Permit CITY OF TIGARD
BUILDING PERMIT
i,4, „d, ,, DEVELOPMENT SERVICES PERMIT # ° BUP97 -0538
- _,W '' . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/03/97
PARCEL: 1S135DA -03000
SITE ADDRESS...: 11407 SW LOMITA AVE
SUBDIVISION ZONING:R -4.5
BLOCK LOT • JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:DEM FIRST 286 sf N: S: E: W:
TYPE OF USE...:SF SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5N .... 0 sf N: S: E: W:
OCCUPANCY GRP.:R3 TOTAL . 286 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD • 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 0
Remarks : Demolition of existing duplex "B” in preparation for building new
duplex "B ". All debris to be removed and sewer to be capped and inspected.
Owner : -- FEES -- - - - - - --
SEAN VERNIG type amount by date recpt
11405 SW LOMITA AVE. PRMT $ 25.00 DRA 12/03/97 97- 301411
TIGARD OR 97223 5PCT $ 1.25 DRA 12/03/97 97- 301411
EROS $ 26.00 DRA 12/03/97 97- 301411
Phone #: 639 -4423 ••ERPC $ 8.45 DRA 12/03/97 97- 301411
ERPC $ 8.45 DRA 12/03/97 97- 301411
Contractor.
SEQUOIA BUILDERS INC
10540 SW LAUREL ST
BEAVERTON OR 97005
Phone #: 646 -4606 $ 69.15 TOTAL
Reg #..: 000681
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the -
Tigard Municipal Code, State of Ore. Specialty Codes and all other [ 'HY lge /,.1
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started / / A)/ -L. / P --
within 180 days of issuance, or if work is suspended for more a
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- Y
You many obtain a copy of these rules or direct questions to OUNC
by calling {503)246 -1987.
Permittee Signature /,, A ___ Issued By: 6
+++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Y ' a ' ��
Ci.TY Jr • - IGAR Commercial Building Permi Recd B
13125 .S HALL BLVD. Tenant Improvement Date Recd /P, — ..a-0' 7
TIGARD, OR 97223 Date to P.E.
Date to DST,__ �,
(503) 639 -4171 Perrnit # r ic 7- C
Print or Type Related SWR #
Incomplete or illegible applications will not be accepted Called
Nam of Development/Project Existing BuildingNew Building ❑
Job . /e,,
Address Street Address Suite Building
iii LOH /- Data
Bldg # City /State Zip ,Existing Use of Building or Property:
riCo4/ )0/2 97 3 x) '
Name
Property rty .44"tc.. Proposed Use of Building or Property:
Owner Mailing Address Suite 2K A / 7 !t A 7 to .
No. Of Stories:
City /State Zip Phone
Sq. Project
Occupant Name (0
Occupancy Class(es)
Name 2
Contractor c %► z62.I 1 Pt I a LDsev Type(s) of Construction
Prior to permit Mailing Address Suite
issuance, a copy „, this project have a Fire Suppression System?
of all licenses RD 5 yQ �a k3 a .7 • Yes ❑ No)45
are required if City/State Zip Phone
expired in C.O.T. Americans with Disabilities Act (ADA)
database > ett/1 M1+ / ' � 4C/ � Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
Project $
Name Valuation ..
Architect Plans Required: See Matrix for number of sets to submit
Mailing ress ..,Site on back
City/State , Zip Phone I hereby acknowledge that I have read this application, that the information
'....,s_ given is correct, that I am the owner or authorized agent of the owner, and
Engineer Name � -”
that plans submitted are in compliance with Oregon State Laws.
Owner /A ent Date
Mailing ress Suite
Contact Person Name Phone
Sikf/State ,.,....•Zip"'_._ _... Phone Lee / 1 ��ot (mac c V L tS- ( c/O /
oG
FOR OFFICE USE ONLY
indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration 0
-
Repair 0 Other 0 Notes:...:: . - _
Description of work: - .. .
TIF:
Parks: Estimated # of Employees • ®, 'I:a
Note: Site Work Permit Application must precede or accompany Building aU i ! a C 0
Permit Application r `
1: \COMNEW.DOC (DST) 8/97 ^
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) --
B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) --
E (New, Add, or Alt) 2 -- -- 2 -- -- 2(j,o)
B & M & P & E (New, Add) 3 1‘ 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
, :;:::;:: >:: >:;::::::
. ....
n . ih . :j 4 ?:
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�yy.jt��,,J }}ss :::: :•: :•:::::::::::::. �:: :•.::!jii: : . ..... .. :. :•:.�:: :.: :•:::: .: : :::.:�:: ........ .. .. ... ::... .....: ::: . :::: . �.: ::::
::: �• ��� 3: i; 4:: L. �... Aii::: v ii.:. ii. i:' is L i::: is�': i ?-: :i:i::i.f..:::::'r::: �': ... .2 .
: : : :::� :,:i.i: . :2' %Yi % -i> iii vii�i:::: i: r': •i:::ii.•�: ^:: :'::::::*::::�. �:: '::::'.'-':::: :i::: i i: ; : ..:�'�.''.� : :.. .......: .. .. .,...... . . . .
....................... .:.
NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions. f = Fire P = PLM
u = USA E = ELC
S ):: .?3.e::; : : .;: : :; :.:.a.;:::: :i ? :::� ; -; : ; � ` :;: :: �:::;`:' : �t. : . :: : : :::: :.} y:: : s ;r asi:7 as s s ::!:2: ? s `as! G : <? c
: ::: 4 :; d ogig#4 oo#00 01 § -40 ............:.... w Wash. County F = FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
h:Vnatric.Doc
V , .
1 . ' CITY OF TIGARD BUILDING INSPECTION DIVISION
' 24 Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
4
Date Requested: /— /.5 q A.M.. ,�,, P.M. MST:
Location: /1 SG() r 9` " ,15LC. J BUP: C7 7-6,53g
Tenant: . Suite: / , Bldg: / • MEC:
Contractor: L� ,r Phone: 3 l ,r' 4 00 - PLM:
Owner: Phone: ` �� �I ELC:
' 1(1 , /,r) " *) C0 zz/`M i ELR:
• ea " SIT:
BUILDING / BLDGAcont PLUMBING ) MECHANICAL ELECTRICAL SITE
Site �Po t/B eam -- Pcst/B Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing To • Out Gas Line Rough -In UG Sprinkler
Foundation Insulation 4gErP Hood/Duct sect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
(A .! • ---• Approved _ Approved Approved Approved
-__
Appr /Sdwlk __- -.� ,,..,. Not Approved Not Approved Not Approved
i ' • 1 ) I ' r FINAL FINAL FINAL
/ / � / d _ _ __ .J
_.. —~ .. _ _ ,—�_i_� .t� /���" tom
•
—
0 r reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: _ Date: / — Ai Pg Page of