Permit , •
CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00288
���;* DEVELOPMENT SERVICES DATE ISSUED: 7/9/2004
sa1 ''�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11507 SW PACIFIC HY D PARCEL: 1S136AD -04000
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SUBDIVISION: VILLA RIDGE ZONING: C -G
BLOCK: LOT: 007 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 23 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: $ 16,500.00
Remarks: TI ADA restroom and office (in both suites C and D).
Owner: Contractor:
SMITH, EDITA M ROBERT TODD CONSTRUCTION INC
833 NW 170TH DR 4080 SE INTERNATIONAL WAY #D -1
BEAVERTON, OR 97006 MILWAUKIE, OR 97222
Phone:
Phone: 653 -5704
Reg #: LIC 98517
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 6/21/2004 $134.23 Electrical Permit Required
[FLS] FLS Pln Rv 6/21/2004 $82.60
Plumbing Permit Required
BUILD Permit Fee 7/9/2004 $206.50 Framing Insp
[BUILD] Gyp Board Insp
[TAX] 8% State Surchari 7/9/2004 $16.52 Final Inspection
Total $439.85
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: Allgat_,,, /
Perm ittee .`,�
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
15 sW MC fiwy NED
Building Pef mit Applic I o FOR OFFICE USE ONLY
City of Tigard - , , 200 R a 1 o q B8 Permit No. 2 0:1? ).®'V// g1
13125 SW Mall Blvd., Tigard, OR 97223 ' �
Phone: 503.639.4171 Fax: 503.598.1960 F TIGAF 2• P lan B /else Other Permit:
C� i Y T v e.,, X1 I� _ V
Inspection Line: 503.639.4175 � r'I I' L. Date/By: Date Rea By: ® See Attached Checklist for
w
Internet: ww.ci.tigard.or.us BUILDING Notified/Method: ti / Supplemental Information
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
®'Additio ]teratio eplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ) ommercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other Number of bathrooms:
JOB SITE INFO TION AND OCATION - - Total number of floors:
Job site address: //� 7 <4/ p m f L L , 2 7 ) . New dwelling area: square feet
City/ State/ZIP: // �r O/_ y Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: : -/i '71-",77-c.- Covered porch area: square feet
Cross street/directions to job site: / � t 1'71-",77-c.-
aeArr Deck area: square feet
Other structure area: square feet
• REQUIRED DATA: COMMERCIAL -USE CHECKLIST.`•
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. /
,, /��
� � V a ���t.` 1�� t Valuation: $ / `�"—
Existing building area: square feet
New building area: square feet
M PROPERTY OWNER , . 1 . • ❑ TENANT. Number of stories:
ii, o Name: 6//7 I' (l y&v- -r Type of construction: V
Address. 6 r Z� M / / -/ %d fad Occupancy groups:
City/State/ZIP: y l.�
/Z- Existing:
(..co Phone: 03) 3 -3 /7 / Fax: u-p J ) , E9- 2 / 3 5 New:
(11 . . ' ' ■,W ❑ CONTACT PERSON
I
Business name: `' / , All contractors and subcontractors are required to be
riN Contact name: K c) ?t7f— /C licensed with the Oregon Construction Contractors Board
// �` / / under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZIP tact : applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:`: ( )
13q•
E -mail: Q� U
CONTRACTOR �•
•�
0 4
Business name: � ( / BUILDING PERMIT FEES*
Address: '616 D ! iyt 2 iJ/4 y ' /3 - //
Please refer to fee schedule •
City/State/ZIP: /:1441-076c... 972" 1`) � Fees due upon application
Phone: (23) 570V Fax: (S9 e .-3 - $ 72 , f
CCB lic.: ?��/ Amount received
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: e/, ` I • Allr Date: hi/91 • Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\BUP- PennitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
Building Division
7 /I� j Plan Submittal Requirement Matrix
� =--' Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(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.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
4i 'N) .2
k, - ''' CYO .1/4 .
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Building tv '9] p
���, ' rlll`�,\ Accessibility: Barrier Re 1\ rovement Plan
City of Tigard
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities
unless such alterations are disproportionate to the overall alterations in terms of cost and
scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ ( .
MULTIPLIER (25% barrier removal requirement): x .25
c7 %' .
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ q t I z$
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
(a) Parking $
(b) An accessible entrance: 0 lv $
v
(c) An accessible route to the altered area: 0 $
( At least one accessible restroom for each sex or a single unisex - ��
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
i:\ Building \Forms\AccessImprvPlan.doc 11/25/03
CITY OF TIGARD 24 -Hour
BUILDING; Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP�de q od z g�
Received Date Requested 7 _a AM VPM BUP
Location // . C 7 � Suite C — D MEC
Contact Person A -A Ph ( - 5 / D / PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner i ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
0..r:
( PASS PART FAIL
N• 1.11 =ING • • /
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 ��•� / , d�:■ r
Low Voltage ankiMai E araWrIP
Fire Alarm
miff
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 Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL