Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00124
ei DEVELOPMENT SERVICES, DATE ISSUED: 5/4/01
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134CC-01700
SITE ADDRESS: 12325 SW KATHERINE ST
SUBDIVISION: MARY WOODARD SCHOOL ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS FIRST: 960 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 960.00 'sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 3 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 15 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: $ 12,800.00
Remarks: Construction of new 960 square foot of multi - purpose agricultural shed.
Owner: Contractor:
TIGARD - TUALATIN SCHOOL DISTRIC RICHARD R. MINICK DBA/R +M
6960 SW SANDBURG ST 1282 3RD STREET UNIT 30
TIGARD, OR 97223 LAFAYETTE, OR 97127
Phone: Phone: 503 - 864 -4807
Reg #: LIC 78688
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Foot/Found Insp
PRMT CTR 5/4/01 $168.10 27200100000 Framing Insp
Final Inspection
5PCT CTR 5/4/01 $13.45 27200100000
PLCK CTR 5/4/01 $109.27 27200100000
FIRE CTR 5/4/01 $67.24 27200100000
(additional fees not listed here)
Total $674.06
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature: ,(�
Issued By: i !�
Call 639 -4175 by 7 p.m. for an inspection the next business day
- -rt/7 _. Z 21 4124
41 , ,
Building Y
rived: ` G/ Permit n o . U t l �t
t - Jy� City of Tiga1
Projecdappl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt n o.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family lew construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: I Z325 5t t) k.'A rauvE 57 ilvA+�t� 1 0 r2 Bldg. no.: Suite no.:
Lot: I Block: 'Subdivision: I Tax map /tax lot/account no.:
Project name: pi t-' n pv> 5e i21 G ✓TV(L,) -t_ St ��
Description and location of work on premises/special conditions: CON.512 or= S> — For?_ v5.: w 1 i N
717 tnl Do��w11-il „7 gy; S
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: :7GA ) TVA L SC-4/001- � isr ' c (Floodplain, septic capacity, solar, etc.)
Mailing address: -9- 0 5 ,5A vi2c-, S i •• 1 & 2 family dwelling:
City: j /GSA- T ,State: Ott ZIP: 97ZZ3 Valuation of work $
Phone: 43/ - 4018 I Fax: 431- 46201 E -mail: No. of bedrooms/baths _
Owner's representative: J20,1 )-f��sc 1 Total number of floors
Phone: 43l - 40/8 Fax: E-mail: r h , J E i `Y'ew dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: 776q��- 72
S cWOoL l� iSlY-fer-- Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial/multi - family:
CON77ZACTOR Valuation of work $ 12 8
Business name: o Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.) ?‘
Address: x..749 . / 4 s ;,o r_
:- � - t of ue � r t . Number of stories 1
Phone: Fax: E -mail: Type of construction
ng:
CCB no.: - 7 plc 7% k$ /1/1 S Occupancy group(s): ExiNew:
City/metro lic. no.: SD 3 — Re, q - L.I _7 Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: 5L )( provisions of ORS 701 and may be required to be licensed in the
Address: Z 13 S,- J Aisti jurisdiction where work is being performed. If the applicant is
City: ?or '- � State: 02 ZIP: �j JL 0 exempt from licensing, the following reason applies:
Contact person: X rvi C J l Plan no.:
Phone: . 23 224 42t.36 Fax: Z7-4- 4836 E -mail:
1 NGINEER
Name: 6 244 G 61 4A LL Contact person: l - U L : ` - > Fees due upon application $
Address: 23 Zo S to INA:S itiniG7t) ' 1 57 Date received:
City: i"n it...t.iktii Li 'State: 012 'ZIP: 9 72_Z Z Amount received $
Phone: 5b3 ts9 5913 I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied with
with w liether sReCified erein or not. Credit card number: / /
c � Expires
Authorized signature: i ate: 71r- 7 Name of cardholder as shown on credit card
• $
Print name: Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6iVOICOM)
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COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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 plan sets for distribution purposes (for Contractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Rescue).
Total # of
TYPE OF SUBMITTAL Plans KEY:
Submitted
S = Site Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
B (New, Add or Alt) 1* B = Building
F (New, Add or Alt) 3 ** F = Fire Protection System
M (New, Add or Alt) 2 M = Mechanical
P (New, Add or Alt) 2 P = Plumbing
E (New, Add, or Alt) 2 E = Electrical
New = New Building
Add = Addition
.Alt = Alteration to existing
building
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3" technicians.
I : \dsts \forms \matrxcom.doc 10/27/00
CITY OF TICUARD 24 -Hour
-BUILDING' Inspection Line: (503) 639 -4175
IIPE O . DIVISION Business Line: (503) 639 -4171
Received _ • Date Requested , ( —/ AM PM BUP
. Location f --3oLs /(da--ia/L-416- :.Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner IA 1 . Ii14 _.,
A.. Li) am.. ' ELC
looting
°Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: .9 c 0 �mi �4 �► °G a SIT
Post & Beam
Shear Anchors k/‘ tis
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall c° .� e f
Fire Sprinkler V
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART 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
ELECTRICAL
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 Line j
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO, OT REMOVE this inspection record from the job site.
PASS PART FAIL
•