Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00069
11 fl �l DEVELOPMENT SERVICES DATE ISSUED: 2/25/04
..u,� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114A0 00100
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: 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:
Remarks: Demo interior.
Owner: Contractor:
SCHOOL DISTRICT 23J ROBINSON CONSTRUCTION
13137 SW PACIFIC HWY 21360 NW AMBERWOOD DR
TIGARD, OR 97223 HILLSBORO, OR 97124 -9321
Phone:
Phone: 503 - 645 -8531
Reg #: LIC 63147
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 2/25/04 $62.50
[TAX] 8% State Surchart 2/25/04 $5.00
Total $67.50
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: .
Perm ittee
Signature: ( 2 /Q
C 639 -4175 by 7 p.m. for an inspection the next business day
27/W
Building Perfnit Application - FOR OFFICE ,USE ONLY ", ` ' .
Received Permit No 801554 -63(36) & ' T
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �) '�,,y,7� r,
� I r� Date/B
Other Perut: DV -Pa (J� — f/"�
Phone. 503.639 4171 Fax: 503.598.1960 dig • I ,
Inspection Line: 503.639.4175 �/��� A Date Ready /By lures 0 See Attached Checklist for
Internet' www.ci tigard or.us Notified/Method Supplemental Information
;50 .,0. CIS',;... t:i�:&„750, .,1:nb'.; u.fi, ',tt;r- - -k� ;'�rc,�g�•�.j# ��,r „s ..;SY!,sk: _ -.�] 4k Yh.,M ^'.. €1 .`; C ,;rr
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� ❑ New construction .2 molition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, matenals, labor, overhead, and the profit for the
;,, ,,r ;s:. n ;, :T
„ ..,s -w Y;z- -'.' 4,' . " a , 4. ., 4"'"4'''' t <�:',y', �J ',., . <,Vi;,,i,''; , �.1 work indicated on this application. _
; {,y' : ' , -,. ,, ,> . ,; °` . <° , ' , ECATEGORY ', : A OF- ',CONSTRUCTIONs,' A,: -.4 A ;' - ' , t ;l , . ,, , < r � ',.; y . � I
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Valuation: $ �, ��_
❑ 1- and 2- family dwelling 1 Commercial /mdustnal
❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
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"A :' r r ; ': i il,i JO S 1" . Al INF,ORMATION ^LQCA ,' itt,; „ n''''' Total number of floors:
<f���f����' " "' :rte- '���1E Lh�1 .r - r`a�� ar�#'� „ t nr +s��."u - ate, '. ,� v�'>^�''. ^. f� , u �"� . �'� , N^ :a'i4 ''
Job site address: Cr Qe6 S W New dwelling area: square feet
City/State /ZIP: \ i 3 G 2 q ') � � Garage /carport area: square feet
Suite/bldg. /apt. no.: Op Project name: ` c 0 1.. Qhp� T Covered porch area: square feet
Cross street/directions to job site: S L.) 4 a U j3 UO i .., r Deck area: square feet
0 tn fir. R, 6 Other structure area: square feet
11 R•SQUIRED=DATA:',COMIKER US C HECKLIST'
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.: 2.5 y A,N, 00160 equipment, matenals, labor, overhead, and the profit for the
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” "Mn :, '= , .., :t , IDESC RIP,TION ,OF`1 WORI{'`"as, R � ',:; „, f r work indicated on this application.
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Valuation:
De •y
Existing building area: square feet
New building area: square feet
," e RRO ERTX: : ,. ; ^ '.,1 „ ; s ,, ®:'TENANT : ,;Z: 4 Number of stories:
Name: 1 cfr C —'T13 e.k r,.,,,-k „., S uA...6 o \, P ts-tu :4_4. Type of construction:
Address: 19 ( 4 (n S W ,Se. ,wc\ yuet Occupancy groups:
-
City/State /ZIP: '1-1 ct al4- J O Y?, (1 g 7 Z 2 3 Existing:
Phone: (503) 43 1 -4000 Fax: (So)) 4J ( - 1 1 0 4 i 7 New:
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x . , rt i., �AP rLICAN i ; +;? , � rd 4CONTACT „ PERSON= ; - r, ' ,F E, `, v.,,,;,.. ' .,
� ,, ❑. ;: , ,� 'bb , � +�r �-. ® .,<,._ .k..3,w; ^ � .,_����..:.'� .. °f' ',�`�.., �,�� NOTICE
'"-„ , +;*Ffi:.p .f.aus.�Xa rf'� ii P;41', ..,. <,- tit.%., �,+� +s��izzx. :�cl ;ae2:,.. .. ^ati � ; , �� a- -
Business name: ;D 0 W W _ All contractors and subcontractors are required to be
Contact name: i f�,` �'���y 0 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 3 1 9 S L \o G.S r.4 �,,• S s $n IX 20 0 jurisdiction in which work is being performed If the
City/State/ZIP. 1 Q applicant is exempt from licensing, the following reasons
Ci
ty p 0 r AG..v. O'2 S 7 0 L i apply:
Phone: 6O3) Z2(Q- 6 4 SO Fax:: (S'63) Z,7 3 - 9 14 2
E -mail: r e. I kL i S d0 W 4. (,0 tn.,
tart r, ,, �, °;I ,t, :21:4,:;,;,, =�t._k,, ','a ,;t. :m ,ra' .z has ;,d�; :01 s;:
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&,*w " Business name:
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r�,SCJYN �.�irS�.c - � ' BUIL; DING ; FEES
Address: 3 ( 11(,J Pr (,V CC u D . Please refer ER to fee schedule.
City/State /ZIP: _l 11 S toy d ft. R/ 12.
t _ l Fees due upon application
Phone: (503) 4 S - cz)5 3 I Fax: (j03) (a k s- - 5 3 5 f
Amount received
CCB lic.: G 3 ( y 7
Date received:
Authorized signature: ` 1, r - _ - b This permit application expires if a permit is not obtained
Y �Y t ` within 180 days after it has been accepted as complete.
•t
Print name: `, — a . c S Date: 1„1 2S(0 y * Fee methodology set by Tn -County Building Industry
R Service Board
i \ Building \Permns \BUP- PermitApp doc 12/03 440- 4613T(1 I /02 /COM/WEB)
Building Division
41141V Plan Submittal Requirement Matrix
`=- Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
?t ..;� ti ne Submittal ; •;.z >-.�.;NN •' ° ' ,
# of Plans:
* $�; R, �`„ , ", .}{ " `' ,:, 2»� � ar , >'tw,°'°.,aS ^.e � , .fii4` ti' b$. pis' ';'r "`: � ^� ',�r� � }:. '
* a � �� ry ,`s "� €;•'�`i �. g''w.�� :`.q' -` 5;•e �a.;z :av�, a`-.� }.,r,��,��. �,..`.�,r';,s'.
;;44 " ncludes��ngsv, dditions and alter =,atio 3 - `"
w , -( :.� x.. Y ) ; ' ,., Req'.uzred ate N
• " ' s! �, r.:• �'. �x � `irv:?z e 7:';• . n . , � ^ . , � ,"�; Y` , Ifr , ,Fr'�'�,.�'w,:.i..� >,�� >, ,.�;'zE �r "•- a ";�,•k�..'.,'s =_
'r'a�'�ttt^ „” !•,' -�,;: >`:�d;� :•: '.d �,c�.;{�,a';gai.2'i� `zSt': ,f�: r}�'';n'�- „;¢ 'd`'' ^; ?; v�a ,'f
. ;,. , „ 1 S,U ! l7'mittal "`.
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 l,
•
•
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 ah
Oregon licensed fire suppression engineer, or NICET level "3” technicians. • • •
i:\Buildmg\Forms\COM- PlanSubReq doc 12/24/03
-.CITY OF TIGARD 24 -Hour .�
.13UILia1NG Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received / 2 l• "2 Date RequRsted _ 3 �� Oz AM PM BUP
Location Q(iC ') W p a14 7 Suite MEC
Contact Person -o///7 Ph ( ) - — Z PLM
Contractor Ph ( V ) SWR
BUILDING Tenant/Owner �( iii . . 2 _ S • ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
0-t
A - ART FAIL
BING
Post & Beam
Under Slab \\
Rough -In
Water Service
Sanitary Sewer ,
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
ELECTRIC AL
Service
Rough -In
. UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line J
ADA / / +
Approach /Sidewalk Date Inspector Ext
Other:
Final Do NOT REMOVE this inspection record from the job site.
PASS PART FAIL