Permit . • . . BUILDING PERMIT
A CITY OF TIGARD PERMIT #: BUP2003 - 00156
0r � DEVELOPMENT SERVICES DATE.ISSUED: 4/22/03
--- r�l l� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
1 SITE ADDRESS: 11860 SW PACIFIC HWY PARCEL: 2S101BB -00400
SUBDIVISION: ZONING: C -G
BLOCK: LOT: 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: UNK : 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: $ 5,400.00
Remarks: Replace material on awning.
Owner: Contractor:
SPIEKER PROPERTIES LP SECURITY SIGNS INC
4380 SW MACADAM AVE STE 100 436 SE 12TH AVE
PORTLAND, OR 97201 PORTLAND, OR 97214
Phone:
Phone: 232 -4172
Reg #: LIC 122809
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 4/2/03 $100.90
[TAX] 8% State Tax 4/2/03 $8.07
[BUPPLN] Pln Rv 4/2/03 $65.59
[FLS] FLS Pln Rv 4/2/03 $40.36
Total $214.92
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: d aZ 4'/A J b
Pe rm ittee
Signature: ill GHQ _L (0,Q e � y u
Ca 639 -4175 by 7 p.m. for an inspection the next business day
11866 SP ) P �ci F/ c -- ft
Building Perms t Application- FOR OFFICE USE ONLY
♦� R eceived Q Building •
Date/By -3 ' Permit NADU ?.2003 ^ 0 01 ,
• ity o Tigard Planning Approval Other
I Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review 4 O ther
Tigard, Oregon 97223 Date/By: q--is-0/05 Permi No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 D - 030 1 11 itis Post - Review Land Use
Internet: www.ci.tigard.or.us � - Date/By: Case No.
Juris.: ®See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF ONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: I 1 Svs( ?psC,tioic tr iiorr• Total number of floors
New dwelling area (sq. ft.) •
Suite #: I Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: 1 � t. , C..0= V« —E..1— Covered porch area (sq. ft.) _
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WO L ULL 5, /Ae the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
OIC *v"( 01142 4 I AL gegI.1 Cak
A- A- 'r'rps.G1 () t s C c - - S i cc Ci e.1-1 Valuation
$ 5/ 7'
Existing building area (sq. ft.)
P,W /ll 1, IL. (CJ. IM AT a441L New building area (sq. ft.)
Number of stories /
❑ PROPERTY OWNER l Type of construction
Name: "(ZOSS C;%/.c) c__AE%r Occupancy group(s): Existing:
New:
Address: i i 43Cc[ Sy.) Q et,(F 1- 6.eff, _
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: I Fax:
E -mail: BUILDING PERMIT FEES*
Please refer to fee schedule.
CONTRACTOR
Business Name: G C.CXL ITY ' /[ ( $ Fees due upon application $
Address: L{3 ( S l2 . ...
City /State /Zip: 'P,,,- . de ow 2 /(4 Amount received $
Phone: z 4 r't; I Fax: 2:3c, t So j Date received:
CCB Lic. #: 122
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: _C�-` , ^ Date: Li 12 ' 3 180 days after it has been accepted as complete.
air �I' (i #.4 '562.44.0 *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) (t U
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 ( l . SG Itc3(
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C Plan Submittal
� a�i�'! 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)
- � L . . 1, . ,
Plumbing - Site Utilities 2
Building 1*
Fire Protection System
Mechanical 2
Plumbing - Building Fixtures 2
1 i .
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 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business' Line: (503) 639 -4171 MST
l L BUP 3 -06
Received O Date Reque ted — a% AM PM* BUP
Location d Suite MEC
Contact Person Ph ( ) Lit PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ (_4 ELC
Footing
ELC
Foundation
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 r-
Fire Alarm 6 -e v /t. r . L
Susp'd Ceiling
Roof 0 L Le' ( X i S r/ a t4//t-e / wr— , G�
/ -
PASS PART FAIL
PLUMBING
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 4- /7 z y U 3 Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL