Permit `L CITY OF TI GAR® BUILDING PERMIT
PERMIT #: BUP2005 -00033
° �I
DEVELOPMENT r SERVICES (503) R 639 -4171 DATE ISSUED: 2/1/2005
-- 13125 SITE ADDRESS: 07080 SW FIR LP 2-00 PARCEL: 2S101 DB 01000
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK ZONING: C -P
BLOCK: LOT: 012 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: B 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: $ 14,860.00
Remarks: TI - new reception area on second floor.
Owner: Contractor:
SHROYER RANCHES INC VJ CONSTRUCTION
BY REX SHROYER 18428 STEAMBOAT WAY
PO BOX 1538 g73 WEST LINN, OR 97068
PI��LOMAT 541 -929 94
Phone: 503 - 515 -6478
Reg #: LIC 106905
FEES REQUIRED INSPECTIONS
Description Date Amount Firewall
[BUILD] Permit Fee 2/1/2005 $187.30 Framing
[TAX] 8% State Surchari 2/1/2005 $14.98 Final inspection
[BUPPLN] Pln Rv 2/1/2005 $121.75
[FLS] FLS Pin Rv 2/1/2005 $74.92
Total $398.95
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 -001 1 a ough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ( ) 246 -6.'• or 1- 800 - 332 -2344.
Issued = i{,
Signature: a
Signature: At,
Call 639 -4175 by 7 .m. for an inspection the next business day
Buildin Permit Application . FOR OFFICE U S E; O N LY� - "' � `'' ' ,
City of Tigard DateBy ? 0S Pernut No :YL, 1 y_o�o3
13125 SW Hall Blvd , Tigard, OR 97223 D to
Plan Review Val / �LLJ�YY++��`"'^^``
small p
Phone: 503.639.4171 Fax: 503 598.1960 � ��� L N pt' i DateB OtherPermit:
Inspection Line: 503.639.4175 c .:....,40- '! j Date Ready /By. 0 See Attached Checklist for
Internet www ci tigard.or.us Notified/Method / t (' y Supplemental Information
�; r�. :.rv�xa a.s�:t�; ^,` -�,,, ,<ii:^�.�- «.: <.�. -- ,- ;,;,�.�. �•-� � - ':�:`, ��u� at*�° -:?.�. �, �:. s�' a;» 2r ;.�s<`;:;:��•si:�.;.; ; ^.�.
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i' `" :. ,. i TYPE;sOF �RIuu, . ° , tk : , 7 , ,„ :a RPQUIREDDAT N ,f' M , X ._.
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0Addition /alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
:e: 3 .,'= - i '--6 -EArt':'° _ � _ °;�' ` =” <' ”: " work indicated on this application
lam`" �;: .�' ;�.„�' �tg+ # ,.- °ri *�� � ,., <�,„ �•�, ",. t�,r�x:
i :C IEGORY OF CONSTRiIC= i' ;F "
El 1- and 2- family dwelling �]C,Commercial /industnal Valuation. $
❑ Accessory building 111 Multi-family Number of bedrooms:
❑ Master builder 1:1 Other: Number of bathrooms
fli t 'a« » 'S ,_'.;e'°: a a i ; r`= ' , ,.s° -t .:r',4' �,. . .`�e' 1,: ,, _ •. p ,.: K - i ,, ` i >3�,�'•sik+:i.p e «`3 �:
i, ;� "2. '' Total number x { ; �4 `ivi: . x . JOB S]TE° 9° ° •D. =I OCATIQN. ' :' ' A, ' b of floors
�.`,� °�� �...�. >�� �x- .i« « „�arEZaat *;� „�.- sa ,;�x �a ° °�ai• >:,, ��`�,'x,��i� r'�_
Job site address: 708 S. (v. file LOOP . 2 b New dwelling area: square feet.
City/State /ZIP: 't r cofleD ole 17 2Z 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: IQ/ft Project name: I/ I A II _ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
4iRE(Q.IJIRED�D - C OMMER CIAL,;USE CIIEC1 JST'
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
' °' : ; mow; ' = a work indicated on this a
i.,s., ' „ ' ' 1 1,. ' ; r,; ., E - le Oliiz' O RK s` ` '- _ . 1-; , it 1 o application.
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7 /iv /�✓ l/, C c�iv Ts - (' tom ' z . ,h(Lei ^• . 7 Valuation: $ � �6�. Ot�
�.1 t ._ O•-
, w- /� Existing building area: square feet €700 e w New building area: square feet goo
NI zID , spa-:; `,1,. -._. .: b: « ... ;sa '- a a, :. +« ,th .';:<;:r;° t
' P # R® EB X ®WNE«R . ' „ : :; . _ ' "T ENAN > =r
i r. :,!: " i „ Number of s ones
Name: S /f, DYER net-iefrif Type of construction: 7%
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( 5Zfh q29 2691 Fax: ( ) New:
,
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.'' �� „ 1.0 1, ; °�I� AP LICAALVT *�,' . °A,x 4 - ® CONTAC.Z PERSON:. •tk /_/( . ;, ; ; 3., =:s' ;w . ,.p ;
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Business name: 1 CNV- STiet) C 770A1 All contractors and subcontractors are required to be
Contact name: VT ,TtVAa vic. 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: ((3) S Sf� (: � � f W 4 7 "'"JS ! le c? e-TD Fax:: ( ,)
E -mail: V✓ 0 t/CT7OW . / • UM s
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' }SI � - . «�a�"' - t `, , «_ ; � �;
'A ' -4 : O z V IZ . _ : ` CONTRACTOR ' : ` , ' ,- � ; . ... , < ; .�; If
Business name: V t CONS CT�ON V DA.13 "�1f1 ft`06,, t ' �.« < . . "- ,. ,.,t, .^ -, _
f
p /, d �/ „M ' 1 1,q ,. ';,BTJA. DING °-PERMIT 'FEES*
Address: 7Z O p s-! r �TT i1 7 ' I /
A / Q eb 1 7nW c � Please refer to fee schedule.
Ci ty W � 4I ,�+ /State /ZIP: /" /L
Fees due upon application
Phone: (.593) (9,c 6q7,1' Fax: (.5/ N.4 077?
CCB lie.: /� 9Q.7 Amount received
`' 9 l o
Date received.
Authorized signature: / / 4 ar , ai (f This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: V • C// t' V/ G Date. $ 2/o i12t . * Fee methodology set by Tn- County Building Industry
Service Board.
1 \Buildmg\Permits \BUP- PermiApp doc 12/03 440- 4613T(1 i /02/COM/WEB)
Building Division
,„, 7 „ . 0 401 ���� Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
r z ,, . `. T e oPSubm , . :_ ., -of Plans.:
' E ncl'ud'e's �w= additionsan =clalterati''ous:'- `` `"
,, .t�� .,� , � 3. �A F.:.- • ��, • ..,:�� )'z� °, R;e- u><r
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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*
.
C.5 C. t_. •
Fire Protection System 3**
-..,� 1 ,
Mechanical '•',.
Plumbing (building fixtures) 2':y �s`'> �, ,�:' --a
.
Electrical
Plan review is dependent upon submittal of a completed application and r ,
7..
After plan review approval, the Plans Exam the a plicant ro request- •
additional sets of plans for distribution purposes (for contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue) \j':`,}',`': ;� �'%`�� r: •tip s ti :
* For over - the - counter commercial tenant implFtvp' ts,•submit_2'Sets 3of pl ns,
** "New” fire protection systems require that plans bear the original seal ofa
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
.—. f �y;� . S :S L • 4 to ` x
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 00033
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2005 .A�nn"
Phone: (503) 639 -4171
A 4��0 1 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .1:11■
INSPECTION WORKSHEET FOR DATE: 3/24/2005 TIME: 7:09AM PAGE: 11
S
SITE ADDRESS: 07080 SW FIR LP 2 o d CLASS OF WORK:
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK LOT #: 012 TYPE OF USE:
PROJECT NAME: KCM INC
DESCRIPTION: TI - new reception area on second floor.
OWNER: SHROYER RANCHES INC, PHONE #: 541 -929 -2694
CONTRACTOR: VJ CONSTRUCTION PHONE #: 503 -515 -6478
Inspection Request Scheduled For: Date: 3/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
299 Final inspection 002734 -02 0 U , 503- 515 -6478 N
Corrections/Comments/Instructions:
00 t-"
F 1 AM O e___ 00
e) k._ r 6 OGCUP/
i
U '\(.\
a o,
S
(; O
/ PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: k yr f•J 13 IA LO L lc-- Date: 3 - Z q' 65 Phone #: (503) 718- 2-751