Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00499
: .��I DEVELOPMENT SERVICES DATE ISSUED: 9/18/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S135DD 04300
SITE ADDRESS: 11850 SW GREENBURG RD
SUBDIVISION: ZONING: R -
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E:. W:
OCCUPANCY GRP: R1 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: $ 35,000.00
Remarks: Remodel of (3) units of tri - plex to meet building code.
Owner: Contractor:
PATHFINDERS HOMES INC SEAN L. MUNROE
20055 SW PACIFIC HWY STE 105 4945 SW 192ND
SHERWOOD, OR 97140 ALOHA, OR 97007
Phone: 503 - 625 -9151
Phone: 503 - 356 -6706
Reg #: LIC 144938
FEES REQUIRED INSPECTIONS
Description Date Amount Foundation Insp
[BUPPLN] Pln Rv 8/18/03 $71.83 Post/Beam Insp
[FLS] FLS Pln Rv 8/18/03 $44.20 Underfloor insulation
Framing Insp
[BUILD] Permit Fee 9/18/03 $358.30 Insulation Insp
[TAX] 8% State Tax 9/18/03 $28.66 Exterior Sheathing Insp
(additional fees not listed here) Final Inspection
Total $763.18
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: ' ;' f 4,��1 41) i
Perm Signature: / i �
Signature: ,/,/
Call 639 -4175 by 7 p.m. for an inspection the next business day
l/85-6 3GtJ GRc.7eN eU,.s-
Building Permit Application " . . ,, ` " -' FOR O ONLY `'4 _ -.':€
Received y i Building
Date /By. 0 g/ 6 ' ' Permit No. � 6'er e ll,
City of Tigard Planning Approval Other
Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review - /�S S Other
'1
- Tigard, Oregon 97223 Date /By: S Permit No.:
Phone: 503- 639 -4171 Fax: 503 - 598 - 1960 -0101 ? Post- Review Land Use 7,.. )/0,...
NIk 1 J I -.a Date /By: y , t �'0 f C L Case No.
Internet: www.ci.tigard.or.us - Contact s ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Il C, , Supplemental Information r
':c -! � � -�„i �� �.�'�� »E;�'s� Ae'�= z`:.�'£ ?r� "' i.tr'�t°rr'��;�:± "�;'., �u���,�',.` "��a.s,:..` �
f° m` � . 'c,�, _ , :; . "TYPE OF, WORK N _ , ` . , ` r 0 ,k _ i REQUIRED','DATA" l' AV,
El New construction El Demolition ,z I ., & 2FAMILY DWELLING . 4t
:. , 1_� , , .A - r 1 . � „,_, ,�. a: ,A .„ h , ,. , sM 41_, ..:. �
❑ Addition/alteration/replacement ❑ Other: .
. -e �� ;
y �`'�'ti' �, �° ,- - i�CATEGORrY�OF�CONSTRUCTtO '`;. � Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ❑ Commercial /Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
E 1 1- �,� ` ; a AVON l No of bedrooms: No of baths:
,�� , -,OB SITsE-�INFO andI,QCATION
Job site address: /1 6 0 7 a f/J 'Du Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: r QS l lr1 +F14'1)Em I jJ el Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
e - REQUIRED = ATA � $t
Subdivision: Lot #:
ms' ` ,' ; COMMERCIAL USE cHECIMIST _ ' ;
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
5 ;.-=� ra y .-tw° ,• a" : : :T `P : ,'.<7 }« >x; ". it nearest equipment, the value (rounded to the nrest dollar) of all equip, materials,y�bor,
.�.,: :. ,,.s DES.CRIPTIQNOFWORK.,�: 1 - ; -A "'I
` q \
overhead and profit for the work indicated on this applica n.
/�. _ . � c _. ,-r� _ Valuation $
Existing building area (sq. ft.)
. New building area (sq. ft.) `'
Number of stories
• ,. PROPE' Y,OWNER , : 11 . AP:N NT' P - ' Type of construction 5
Name: ,4„,„,„ , V;tt.Q4 r 1A%- -C Occupancy group(s): Existing: /
Address: , Od _ i New. / J
le�i lQs
City /State /Zip :. / r � 9
r, 7/$
Phone: ..„..,3- & y'/S> Fax: - lcds y/s NOTICE: All contractors and subcontractors are required to be
9
s , _ _,,,.. _ - . F .,, licensed with the Oregon Construction Contractors Board under
A PPLICAN, T4 ,4Vsczn „- : 4 l r CONTACT P,ERSON; "° ,`°
R '
r ' . provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip: .
Phone: I Fax: 74�� �:
t BUILDINGPERMIT TEES* 7 t k E
E -mail: �= 4 , ,� e � a ? �. l v:
; .a ,.� _�.:.. = , � ` f Please r ty a sch d ui , ... t 'k
y Et z ,.;�- ONTR,ACTQR� g ''� �„ _. e
Business Name: r / ■-...., / . emu r - -rl-G. Fees due upon application $ ..._ )
Address: . a , , , , 1:
Cit / State /Zi I. . X. ' i/o Amount received $
• Phone: ,,*3-6,:23 q/'5 Fax: ,6/ '- 6d— -9/7 Date received:
CCB Lic. #:
Authorized
Signature: "Aar, Date:_ 4/ -44 Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) 71' 81
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 O
tet. Z
A k . Plan : Submittal Requirement Matrix
6111. Commercial & Multi- Family
City of Tigard New, Additions or Alterations
TYPEOF SUB MITTAL # of P lans
(Include New Add it i ons or AAlterat Require a
'240R MAW_
Site Work 4
(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.
is \dsts \forms \PlanSubMatrix.doc 2/27/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (5 3) f69 -4175
MST
INSPEgTIbN DIVISION =Business Line: (5 39 -4171
OM 3 _OD 6-1 a do
Received ' ) /2 ` .., Date Requested 3// ( /OI AM PM al, 0l') V9 9
Location 176 56 Suite MEC
Contact Person Pfi ( 5-0 3).3 3 2 O9 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
g Access: fn ELR
Ftg Drain , r l 4 .X._ 01 Crawl Drain --
Slab Inspection Notes: / SIT
Post & Beam l (/ lJ C a—1
Shear Anchors
Ext Sheath/Shear ,
heath /Shear
Int Sheath /Shear ', 3- 00 J C V - 7'd J ,r) — d
Framing
Insulation G' { '
Drywall Nailing �
Firewall I 72 —.e-JS -I — ° c �f J C #�� -��¢ -ate.. e -- '�
Fire Sprinkler L.
Fire Alarm
Susp'd Ceiling
Roof
O. -
S *ART FAIL
P I BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer ` •
Rain Drains
Catch Basin / Manhole
(2) ( 7/ (----
Storm Drain i/
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
/
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL .
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach /Sidewalk Date j\ \/ Ins pector �� �\ " '� — Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL