: Date: 918/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess. x
299 Final. inspection 055233 -01 W3- 8051210 AP
Corrections /Comments /Instructions: 2 :
A PASS M ARTIAL APPROVAL CANCEL NO ACCESS
II FAIL C i LL FOR INSPECTION I I ADDITI NAL FEES ASSESSED
, 7 ‘ 0
Inspector: — Date Phone #: (503) 718- 2-41
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