Permit 410 CITY OF T I G A R D BUILDING PERMIT
PERMIT #: BUP2002 -00330
! DEVELOPMENT SERVICES DATE ISSUED: 8/14/02
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DD -00101
SITE ADDRESS: 06975 SW SANDBURG ST
SUBDIVISION: TIME SQUARE ZONING: C -P
BLOCK: LOT: 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: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 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: $ 2,700.00
Remarks: Install new emergency 911 antennas and LMU equipment on rooftop.
Owner: Contractor:
WESTON HOLDING CO LLC BROOKSTONE TELECOM INC
2154 NE BROADWAY 27450 YNEZ RD. #300
PORTLAND, OR 97232 TEMECULA, CA 92591
Phone: Phone: 909 - 694 -4114
Reg #: LIC 00 110380
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
5PCT CTR 7/31/02 $5.77 27200200000
PLCK CTR 7/31/02 $46.87 27200200000
FIRE CTR 7/31/02 $28.84 27200200000
PRMT CTR 7/31/02 $72.09 27200200000
Total $153.57
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe mi ittee
Signature: ��� /
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
I
. . .
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.,
Building Permit Application
OFFICE USE ONLY
' i City of Tigard Date received: 7 g/ Q x,00
. Permit no.: .2-003
Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW HaIli.W ¢l 1. ` D
Phone: (503) 639 -4171 1 � t �/ Date issued: By jbb Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
t i JUL 31 2002
1
I &2 family: Simple Complex:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi- family 0 New construction ❑ Demolition
0 Addition /alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: 4 75 5W Sm v►d kten R.1 Bldg. no.: Suite no.:
Lot: I Block: Subdivision: _ I Tax map /tax lot/account no.:
Project name: Av 14 .. EQI I ( _ \ ) - 3 c) - -
Des tion and location of work on premises /spgcial conditions: InS � I n Clyel .i q 1 1 �c► � 441.4s
cri
UN R. Gttit' DAY ynof.{ .
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: ATy'T Wifeless " 1c S (Floodplain, septic capacity, solar, etc.)
Mailing address: (pi 7 5 ,01 f- ( 0 , 1 & 2 family dwelling:
4:3 City: 6e0444„ {State: IZIP: tg1 Di Valuation of work $ —
Phone: IFax: IE -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
•
APPLICANT Garage /carport area (sq. ft.)
Name: li QS eguatradve Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.) ri
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial /multi- family: oo
Ca
CONTRACTOR Valuation of work $ 2700 "` r
•
Business name: fay e, Teieep I rte.,. Existing bldg. area (sq. ft.) v
Address: 9. 0. 80x, wu, New bldg. area (sq. ft.) o
C ity : rtwe,(a ct. State: CA ZIP: 12‘61, Number of stories .t
Phone: I Fax: I E -mail: Type of construction 4 -
O Occupancy group(s): Existing: t
CCB no.: �L -!�(o New: a
City/metro lie. no.:
( (6 3 0 it Notice: All contractors and subcontractors are required to be d
ARCEIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
S , Name: (4.g provisions of ORS 701 and may be required to be licensed in the
.r. Address: (I I OW Co(yl,Ngb j q jurisdiction where work is being performed. If the applicant is
b City: State: e .. I ZIP: 4172.01 exempt from licensing, the following reason applies:
Contact person: aryl 9tOWY Plan no.:
Phone:03 2,22 iaoo Fax: 2,7,2 - 2f E -mail: P,.
ENGINEER OFFICE USE ONLY y
1122111 , Contact person: Fees due upon application $ 1$3.57* ?'
Address: Date received:
City: IState: IZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All ovisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied " h, wh r specified herein or not Credit card number: / /
Expires
Authorized signature: Date: 7 1 0 Name of cardholder as shown on credit card
Print name: Reb CC4 IWr / I kelt f $
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00 /Cotta)
r
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:, (503) 639 -4175 •
(az
INSPECTION DIVISION Business Line: (503) 639-4171 _ �� �
P
Received Date Reque ed /4) AM PM BUP
Location �i / ✓I .' Suite MEC
Contact Person 9 Ph ) /c — SD 3 — PLM
Contractor Ph ( ) / 76 d SWR
BUILDING Tenant/Owner /7 f r w )?-r Le SS ELC
Footing ELC
Foundation n Access:
Ft �j ,
Crawl Drain s ' / /� � ELR
Slab • • - Notes: "1 0 0 SIT
Post & Beam PAAVit-
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm I
R Ceiling
Roof °�
O r:8-hun
S PART FAIL
PL MBING
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 J �/ 6 7j
Approach/Sidewalk Date 9/ I i LC Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL