Permit •
A i' crry OF TIGARD PERMIT #N BUP2005 -00572
_L �I(� DEVELOPMENT SERVICES DATE ISSUED: 10/26/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135DD- 05000
SITE ADDRESS: 11975 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: 3' x 25.6' 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: $ 2,000.00
Owner: Contractor:
DORN, FRANK D + RHODAJANE TRS PIKE AWNING CO
do TRENARY, BRYAN W /JUDITH A 7300 SW LANDMARK LN
WEST, ROBERT C PORTLAND, OR 97224
B AVERTON, OR 97007
one: Phone: 503 - 624 -5600
FEES Reg #: LIC 32364
Description Date Amount REQUIRED ITEMS AND REPORTS _
[BUILD] Permit Fee 10/26/200° $62.50
[TAX] 8% State Surchari 10/26/200f $5.00
[BUPPLN] Pln Rv 10/26/200f. $40.63
Total $108.13
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
requir- : you • ollow the rules adopted by the Oregon Utility Notification Center. Th a rules are set forth in OAR
952 -501 -0010 thr• gh OAR • .2- 001 -0100. You may obtain a copy of these rules i ct uestions to OUNC by
cal ng 503-246-669 0332 -2344 A r
Is ued B / Permittee Signature:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit cans 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.
/IP Builduk 3Permit Appli '®' V ED I0I( 0rrlc► ►'SE ONLY •
City of Tigard R�e� Received Permit No: : �, 9 , r
Date/I3 .
of��! !pert 7
13125 SW Hall Blvd., Tigard, OR 97223 c Plan Revie
Phone: 503.639.4171 Fax: 503.598.1% p TO ' /'* l''' ICI Date/B Other Permit:
Inspection Line: 503.639.4175 ' ' - i L : Date Ready/By. F 65 See Attached Checklist for
Internet: www.ci.tigard.or.us V TIGARD Notified/Method: Supplemental Information
or( 0‘
nNIS
pp����J �D1PIG
"1"YP� OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work perform -..
Indicate the value (rounded to the nearest dollar) of all
14 Addition/alteration /replacement ❑ Other: equipment, ma - ' • , labor, overhead, and the prof or the
CATEGORY OF CONSTRUCTION work indicated on application.
El tm
I - and 2- family dwelling . S.Conercial /industrial
Valuation: $ 2-000 / L/
1:1 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: ! l e/7 s l ) Akj lvi C /A-) ' New dwelling area: square feet
City /State/ZIP: 72 64/24() ®r2_- q 7 7.-Z3 Garage /carport . • :: square feet
Suite/bldg. /apt. no.: I Project name: eit C. CA (3J1P Covered porch area: !dare feet
Cross street/directions to job site: Deck area: squ. e 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
,�w,�/1 / 6 . J J Valuation: $ 2 t OO. 0 / �� Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I U"` TENANT Number of stories:
Name: 17,4 vi m scri i74 Type of construction:
Address: J� ` /+SC e [�' 4.s A /� Occupancy groups:
City /State/ZIP: Existing:
Phone: (SUS) S x'7 k Fax: (O 7 9 New:
❑ APPLICANT /21 CONTACT PERSON NOTICE
Business name: Q44. ,,,,,, co p t--'m All contractors and subcontractors are required to be
Contact name: ..1 1/A•-) V0/LEL licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: S A t / ,. , n u "J 1)e . / jurisdiction in which work is being performed. If the
City / State/ZIP: SA [� 7 4 /�� applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E- mail: v/) (. G4‘.C4,0E- C!4 &/ IJG V .
CONTRACTOR
Business name: i c Aw »/ A./4
BUILDING PERMIT FEES
Address: 7300 Ste, 4'4,t/& L,..._) Please refer to fee schedule.
City /State/ZIP: ?yet //) O2 q 7 E-2--q
� Fees due upon application
Phone: .1) Z V- s 6 )�} I Fax: (4-03 p/
) ((�_ _S—V1710 Amount received
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: �.JO i 2 1i I Date: /0 •-7, d� a Fee methodology set by Tri -County Building Industry
Service Board.
i:l Building \Pennits\BUP- TI- PennitApp.doc 12/03 4104613T(11/02/COM/WEB)
. u L A r Building Division
ASV i,k,,Li 1;1,,1, 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\Pcrmit \BUP- TI•PermitApp.doc 12/03 410- 4613T(11 /02/COM/WEB)
CITY TIGARD
BUILDING PERMIT #: BUP2005- 00572
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/26/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/12/2005 TIME: 7:02AM PAGE: 58
SITE ADDRESS: 11975 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CASCADE CABINETS
DESCRIPTION: 3' x 25.6' awning.
OWNER: DORN, FRANK D + RHODAJANE TRS, PHONE #:
CONTRACTOR: PIKE AWNING CO PHONE #: 503 - 6245600
Inspection Request Scheduled For: Date: 12/1212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 023277 -01 503-598 -7428 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r I
Inspector: 1, � ` Date: l ( Phone #: (503) 718-