Permit 3
JM 0
' '� CITY OF TIGARD BUILDING PERMIT
A � PERMIT #: BUP2003 -00037
al DEVELOPMENT SERVICES DATE ISSUED: 1/21/03
l - II 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 14800 SW SEQUOIA PKWY PARCEL: 2S112AD -00900
SUBDIVISION: ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM 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 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:
Remarks: Demolition: Slab on grade, existing soffit, store front and structural columns.
All debris to be removed.
Owner: Contractor:
HOME DEPOT USA INC FERGUSON CONSTRUCTION
370 CORPORATE DRIVE 7433 5TH AVE. S.
TUKWILA, WA 98188 SEATTLE, WA 98108
Phone: 1- 206 - 574 -3567
Phone: 206 - 767 -3810
Reg #: LIC 91351
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 1/21/03 $62.50
[TAX] 8% State Tax 1/21/03 $5.00
[ERPRMT] Erosion 1/21/03 $26.00
[ERPLN] Ero Plck -USA 1/21/03 $8.45
(additional fees not listed here)
Total $110.40
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.
Al e'
Issued By: /d,m , �
Pe mi ittee
Signature:
Call 6 9-4175 by 7 p.m. for an inspection the next business day
V6m 0 FOR OFFICE USE ONLY
Bl - g Permit Application Received �� _ Building
Date/B /By :
I —o & 1 —O Permit No (J� OQ937
Planning Approval Other
City of Tigard Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 639 - 4171 Fax: 503 - 598 - 1960 Ao, � "� F j Post- Review Land Use
e _ I Date/By: Case No.
Internet: www.ci.tigard.or.us '' Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY 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 ❑ 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: , V K w , Total number of floors
/ 4 4S D c S �l S C u o / A New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: // ` Ocpn l mn / cwT.hL C T. Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: S L A-iS o n> t - / Q (kDe. Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIP ON OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
� ''".tir-.2 0 i , r S,O,G CXis sdr -ciT
S i�2E /`Ronr T 5 id2 UrTCf e.g / Co /y ,V;415 Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
O PROPERTY OWNER I ❑ TENANT Type of construction
-1 � J Occupancy group(s): Existing:
-/
Name: � . < ' 6) ? New:
Address:
•
City /State /Zip:
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑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: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
CONTRACTOR
Business Name: /7" ,QGu$ory Cvnr STnQd Fees due upon application $
Address: Aj y 3 3 - 1" /a v/- S'.
SE- _ Amount received $
City/State/Zip:
� T - � - I4111 _ 9110 9
Phone:266 - /76 r, -,3 qi„ I Fax: .2 C , -/ 7 - 7 q ya Date received:
CCB Lic. #: A q' I FS i • k
Authorized 5 -'a-A-9 4) 41 Notice: This permit application expires if a permit is not obtained within
_sygnat r : Date: 180 days after it has been accepted as complete.
/ *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name) j is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 ` / 0 446.
. .
4,040,1# Commercial Plan Submittal
11 Requirement Matrix
City of Tigard
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:\dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3 - 660 37
Received / Date Requ ted , AM PM BUP
Location / 1-J Suite MEC
Contact Person Ph ( . 2 db) ?"5:-S 3 6, 5 3 PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner k w ELC
Footing
Foundation Access: ELC
Ftg Drain 7-7-4 L ev ( 0 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
Other: D.QivA..d
PASS PART FAIL
PLUMBING
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 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / 3
Approach/Sidewalk Date ! Z /P / Inspector / Ext
Other: •
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL