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Permit ._ ..;._ C ITY OF TIGARD BUILDING PERMIT #: BP2004 DEVELOPMENT SERVICES DATE ISSU 6/18 2004 ,iii--,iii - 13125 SW Hall Blvd.. Tigard, O R 97223 (503) 639 -4171 SITE ADDRESS: 13815 SW PACIFIC HWY 60 PARCEL: 2S103DD -00800 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: 5N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 8 BASEMENT: sf AREA SEP. RATED: STOR: 1 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: $ 4,800.00 Remarks: TI, create new walls. Owner: Contractor: D.W. SIVERS COMPANY DW SIVERS CO 4730 SW MACADAM AVE 4730 SW MACADAM AVE SUITE 101 #101 PORTLAND, OR 97239 PORTLAND„ OR 97201 one: Phone: 503 - 223 -2680 Reg #: LIC 102469 ° FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 6/18/2004 $91.30 Electrical Permit Required TAX 8% S tate Surchar 6/18/2004 $7.30 Plumbing Permit Required [TAX] � Framing Insp [BUPPLN] Pin Rv 6/18/2004 $59.35 Gyp Board Insp [FLS] FLS Pin Rv 6/18/2004 $36.52 Final Inspection Total $194.47 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -00 • • .u. h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by callin 03) 246 -669 • qr 1 -800 332 -2# Issu d B __ ' / S Permute Signature: �� 94 ly 7 p.m. for an inspection the next business day Building Permit Application FOR OFFICE USE ONLY City of Tigard N ED' Re eiv / 0 �t: u 1 ,00 ODd�$�O 13125 SW Hall Blvd., Tigard, OI�'91 �j Plan Review Phone: 503.639.4171 Fax: 503.9 0 o,,' ;;yjl Date/B : OtherPemdt: Inspection Line: 503.639.4175 `� li,(1� F . - Date Ready/By: I ® See Attached Checklist for Internet: www.ci.tigard.or.us 1JIJ Notified/Method: lab Supplemental Information pap M OF �IC� j REQUIRED DATA 1 =•AND 2- FAMILY DWELLING �� Pe rmit fees are based on the value of the work performed. ❑ New construction 0 p Indicate the value (rounded to the nearest dollar) of all . Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the . CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling , commercialJindustria1 Valua ❑ Accessory building - ❑ 'Multi- family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: i 3 5 tq4 PiCif f i (j kkoy. New dwelling area: square feet City/State/ZIP: 77442C) OR , �/. .4. Garage/carport area: square feet Suite/bldg. /apt. no.: (pc Project name ! CI P . Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA COMMERCIAL -USE CHECKLIST.;,' Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK - work indicated on this application. / POW e% F'IYI. ` aeV}" elle7 priu3k. 'I � Valuation: $ / O TD PM 1W21-€ Existing building area: /A5-/ square feet New building area: square feet 74 PROPERTY OWNER ❑TENANT ° . Number of stories: Name: VW �� do Type of construction: Address: 47a,, ai be)/ Occupancy groups: City / State/ZIP: F3A e2 ® f 2 Existing: ' Phone: ( • ) Fax: ( ) /j, New: (./ APPLICANT . ❑ CONTACT PERSON ; ; ' NOTICE Business name: 1)1 ►J Etpi�� ike f1- f p t.. All contractors and subcontractors are required to be Contact name: Y� A ! licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 71 "'� tJ A /7E zco jurisdiction in which work is being performed. If the /C)j� q7 applicant is exempt from licensing, the following reasons City/ State/ZIP: `/, ! /9 apply: Phone: (l 3) 2� g q-7 j 3 4 7 Fax: ( z� ° 5 721 E -mail: // �� • CONTRACTOR - Business name: i7vki � �j � ` ft ` � W ' A V / 0 ( BUILAING to f e e sFEES* c Address: I l� . Please refer ro fee sc City/ State/ZIP: ?1 1 2 D� R 7 ��"r7 G� Fees due upon application Phone: � ,`� �) ,Zz...ZF�p0 Fax: � `0 5.4 CCB lie.: /Q �.�.6 y /40/17/01-1 Amount received Date received: Authorized signature: // , „ ,ht C This permit application expires if a permit is not obtained !�� \ within 180 days after it has been accepted as complete. � � Print name: ; A ` , Date: /� \ / � � * Fee methodology set by Tri-County Building Industry Service Board. i:\ Building \PermitABUP•PermitApp.doc 12/03 440.4613T(1I/02/COM/WEB) Building Division -- / � � j 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 \Forms \COM- PlanSubReq.doc 12/24/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP 40 — 4U 3 Received Date Requested '- AM ✓ PM BUP Location / 3 z5 1 Suite 6 MEC Contact Person 1 Ph ( ) - 2g9 - (0/ 77 PLM Contractor Ph ) SWR BUILDING Tenant/Owner c2 _tf l £ (J ELC Footing ELC Foundation Access: Ftg Drain / k � " ELR Crawl Drain Slab Inspection Notes: SIT Post Beam ( \__� Shear r Anchors � !''V C/ pLe/e Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing tat Firewall Fire Sprinkler 1011. Fire Alarm Susp'd Ceiling Roof Other: OF' S S PART FAIL • RING 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 I Rough -In I`�l,,I1�'-�OM_ 4��i. UG/Slab 'W _ Amy - 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 reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP x0 ooa 8‘ Received Date Requested 7- AM PM BUP Location / 3 /s Suite 67 0 MEC Contact Person Ph ( ) /7 89 -Col 71 d ip a 7O / ej x-77 Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain r /� ELR Crawl Drain l Slab Inspection Notes: SIT Post & Beam Shear Anchors t, Ext Sheath/Shear / /.ire // .44144 - Int Sheath/Shear Framing / Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final P ASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Oh = r: of PART FAIL HANICAL 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 reinspection RE: El Unable to inspect — no access Fire Supply Line Z 177<, ADA Approach/Sidewalk Date Inspector Ext _ Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL