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Permit w , 111 v CIS' OF TIGARD BUILDING PERMIT PERMIT #: COMMUNITY DEVELOPMENT DATE ISSUED: 2 200 - 00069 7 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 102AB - 0350 0 SITE ADDRESS: 12405 SW MAIN ST ZONING: CBD SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE 2 LOT: 1 -2 JURISDICTION: TIG Project Description: TIGARD CHIROPRACTIC CLINIC. Re -Roof. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 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: $ 6,158.00 Owner: Contractor: ERDMAN, TERRANCE E AND JBC ROOFING ERDMAN, THOMAS M 12155 SW GRANT AVE STE C 12405 SW MAIN ST TIGARD, OR 97223 TIGARD, OR 97223 Phone: Contact #: PRI 503 - 968 - 1235 FEES Reg #: LIC 98255 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 2/5/2007 $110.50 [TAX] 8% State Surcha 2/5/2007 $8.84 Total $119.34 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: Permittee Sig _ Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application � �^ Datereceived 4 Permit no: 7 oo 4 , aJl�l City of Tigard a ‘i Project/appl.no.: ! xpire date: Address: 13125 SW Hall Blvd, Tig OR 9 223 City Cit y of Tigard Phone: (503) 639 -4171 FEB - 5 .2L''' Date issued: By:. I Receiptno.: Fax: (503) 598 -1960 Case file no.: Payment type: CITY Or iivAhro Land use approval: UUILDINSD I1�1C►n- 1 &2 family: Simple Complex: TYPE OF PERAIIT ❑ 1 & 2 family dwelling or accessory r. Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: /2406 So7 Al J ST 11GAK2n t on 5-3221 Bldg. no.: Suite no.: Lot: I Block: 'Subdivision: 'Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: no al (t 4: OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name:��npo Ct.l(RMP-PA - 1C C/ 11►11C ( Floodplain ,scpticcapacity,solar,etc.) Mailing address: I & 2 family dwelling: City: 'State: 'ZIP: Valuation of work $ Phone: 'Fax: 'E -mail: No. of bedrooms/baths Owner's representative: Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: 77C "/Fcci? i (UG . L LC Covered porch area (sq. ft.) Mailing address: 1 21 LT S w ( -'Q,✓J ,-(-- ,e Deck area (sq. ft.) City: State:c2 ZIP: 22. Other structure area (sq. ft.) Phone: - S6e- 12?S --- ' Fax: E - mail: Commerciallindustrial/multi family: / '2' CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: 113 C RGG r11UG f._(_, Cr New bldg. area (sq. ft.) Address: (2 I Sw G Arl)!` Number of stories City: . f16 #iM t ' State: C'( I ZIP:51 22 3 Type of construction Phone 123c I Fax:03 6o3CS'6' -mail' Occupancy group(s): Existing: CCB no.: ' 5 2 5' New: City /metro lic. no.: 4 Notice: All contractors and subcontractors are required to be ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: I State: I ZIP: exempt from licensing, the following reason applies: Contact person: f Plan no.: Phone: Fax: E - mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: 'State: 'ZIP: Amount received $ Phone: 'Fax: 1 E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Na all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this ❑ Visa o MasterCard work will be comp!' ith, w th Hied herein or not. � Credit card number: e,rpirc/s Authorized signatu . Date: _� Name of cardholder as shown on audit card $ Print name: JOU 0 h / 5 h 1 VY) 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 (603/ OM) CITY OF 'TIGARD BUILDING DIVISION PERMIT #: BUP2007 00069 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2/512007 Phone: (503) 639 -4171 1(4 Inspection Requests (24 Hrs.): (503) 639 -4175 F'I + � �.. INSPECTION WORKSHEET FOR DATE: 2/6/2007 TIME: 7 :02AM PAGE: 27 SITE ADDRESS: 12405 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE 2 LOT #: 1 -2 TYPE OF USE: PROJECT NAME: TIGARD CHIROPRACTIC CLINIC DESCRIPTION: TIGARD CHIROPRACTIC CLINIC. (F.e -Root, OWNER: ERDMAN, TERRANCE E AND, PHONE #: CONTRACTOR: JBC ROOFING PHONE #: 503- 968-1235 Inspection Request Scheduled For: Date: 2/6/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 250 Roof nailing 043009-01 503 -968 -1236 N Corrections /Comments/ Instructions: , . - 40 Pte. • ' a 11op , . jj9gI ►` nni . r- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ` li CALL FOR I PECTION ❑ ADDITI AL F ES ASSESSED Inspector: d IJf 1 tf Date: Phone #: (503) 718- -/' _," • CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2007.00069 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71b12007 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 F:_- INSPECTION WORKSHEET FOR DATE: 2/9/2007 TIME: 7 :04AM PAGE: 55 SITE ADDRESS: 12405 SW MAIN ST CLASS OF WORK: SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE 2 LOT #: 1 -2 TYPE OF USE: PROJECT NAME: TIGARD CHIROPRACTIC CLINIC DESCRIPTION: TIGARD CHIROPRACTIC CLINIC. Re-Roof. OWNER: ERDMAN, TERRANCE E AND, PHONE #: CONTRACTOR: JBC ROOFING PHONE #: 503.96E1 -1236 Inspection Request Scheduled For: Date: 2/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 043171-01 503-96 13-1235 N Corrections /Comments/ Instructions: A lk r, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FO' INSPECTION ❑ ADDITI o NAL ' EES ASSESSED Inspector: 'APIA I ` �/L Date: Phone #: (503) 718 - 0 VIII