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Permit , r, CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00275 l DEVELOPMENT SERVICES DATE ISSUED: 6/14/2004 �'I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11565 SW DURHAM RD 100 PARCEL: 2S110DC -02400 SUBDIVISION: SDR1999 -00022 WILLOWBROOK II ZONING: C -G BLOCK: LOT: 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: 26 BASEMENT: sf AREA SEP. RATED: STOR: 1 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: $ 87,250.00 Remarks: 1st time TI, dental office. Owner: Contractor: DOUGLAS FRY NORWEST GENERAL CONTRACTORS INC 2423 REMINGTON CT PO BOX 25305 WEST LINN, OR 97068 PORTLAND, OR 97298 -0305 Phone: 503 - 348 -2237 Phone: 503 - 291 -6986 Reg #: LIC 89425 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 6/14/2004 $678.66 Electrical Permit Required [TAX] 8% State Surcharl 6/14/2004 $54.29 Plumbing Permit Required Framing ming Insp [BUPPLN] Pln Rv 6/14/2004 $441.13' Gyp Board Insp [FLS] FLS Pln Rv 6/14/2004 $271.46 Susp Ceilng Insp Total Final Inspection $1,445.54 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling . • •. -.•99 or 1-800-332-2344. Issued - : ■ . _ - - .1 i Permittee Signature: At , i MP Call 639 -4175 by 7 p.m. for an inspection the next business day 1 Building,Permit Applicatio � FOR OFFICE USE ONLY City of Tigard G d\‘‘ R / /b /� �' Date/By: Of 13125 SW Hall Blvd., Tigard, OR � Plan Review Zil Phone: 503.639A171 Fax: 503.59 1960 - a aNl iP ;y � i ts //u 1 A , I Date/B ' I' "/ Ai Other Permit: � � Oasr ,�� Inspection Line: 503.639.4175 \�� G� c am' _,. Date Ready /By: Q See Attached Checklist for Internet: www:Ci.tigard.or . us ��+ O C. ` `\S I Notified/Method: Supplemental Information C ` ` G C ) - =-' ,Wig. per: - s ; -r, A r r t �' ; s ii -, ;. itith 4 it , man _ a= ,,„ , ,-�;_ = 2 - v &- �i 0 . ;R, 4 - - ' RE ' UIRE D D ATf A 1- AND 2 "I N G � ;t.3 .�" �4:�...,.�:.�a -:��_ ..�?rT:.,r�w �v....- �.�a.'�;d" .�:��.�� b. a� ;.l:i:�:�!.$ Q '' ,.,,.. °.,.�;�., .. .,saatl. ��.�',�v.�r�+.+�'.a.:, h..�:.�ca+:�.:w�a5a:� �'„<te°..� .w � -x,e . - ❑ New construction ❑ Demolition 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, materials, labor, overhead, and the profit for the W ''`;_ ? e *'0', ' E u. ;; -€� s e . �. ; � rt .. .. 1 , - ,�cea.. -, r > >;'„.- �a' : »r '.3;r' ` ?'"a;k"'r s, °::k, `�:::i u $'� ' ,:;'-s = ,h:;,t 4 '`'~ � . k ATEG R OFD C J IOIYt Nµ . e mm t work indicated on this application. Valuation: S ❑ 1- and 2- family dwelling El Commercial /industrial ['Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: . J A B SITE IIYiURIATION D�LOCATlIO1VP fr .I ''` Total number of floors: Job site address: 1 I S to S S l,„) u tiN A AA. a o New dwelling area: square feet City/State /ZIP: T' 1 G A 2 i) a 2 '9 '7 2 2 4 Garage /carport area: square feet Suite/bldg. /apt. no.: j 00 Project name: % -fZ 5G4h./ /0 D7 Covered porch area: square feet Cross street/directions to job site: /4 w / G) cal a 5 1.J 'D vi2i-1 , 4e.& (Z,D Deck area: square feet Other structure area: square feet t REQUIR�Binw % C O MME R C I A L $ CHE'CKLIST 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 , . `R Ntr equipment, materials, labor, overhead, and the profit for the r ,� ` � � =S�l2IP ' iOhI O�WORKr �. �, L I, work indicated on this application. �,� _ 1,-,1470,'m ;i - - _ v & 't,�� e ,b . i;, mss .�;.. ��._ _ Valuation: $ t'7 250 Existing building area: square feet New building area: square feet ,.., -�, ,;�, ,11+; . +,t .as2 _ ',�'t<r,; io �.w si � .1':'.t, '�k ;; it .t e? ; ' r,'-"v^,.=r ,: , 4:j �.,5gi=t' r, f... ,, -^=.e .. :' 5i, s t L R1<20PERTY: O ER „ kTENAN , � Number of stories: k - c.°,: mt a ewe _.: °.., t »,4.a a ��a � ... u Name: - Do u a Fa - Type of construction: 5 Address: oi l 9. 1 0677 Cr— Occupancy groups: 13 City/State /ZIP: J - S T ) J J se /L .9 7a(o 4( Existing: Phone: (5-03) 351g - p.9.3 7 Fax: ( ) New: �� ' i. ^" -'p :'""'� $.'fi� #' - + 4 ..�"_,ar �;�`- �,' °'�Y;'zt -'e�?i ✓a::,;i a4y�- ��^�''_ � _ , , AP I IC t i . y H X €,.: , t 'CONTACTY BERS®N e. eft ' . „ g . a =r • E%.,: pn . = tr t �� ,�� - _< ».��:��z ;��r�t ��..�.� ,. - ��.�f�Asx��K;.��_. VW' �.� � ,r ��: �1YOTtIC �j �,�,`s�� ,• . ate ..�� -_ e, . �s,' � �, � ay.<, � . -. ,� Business name: U PlLt:cl S t 0,.) ( 7 s t C�,/ -) All contractors and subcontractors are required to be e Contact name: licensed with the Oregon Construction Contractors Board (�A/Ll.,� 10 0 S K A under ORS 701 and may be required to be licensed in the Address: 1 S O 0 ,. 1., j 1 s AvLs s v 1 T 6. ) D 2 jurisdiction in which work is being performed. If the City/State /ZIP: 2 applicant is exempt from licensing, the following reasons per, TC..a,v D ©t2- a 7 20 4 apply: Phone: (5O3) Z3.3 _ -ft (o v Fax: : (507) 2_3-3,_ 4l G 5 E -mail: ;� ' ` � , I� „ ea tr off' t :4 �-�,�. ,. . � -_ � ��.� °� � ,� :�.�. ��. .>w� _ �'e r �� tom. � > � � �_ _ Business name: /� � .. ?Jo � � " - C1 w� - ,"e;:,: �BTIID G�ERiVI ., � Address: � .. ..., . .. ,,.. , .,- -.. �,. p 00 x 2 5 3 0 5 City /State /ZIP: nn Please refer to fee schedule. A D � �"'� 1) 2-9 Fees due upon application Phone: (507) 29► ( - 1 5 4 Fax: (56 ) 2_0 ( _ 70 ? G. Amount received CCB lie.: 14 • Date received: Authorized signature 6.,..k.._ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. � 1) Print name: 4 e 1 r-J J O j S It A Date: G 1 9 /Q 4 * Fee methodology set by Tri- County Building Industry Service Board. i:\Building \Permits \BUP- PermitApp doc 12/03 44 0-46 13T( 1 1/02/COM/WEB) 4 Building Division ,, h ,, "'�!�lki�Vv Pla Submittal Requirement Matrix C ommercial & Multi- Family - New, Additions or Alterations City of Tigard ' ype of Sub tta�l 4.� i � , �� ,� �� "� � � ' �` # - of Plans g (I tid n e V adthtiio and �a � xons) F . �2 at f 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 of 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:\Bui lding\Forms \COM- P1anSubReq.doc 12/24/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST I� Received Date Requested / 0 — / Z AM le PM l/ BUP Location I / <S7o S D L� Suite / U MEC -- • • 3'7D • Contact Person �A i Ph ( ) PLM Contractor Ph ( ) 7 1 6- OS‘-3 SWR BUILDI � Tena Owner ELC Oo g ELC Foundation Access: Ftg Drain 6D X AI 6- ELR Crawl Drain / " Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Drywall on Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling " Ali Roof �— i`�` O ler: n.p■ ® PART FAIL = ING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final AIL AlEClIAAIIC Post & Beam Rough -In Gas Line • • - Dampers 4 0 - PART FAIL RICAL 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 El Please call f.. reinspection RE: U - • to inspect no access Fire Supply Line ► 1 40 W.< ADA Approach/Sidewalk Date , Inspect Aar L _ k _ I �'��1 Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL