Permit ..r -(r
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00162
4 DEVELOPMENT SERVICES DATE ISSUED: 5/16/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11875 SW PACIFIC HWY PARCEL: 1S135DD -00900
SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING: C -G
BLOCK: LOT: 021 JURISDICTION: TIG
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: $ 14,000.00
Remarks: Installation of (2) canopies.
Owner: Contractor:
LEFEVER, GEORGE & TAMMY ACME CANVAS PRODUCTS
11875 SW PACIFIC HWY MIKE CROSS
TIGARD, OR 97223 9116 SW 51ST .
PORTLAND, OR 97219
Phone:
Phone: 245 -8771
Reg #: LIC 88019
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[FLS] FLS Pln Rv 4/4/03 $71.08 Structural welding final reps
[BUPPLN] Pln Rv 4/4/03 $115.51 Final Inspection
[BUILD] Permit Fee 5/16/03 $177.70
[TAX] 8% State Tax 5/16/03 $14.22
Total $378.51
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: 4a1/412.,a_ 6
Pe nn it tee
Signature: ` . 40 . :19 „A 1����
639 , • by 7 p.m. for an inspection the next business day
. // 8 S sW .p ip,c wv
Building Permit Application FOR OFFICE USE ONLY
Received ' / s� Building c
Date/By: 4 / J D 7 Permit N o.: P ✓ - GQ�2
\ City of Ti and Planning Appr val Other r
Y g Date/By. Permit No.: SID
13125 SW Hall Blvd. Plan Revie�y' 1_�3 �Cj Other
Tigard, Oregon 97223 Date/By: if 'GI /!�v Permit No.: 0
Phone: 503 - 639 -4171 Fax: 503- 598 -1960 rd., .iV Post - Review Land Use 0
Internet: www.ci.tigard.or.us 61... I Date/By: Case No. Contact �ii ® See Page 2 for 1`
c
24 - hour Inspection Request: 503 639 - 4175 Name/Method: - (/ ( Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
7
® Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ l & 2- Family dwelling EM 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: /- /e 77' ,04chqb/40 l-Z Total number of floors
New dwelling area (sq. ft.)
Suite #: Bld ' . /Apt. #: Garage /carport area (sq. ft.)
:71.606400)2L,
Project Name: /l422)77(16- � ' Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
1�.� , C-0-1V EA — 0 -r /- /1-CC S`Yk f,ce3 /� Other structure area (sq. ft.)
99 (A) (AAc-e «' / . c>Y9 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 WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
r-4, 17 cep. , i "r--1c(- 5 .- 7 - 4-1- , (- ,- /t_GOAc - '/ Qo
1-t C. C1 Nt Ai IMD S / &A Valuation $ /`i 0C29. Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY NANT Type of construction
Name:
Address: OWNER TE
/I// � E � Occupancy group(s): Existing:
�� � N^ 1701-C- New:
o--1 �� 5 � fd"v
City /State /Zip: -r /fr ilplA tog. 9 yy,3
Phone: (434(-0-1/ C7 Fax: NOTICE: All contractors and subcontractors are required to be
❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
❑ APPLICANT
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:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
�
, CONTRACTOR
Business Name: c-1 fi Jt a-Cd/ er, Fees due upon application $
Address: / q soy S• cc] se•/l44 i - r7
«' City /State /Zip: - ft 6 4-d-1 / e' . g7j,. Amount received $
one: S 37.5V I Fax: 90 - -3) 33 Date received:
CCB Lic. #: 080/ �/ l.P - r4/ -o�
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: / � r.,,, r.,,, Date: 2/-4-03 180 days after it has been accepted as complete.
/ / lc 6. Cif-065 *Fee methodology set by Tri- County Bu' ing Industry Service Board.
(Please print name) - 70,�P 1 t 5 .57 51 is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 FL-5 7 1 • og 18�•p
_ r ,.
•
Commercial Plan Submittal
- e �! Requirement Matrix •
City of Tigard
TYPE OF SUBMITTAL # of - - ns
(I ludes New, Additions or Alterations) R- . uired at
ubmittal
Site W ` ° 4 '
(� J (must include locat : of all accessible parking)
V � .
- Plumbing - Site Utiliti- , 2
C) Building 1*
'‘, , Fire Protection System , . , ' 3 **
•
Mechanical 2
Plumbing - Building Fi es 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.
is \dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST
INSPECTION DIVISION Business Line: (503) 639 -4171 ,
Received . Dale Requested — , AM PM BUP
Location / / g 73 Suite MEC
Contact Person Ph ( ) 4 D -7 7/ PLM
Contractor Ph SWR
UILDIN Tenant/Owner T 1 L4 --lcr ELC
ELC
Foundation • - r-
Ftg Drain 3-00 c ?- ELR
Crawl Drain
Slab Inspecti • • otes: SIT -
Post & Beam --- - -'- -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ■ i�0/,
Insulation ,�A )
Drywall Nailing U _ —
Firewall i_ —_ Arri
Fire Sprinkler 1� w ���
Fire Alarm �� � —
Susp'd Ceiling ��� ��
Roof AT4WALM4A' ° J- Other: . �r�
. .;,_¢'► PART FAIL 1Wallia7M.147,
RING Post & Beam 1
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 rei spection RE: ❑ Unable to inspect - no access
Fire Supply Line .
ADA
Approach/Sidewalk Date - Inspector Ext
Other:
Final DO OT REMOVE this Inspection record from the Job site.
PASS PART FAIL