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Permit I , • CITY OF TIGARD PERMIT PERMIT #: BUP2002 -00336 il � DEVELOPMENT SERVICES DATE ISSUED: 8/1/02 e 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135BD -01200 SITE ADDRESS: 09802 SW SHADY LN 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: : sf N: S: E: W: OCCUPANCY GRP: B • TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 11 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: 41 I7/ 000.00 Remarks: TI Owner: Contractor: FORBES, DONALD CAROLYN MARK HEMMINGSON CONSTRUCTION BURDICK, DONALD LINDA 6775 SW 111TH AVE, SUITE 200 434 RIDGEWAY RD PO BOX 1552 LAKE OSWEGO, OR 97034 BEAVE TON.. Ol 8 9 9 7075 Reg #: LIC 110660 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Framing Insp PRMT CTR 8/1/02 $206.50 27200200000 Gyp Board Insp Final Inspection 5PCT CTR 8/1/02 $16.52 27200200000 PLCK CTR 8/1/02 $134.23 27200200000 FIRE CTR 8/1/02 $82.60 27200200000 Total $439.85 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 -00 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -66 or 1 -800 33 - 344. Pe rm ittee Signature: / Issued By: / a - .G /gL�i/___) Call 639 -4175 by 7 p.m. for an inspection the next business day • Build Permit Application ih,� Datereceived: 40 `} Permit no '4t �i 4 J ° x-0411 City of Tigard °= Project/appl. no.: ire date: CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: ,� I Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: 1 &2 family: Simple Complex: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition 0 Addition /alteration/replacement 8 improvement 0 Fire sprinkler /alarm 0 Other: • JOB SITE INFORMATION Job address: - ig D2 I A) , __ A: -r-, . , • Bldg. no.: Suite no.: • Lot: Block: Subdivision: Tax map /tax lot/account no.: Project name: Description and location of work on premises /special conditions: OWNER FOR SPECIAL INFORMATION, USE CHECKLIST • (Floodplain, septic capacity, solar, etc.) , Mailing address: . • i , u , y , , .1/ 1 - i 1 & 2 family dwelling: Cityr or ,, 4 , State: pi, ZIP:' - • Valuation of work $ Phone: Fax: E -mail: No. of bedrooms/baths Owner's representative: o A_ , . il Total number of floors • Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: Covered porch area (sq. ft.) , Mailing address: Deck area (sq. ft.) City: State: ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial/industriaUmultl- family: - CONTRACTOR Valuation of work $ /7 ( 0 Existing bldg. area (sq. ft.) �a u i . .� t wJ ► New bldg. area (sq. ft.) Address: • ,, . , �� State:o., ZIP: Number of stories ' Type of construction .3/li Phone: lD - q- Fax:1o4 . -, EMIELI 6 CCB no.: 0 , p Occupancy group(s): Existing: .. New: City /metro lic. no.: cj • Notice: All contractors and subcontractors are required to be ARCHITECT/DESIGNER . • licensed with the Oregon Construction Contractors Board under Name: L L Jw p • A A AN • provisions of ORS 701 and may be required to be licensed in the Address: p L , _ jurisdiction where work is being performed. If the applicant is 'r State: .W . ZIP: - pig exempt from licensing, the following reason applies: Contact person: 4,4, per 0 ,, Plan no.: . Phone: 't,pche -1.9 Fax: lg , ,Dl E -mail: _ ENGINEER. Name: Contact person: Fees due upon application $ Address: Date received: City: State: ZIP: Amount received $ Phone: Fax: 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 provisions of laws and ordinances governing this 0 Visa 0 MasterCard work will be complied w' r; % ethe s . died herein or not. Credit card number: e x ires iP Authorized si attire: , ,.�,_, Date: 9 / - 0 2 - Name of cardholder as shown on credit card Print name: A 1-1Z 1 G •..� 4-1-2..-___ 5 Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44O -613 (smo/COM) • • Commercial Plan Submittal =��.. 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. is \dsts \forms \COM- matrix.doc 9/24/01 Accessibility: I Barrier Removal Improvement Plan City of .Tigard REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per -cent (25 %). VALUATION: of all renovation, alteration or modification being done excluding painting, wallpapering. [1] $ ) 7 , OOd multipl 25% Barrier removal requirement. : 25 BUDGET FOR BARRIER REMOVAL [2] $ 7�5a In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for $ 000 each sex or a single unisex restroom: (e) Accessible telephones: $ (f) Accessible drinking fountains: and $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL: Shall equal line 2 of Value Computation $ is \dsts \forms\Accessibiliry.doc 06/07/02 CITY OF TIGARD 24 -Hour BUILDING _ • Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST UP Received Date Requested $ AM ,PM BUP d=2 Od_3 3 Location '1C3 ° "": Y ' Suite • MEC Contact Person c y?1? Ph ( ) S 7 - a /3 PLM -6 ° 3 11 Contractor Ph ( ) SWR BUILD Tenant/Owner ELC Footing Foundation ELC Access: Ftg d M 00 ELR Drain Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors ELL ` R- Ext Sheath/Shear L l�� l Int Sheath/Shear Framing] al in Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: �� j • RT FAIL (// p e' Post & Beam Under Slab Water Service Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fin. � RT FAIL AL 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 ID Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA /l /l Approach/Sidewalk Date v v Inspector CM /fr'--) 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 te/ BP , -• 33 Received Date Requ ted n ` AM PM A Location � 7 ro r Suite C Contact Person �� Ph ( ) G PLM a -00 3 / Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall , f Fire Sprinkler r Fire Alarm Roof d Ceili g �,� j� ' '` ' 'f Other: — ti / / / /�� — Final a '/ ffi PASS PAT FAIL / — PLUMBING Post & Beam Under Slab e ROUgn -in Water Service Sanitary Sewers Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: d i PART FAIL CHANICAL 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 El Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA �— Approach/Sidewalk Date D , • Inspector Ext Other: Final DO OT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour pUILD;NG Inspection Line: (503) 639 -4175 MST • INSPECTION DIVISION Business Line: (503) 639 -4171 BUP 206 Z - GU 3$ Received Date Requested r - 3v _ AM PM BUP ■ Location 7,6 2- s w -S% Suite MEC Contact Person Ph ( ) 6 V' - /ST) PLM Contractor Ph ( ) SWR BUILDI� Tenant/Owner ELC ooting ELC Foundation Access: � �^ / Ftg Drain Midi '��vv`?�J � /_ . f ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing D - Insulation N �� Drywall Nailing A ° atV Firewall .J l,� / , I -�- 2 Id �' /, �� . -. n t/t3'1 JIX /LL_I Meal Fire Sprinkler Pit) !_ I Fire Alarm z �) ` �G�iL� *G✓ f2.'il1�,e ' ) ?/ C - ,� G�GI.4, 5' Susp'd Ceiling Roof 41 r ""--delr //\ i anal 5 Xix k‘/ v/ 4,% L:t =-fiUL S PART / / PLUMBING ) GC2 -CIZ PART / Vii, - �'yl/td5 - Post & Beam �� Under Slab " `- p " -6 it Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole s 411,(4/Ift-sw-ic Storm Drain .A._/ r! L. ! i 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 El 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 q--0 (/ Approach/Sidewalk Date i'l� Inspector Ext Other: Final DO NOT REMOVE this Inspection rec d from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 ' • INSPrCTION DIVISION ; Business Line: (503) b39 -4171 MST BUP Received Date Requested Y/ AM PM BUP ,02 -'O T '2 Location 9 . 7; , �JAd Suite MEC Contact Person ( Ph ( ) 3 J 4 { - " O v CuP Contractor Ph (_ SWR • BUILDING Tenant/Owner .0 6411_ ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation �B a ai m Fi rewafl Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: F'• ,. ! n'r ra PART FAIL ING 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 ❑ Please call for reinspection RE: Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date 1 / / Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL