Permit • •
A ;,�w � BUILDING PERMIT I
CITY OF F T I G A R D PERMIT #: BUP2003 -00415
1� rAr DEVELOPMENT SERVICES DATE ISSUED: 8/1/03
,.� � 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 13165 SW PACIFIC HWY PARCEL: 2S102CB -00303
SUBDIVISION: NORTH TIGARDVILLE ADDITION - ZONING: C -G
BLOCK: - LOT: 033 JURISDICTION: TIG •
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 2,836 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 2,836 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 98 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: $ 30,000.00
Remarks: Tenant Improvement •
Owner: Contractor:
•
POORMAN, JOHN AND MARTHA BNK CONSTRUCTION INC
14243 NW EVERGREEN ST 10730 SE HWY 212 ,
PORTLAND, OR 97229 PO BOX 66
CLACKAMAS, OR 97015 .
Phone:
Phone: 557 -1085 FAX
. Reg #: 5866 00
FEES LIC REQ U IRE DS INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUPPLN] Pln Rv 7/8/03 $208.52 • Electrical Permit Required
[FLS] FLS Pln Rv 7/8/03 $128.32 Plumbing Permit Required
BUILD Permit Fee 8/1 /03 $ 320.00 Framing Insp
[BUILD] Gyp Board Insp
[TAX] 8% State Tax 8/1/03 $25.66 Final Inspection
Total $682.50
•
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: W 40, .441. /
Pemtittee
Signature: • .
Call 639 -4175 by 7 p.m. for an inspection the next business day
1316( fN PAG /f// fllW`'
',j Bn id 61 Perm A pp li ca ti on Received FOR OFFICE USE ONLY
Building �;
���
Date/B : 1 p p 07 e ,, Permit No. & _,. - ov -07! ,1-�
CA
City of Tigard Planning Approval ' Other
Date/B : Permit No.:
13125 SW Hall Blvd. Plan Review c Other
Tigard, Oregon 97223 Date/B : Z ' 1.7� 1 Permit i
Phone: 503- 639 -4171 Fax: 503 -598 -1960 - - ^ i " � '1 °t- � Date/B : Case No. Post - Review Land Use
-1ii
Internet: www.ci.tigard.or.us Contact Juris.: N See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name /Method: Su , dementalinformation
TYPE OF WORK REQUIRE D ATA:
❑ New construction ❑ Demolition 1 & 2 FA DWELLING
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling g 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: 3 / /,, PI - Total number of floors
! (!/ � New dwelling area (sq. ft.)
Suite #: I Bld ./ t. #: Garage /carport area (sq. ft.)
Project Name: k W / l/V rj (wJv' Covered porch area (sq. ft.)
Cross street/Direction1 to job ite: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED HATA:` '
COMMERCIAL - USE CHECKLIST '
Subdivision: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DES RIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
T -I I. f Id 40J:Ad`'IV — AA;L t1
M ' " Valuation $ a eke
Existing building area (sq. ft.) _ /` .
New building area (sq. ft.)
•
Number of stories I
la ;PROPERTY OWNER . I ❑ TENANT • Type of construction VN
Name: Occupancy group(s): Existing: g,
New:
Address:
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
P
P APPLICANT I 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:T/3S%S jurisdiction where work is being performed. If the applicant is exempt
Contact Name: / �� from licensing, the following reason applies:
Address: 111 o : he
Business Name:T/3) 4 ` -1q� 6 e — 9 7_1
Phone: d 3s—b 2,4F Fax: 54!o - s
' BUILDING PERMIT FEES*
E-mail: Please refer to fee schedule.
CONTRACTOR
Business Name: 00 l 1I V & rft,,,) Fees due upon application . $
Address: 1 6773 llZiJ a ia.
City /State /Zip: ( /�t .( L if S l �/ c) 7 61 Amount received $
Phone: 7._C lax: ,','7-- Date received:
CCB Lic. #: 6 Q 7
Authorized / / ' ] Q Notice: This permit application expires if a permit is not obtained within
Signature: / i _ / D)e: / 13
180 days after it has been accepted as complete.
■ � , - 1 7 teizeJ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) S PL.. IV
is \Dsts\Permit Forms\B1dgPermitApp.doc 01/03 :10 - FL C
t V J
, t
,
,� Plan Submittal Requirement Matrix
. � l Commercial & Multi- Family
City of Tigard New, Additions or Alterations
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 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 \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
CD — 004/ 5
2
Received Date Requeste . - Z AM PM BUP
Location / y Suite MEC
Contact Person Ph (J ) ��� D 23 PLM
Contractor In K CPi1 - 5 h ( ) SWR
= UILDING Tenant/Owner /I- o�—rry ELC
.. •
Foundation ELC
Fog Drain Access: L o 6- `( 6 A.v S. 4d , 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
• .
PART FAIL
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 D Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line /
ADA Approach/Sidewalk Date 9/z z / �` Inspector Ext
Other: -
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL