Permit \ (( CITY OF TIGARD BUILDING PERMIT
r " .. PERMIT #: BUP2007 -00285
COMMUNITY DEVELOPMENT DATE ISSUED: 6/15/2007
•
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102AB - 02200
SITE ADDRESS: 12525 SW MAIN ST ZONING: CBD
SUBDIVISION: ELECTRIC ADD. TO TIGARDVILLE LOT: 015 JURISDICTION: TIG
PROJECT: STONE GALLERY
Project Description: Awning
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: 5N sf N: S: E: W:
OCCUPANCY GRP: M 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: $ 6,200.00
Owner: Contractor:
JIM TOMA ROSE CITY AWNING
26431 S BARLOW RD 1638 NW OVERTON STREET .
CANBY, OR 97013 PORTLAND, OR 97209
Contact #: PRI 226 - 2761
Phone: FAX 503 - 222 -5060
Reg #: LIC 48622
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/30/2007 $110.50
[TAX] 8% State Surcha 5/30/2007 $8.84
[BUPPLN] Pln Rv 5/30/2007 $71.83
Total $191.17
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 Signature: 6f).- C.ec.Ti-..---
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.
• i VAlk 1L
4
Building Permit Application FOR OFFICE USE ONLY
City of Tigard
RECEIVED Received .^ n ,
Date/B : � O / Permit No.: • fj --1:50- • s
13125 SW Hall Blvd., Tigard, OR 97223 7 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1 AY 3 0 ZOOt � "`' i '�iti Date/B : OW ��/, Other Permit:
Inspection Line: 503.639.4175 t_ Date Ready/BY: Juris: El See Attached Checklist for
Internet: www.ci.tigard.or.us CITY ciir° i la3A9D Notified/Method: Supplemental Information
BUILD? D!ViSIOR'
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
J Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
dwelling Valuation: $
❑ 1- and 2-family g ®C ommerciaUindustrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i;2. S v...5 5 , W t h'1 i4 , N 9 New dwelling area: square feet
City/State/ZIP: 4 , 04 .. 4 ...p / Oe... , 972_ 2 3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 7 H 5rOAJE () Lj.- _ / f Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: -2 ,$" /0 2_ AZ - O 2_ 2 -00 Indicate the value (rounded labor, to the nearest and dthe profit of all
equipment, materials, labor, overhead, and the profit f for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ A 2 0 D t t.
i�R.c� P o s Ev ALAI/0i � re. �i(v.� OF 1�u4SD/,ci�'
Existing building area: ei qs square feet
New building area: Gt 95 square feet
FL PROPERTY OWNER ❑ TENANT Number of stories: I
7 Name: Type of construction: ze, c x .- y, p 24)i4LG.
Address: Occupancy groups:
City/State/ZIP: Existing: g i4��f� -nJ T ,
\ Phone: ( ) Fax: ( ) New: �6S ( ft) 9i- (gym° A-E 4. I W,
\ A APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Rd 5 6 641,7-y ,4Wios / All contractors and subcontractors are required to be
-� ��_
licensed ORS with the and may Construction Contractors licensed Board
Contact name: L A A
�� ,/ under ORS 701 and may be required to be licensed in the
Address: /6 3 ,g A.) , £1 r CJV N jurisdiction in which work is being performed. If the
City/State/ZIP: ) jOT^, I v,e_ 9 7 20 9 applicant is exempt from licensing, the following reasons
apply: /� /^
Phone: (5Q� 2 .26_ %L / -7 lE J ,) I Fax :: ( z �. 2 � `. 4.0 6 f�
P V `�P/ r
E -mail: U/ LO W . /h ,j e C. / # y Q.G[J /N G . L..0 '1 - 71 S � g�
C
Business name: Q //�� g.
!�� 56 6 4�,01,c15 BUILDING PERMIT FEES*
Address: 14,3 S ,ii i (l r ��� iiJ Please refer to fee schedule.
City/ State/ZIP: Po kr , / Q, Q , 17 2. 0 q kilt)
�) Fees due upon application
Phone: (S03) 2 Z 6 - 2 7N/ Fax: ( 2.2.2 ..— la Vl
CCB lic.: 4 g 6 2 2_ 15 !t 1 Amount received / r�j l. ii
, Date received: 1 t
Authorized signature: This permit application expires if a permit is not obtained
6 within 180 days after it has been accepted as complete.
I Print name: /_ $ ,
. zu_ ,�� 5' Date: _ - 0 — 67 * Fee methodology set by Tri-County Building Industry
/ Service Board.
i:\ Building \Pamits\BUP- PermitApp.doc 12/03 440-4613T(II /02/COM/WEB)