Permit C ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00163
;�I� DEVELOPMENT SERVICES DATE ISSUED: 5/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DC -03800
SITE ADDRESS: 07190 SW SANDBURG ST 20 ZONING: I -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Addition (new 680 sq.ft. total =3237 sq.ft.) & remodel.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N 0 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 25 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: N MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: N SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 39,980.00
Owner: Contractor:
MCCORMACK, WILLIAM L + DARLENE T PERLO MCCORMICK PACIFIC
7415 FAIRWAY LOOP 7190 SW SANDBURG ST
WILSONVILLE, OR 97070 PORTLAND, OR 97223
Phone: Phone: 503 - 624 -2090
FEES Reg #: LIC 144525
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 4/8/2005 $229.74 Special inspection (see pla
[BUPPLN] Pln Rv 5/18/2005 $27.53
[FLS] FLS Pln Rv 5/18/2005 $158.32
[BUILD] Permit Fee 5/18/2005 $395.80
(additional fees not listed here)
Total $843.05
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 Cent - r. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these - or direct qu -stions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: , ./4 Permittee Signature: L / t _ -;h i _ d _,, —
Call 503-639-4175 by 7:00 a.m. for an inspection that business day.
This permit card 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.
APR -22 -2005 11 :24 ANKROM MOISAN ARCHITECTS 503 245 1035 P.01/02
.�•._ _
winding Permit Application I Y t R l 1 l F I (-• I • : 1 5 1 ' . ( ) N I A
City of Tigard
' "`� — , peenit No.. ,,
Datehl 13125 SW Hall Blvd., Tigard, OR 97223 Plaq Revie / J
Phone: 503.659.4171 Fax 503.598.1960 ,,;,, .� � itl 07 .4 . '� — /J O rPermit: .GC.
Inspection 503.639.4175 Line: 503.6394175 � I Dale Ready/By: � / Jvtlt: See Attached Checkl{sl for
Internet: www.ci.tiiganior.us Notiried/Method j of y -0, � , 2 -- ) Fl ri
Supplemental Information
Y d X t, `H' J\ . _
r ' TYPE OF wok REQUIRED TA: I- AND 2- FAMILY DWELLING
❑ construction El Demolition , ' Permit fees* are cd on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement ❑ Other: equipment, mat als, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated this application.
Valuation: I $ 4960
❑ 1- and 2- family dwelling mmercial/industrial t
❑ Accessory building ❑ Multi - family Number of ooms: o `V
❑ Master builder ❑ Other: Number of b ootns: V p u
JOB SITE INFORMATION AND LOCATION ,s eiggir Total number floors: \\,,
lob site address: 1l") / el l_ • . New dwelling • \N, 3 square feet
City/State/Z P: �T' I .. ‘7102,. Garage carport area: square fat
Snire/bldgJapt. no.: Project same: Covered porch area: square feet
Cross au /directions to job site: /2 et 4 Deck area: square feet
Other structure area: square feet
REQUIRED DA A: COMMERCIA IXBE CHECKLIST
Subdivision: • 1 Lot no.: Permit fees* are ased on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.: equipment, mater als, labor, overhead, and the profit for the
• DESCRIPTION OF � WO> • ' work indicated o this application. e�
�R1 t�•l > � . Valuation: s 3 7, —
/ ifr(dr u. - Existing building area: 3 3 y 3 square feet —
�'[ ` 'L-Y New building urea: square feet
,TI PROPERTY OWNER 0 TENANT ' Number of stories: I
Name:. I A. _ Type of tons don:
Address: iigeo ,r.‘19 _ • ` 1 I a `- Occupancy .s: well O ' S
ry
Ci /StaterLlP. C • a . A �, [' ` / � � Eastinic
Phone: tri��j - • P- Q.0 Fax: ( - ' M New:
-
( APPLICANT ' 0 .CONTACT PERSON • • NOTICE
. -
Business name: v a ge Wide � � 1 c, All contractors subcontractors are required to be
Contact name: '-' l , YY� ^ licensed with the egon Construction Contractors Board
Y O. under ORS 701 aid may be required to be licensed in the
Address: rirt "u u ♦ ty k jurisdiction in w1 ch work is being performed. If the
City/State/21P: "�`•�'� applicant is exempt from licensing, the following reasons
Phone: �1IAG��" �lpp f F ax:: (fit /� ••7) apply:
E-mail: C Cl io & ` ate. MI&
. ',1 •
CONTRACTOR
Business name: nblvoikr - BUILDING PERMIT FEES'
Address:
P:ease refer to fee''schedule.
City/State/LIP:
Phone: ( ) I Fax: ( ) Fees due upon application
CCB tic.: Amount received)
' Dat e received: Authorized signature: TLis penult app ration Empires if a permit k not obtsined
� within 180 ater it has been accepted as complete.
Punt name: ill � � ' Date: • Fee mcthodolo set by Tri -County Building Industry
Service Board.
t: ltuIw+ngTPamnaUavr- r•nivnp,.dm lams 440.613T(11/02/cOMIWEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00163
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/18/2005
Phone: (503) 639 -4171 01 11I
Inspection Requests (24 Hrs.): (503) 639 -4175 °:
INSPECTION WORKSHEET FOR DATE: 8/29/2005 TIME: 7:13AM PAGE: 37
SITE ADDRESS: 07190 SW SANDBURG ST 20 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MCCORMACK BUILDING
DESCRIPTION: Addition (new 680 sq.ft. total =3237 sq.ft.) & remodel.
OWNER: MCCORMACK, WILLIAM L + DARLENE T, PHONE #:
CONTRACTOR: PERLO MCCORMICK PACIFIC PHONE #: 503-624-2090
Inspection Request Scheduled For: Date: 8/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 014485-01 503- 706 -6042 Y
Corrections /Comments/ Instructions:
GUISE.
TPu=-- vo e =31 McCsr2wur 'i-
F /
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• ❑ FAIL CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector:
OW 65
#: (503) 718 - - g? p ctor: Date: Ph ( )