Permit 1
CITY OF T I GA R D BUILDING PERMIT
Ai
PERMIT #: BUP2002 -00460
lsi DEVELOPMENT SERVICES DATE ISSUED: 10/23/02
- t�- I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11636 SW PACIFIC HWY PARCEL: 1S136D6 -02500
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: � FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: .B' f ' � FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2N : sf N: S: E: W:
OCCUPANCY GRP: NONE TOTAL AREA: 0.00 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: $ 770.00
Remarks: Installation of awning over entrance door.
Owner: Contractor:
NACHTIGAL, FRED C SUC PERS REP GRAPHIC AWNING + SIGN
KESSLER, JULES E PO BOX 301038
101 SW WASHINGTON ST PORTLAND, OR 97294
HILLSBORO, OR 97123
Phone: 256 -3938
Phone: 256 -3938
Reg #: MET 2726
FEES LIC REQUIRE 8g D INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 10/17/02 $62.50
[TAX] 8% State Tax 10/17/02 $5.00
[BUPPLN] Pin Rv 10/17/02 $40.63
[FLS] FLS Pln Rv 10/17/02 $25.00
Total $133.13
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 y follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin (503) 246- 6699T;r 1- 800 - 332 -2344.
C /
Issue y: k ......_ � )
Permittee ..A_____ •
Signature: •
Call 639 -4175 b 7 . for
r p"" -----
an inspection the next business day
�, r
Building Permit Application
:ii City of Tigard received: /0A70,- Permit no.. j ���; , y , 0
°= Project/appl. no.: Expir= date: i
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: B I ,I Receipt no.: ` j
Fax: (503) 598 -1960 Case file no.: Payment type: 0
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory l{.Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
fr
Job address: 1 163 (o S , W _ r4 4.412(4 Y-.1 u✓ Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: 5 TIN tZ(a:bOC C'S co 12 at,
Description and location of work on premises/special conditions: !?J T C 4i r ) M rnf 4 O j M.A. C AO 02.-
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
(Floodplain, septic capacity, solar, etc.)
Mailing address: D / A A . , io / ( 7 ' 1& 2 family dwelling:
13757M Ee' Stat& ZIP: — AM 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: C-7 2.M' -i t✓ a4caJtI r i- S I &n,/ 6 i ' ^ ' I Covered porch area (sq. ft.)
Mailing address: •, V- 1.. ON. 3 Di 0 3 8 Deck area (sq. ft.)
11331MITEEMIMINI State: ZIP: 6 ) 7 Z9 Other structure area (sq. ft.)
Phone: z54 3 IMEE13ar. E -mail: CommerciallindustriaUmulti- family: 7
CON7.RACCOR Valuation of work $
Business name: /2.444)4 -tC 0./ s / 6 Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.)
Address: "
City: State: ZIP: Number of stories
Phone: Fax: E -mail: Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City /metro lic. no.: 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: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.: .
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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 0 MasterCard
work will be complied with ether specified herein or not.. Credit card number: Expires
Authorized signature: Date: IQ/ /'1 4 2. Name of cardholder as shown on credit card
• Print name: X51.7 /I w Ua $
Car dholder 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 (domcoM)
A
_o
•
Commercial Plan Submittal
.411 Requirement Matrix
City of Tigard ,
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
• Site Work 4
(must include location of all accessible parking)
Plumbing Site Utilities 2
Building 1* _
Fire Protection System **
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:\dsts \forms \COM- matrix.doc 9124101
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 //
BUP ci6 o
Received Date Requested 461 AM PM BUP
Location 1/ Suite p � MEC
Contact Person Ph ( ) o�.�(D 3 9 30 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
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 -
yr:
tre ' S. PART FAIL
LU 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 r nspection RE: ; El Unable to inspect — no access
Fire Supply Line
ADA D / I Ext
Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL