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Permit CITY TIGARD• BUILDING PERMIT PERMIT #: BUP2006 -00435 1 DEVELOPMENT SERVICES DATE ISSUED: 9/7/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135BD -01100 SITE ADDRESS: 09780 SW SHADY LN 110 ZONING: C -G SUBDIVISION: SHADY LANE OFFICE LOT: JURISDICTION: TIG Project Description: TI 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: 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: $ 20,000.00 Owner: Contractor: LEWIS, GLORIA M + RUSSELL CONSTRUCTION INC. LEWIS, GLORIA M TRUSTEE + 20915 SW 105TH AVE. LEWIS, ANDREW M ET AL TUALATIN, OR 97062 • PORTLAND, OR 97225 Phone: Contact #: PRI 503 - 228 - 9413 FAX 503 - 228 -2770 FEES Reg #: LIC 58918 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 9/7/2006 $235.30 [TAX] 8% State Surcha 9/7/2006 $18.82 [BUPPLN] Pln Rv 9/7/2006 $152.95 [FLS] FLS Pln Rv 9/7/2006 $95.12 Total $502.19 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. i t'` �-. Issued By: a.„ Permiftee Signature: 4. 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. • C:,rilmercial Tenant Improvement `��/ P . Building Permit Application RECE V E i (o R Ole FICI.: USE ONLY • City of Tigard a e.'Jeari to 0�� . , / • . & noot •, • / A ° 13125 SW Hall Blvd., Tigard, OR 97223 St" P 0 2006 Plan Re • • Phone: 503.639.4171 Fax: 503.598.1960 DatelB . Other Permit: - i Inspection Line: 503.639 ' CITY OF T I GARD Date Ready/ By: i c n i D y: ® See Page 2 for Internet: www.tigard or.gov BUILDING DIVISIO otified/Method ,i supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed. 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. ❑ I- and 2- family dwelling jommercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: — 9 1s 0 $w 5 HA 1A) New dwelling area: square feet City /State /ZIP: TI GA f4 , 0/ I 9 ? Z Z 3 Garage /carport area: square feet Suite/bldg. /apt. no.: //a Project name: EQGE PhuANGAL 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. Valuation: $ ZO/ Do° . TGAJAAJT TAAPKOVEtMFNT Existing building area S square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: a • Name: Type of construction: S gil Address: Occupancy groups: 'a Oez City /State/ZIP: Existing: Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: All contractors and subcontractors are required to be . Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is from licensing, the following reasons City /State/ZIP: apply: t' a .% 5 . 3 U Phone: ( ) I Fax:: ( ) 5 / ? 4-.9 :� E -mail: � p, ! /9/ CONTRACTOR I 1 /g g Business name: RUSSELL C'QAI.S 1/0/.1 j.nlC . BUILDING PERMIT FEES' Address: ZOo1 I.; .5K) /OS AVE (Please refer to fee schedule) Structural plan review fee (or deposit): City /State/ZIP: TUAI-A I N . or-, c0 ow. FLS plan review fee (if applicable): Phone: (5 03) 2 Z' - 31 13 Fax: (503) 22g — 2il p . CCB lic.: 51"/i ' I b �j _ _ Total fees due upon application: Amount received: 56/. (9 Authorized signature: - This permit application expires if a permit is not obtained Print name: '"- ICJ � y I D ate : J • Fee methodology 180 days after it has been accepted as complete. • � �o a0 Fee methodology set by Tri -County Building Industry dustry Service Board. I:\Building\Permits\BUP -T1- PermitApp.doc 03/23/06 440- 4613T(11 /02 /COM/WEB) 1111 a. ° ' Building Division Plan Submittal Requirement Matrix T I G n R D Commercial & Multi- Family - New, Additions or Alterations 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 2 ** 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 \Permits \BUP- TI- PermitApp.doc 03/23/06 CITY - OF TIGARD BUILDING DIVISION PERMIT #: BUR200C 00435 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/7/2006 Phone: (503) 639 -4171 1 1, y 1 Inspe Requests (24 Hrs.): (503) 639 -4175 P:_.. INSPECTION WORKSHEET FOR DATE: 9/29/2006 TIME: 7:06AM PAGE: 16 SITE ADDRESS: 09780 SW SHADY LN 110 CLASS OF WORK: SUBDIVISION: SHADY LANE OFFICE LOT #: TYPE OF USE: PROJECT NAME: EDGE FINANCIAL DESCRIPTION: TI EDGE FINANCIAL OWNER: LEWIS, GLORIA M +, PHONE #: CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503.2289413 Inspection Request Scheduled For: Date: 9/29/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 037411 -01 503.519-96B2 Y Corrections /Comments /Instructions: AL 1 IMMITATAIIM' • P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL fil _ ' LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ... Inspector: INIB k Date: 7 0j hone #: (503) 718 - of CITY OR TIGARD BUILDING DIVISION PERMIT #: BUP2006.00e135 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2006 Phone: (503) 639 -4171 e l ,, (11 Inspection Requests (24 Hrs.): (503) 639 -4175 U P_ INSPECTION WORKSHEET FOR DATE: 9/20/2006 TIME: 7 :01AM PAGE: 29 SITE ADDRESS: 09780 SW SHADY LN 110 CLASS OF WORK: SUBDIVISION: SHADY LANE OFFICE LOT #: TYPE OF USE: PROJECT NAME: EDGE FINANCIAL DESCRIPTION: TI EDGE FINANCIAL OWNER: LEWIS. GLORIA M +, PHONE #: CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503 - 2211.9413 Inspection Request Scheduled For: Date: 9/20/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 265 Drywall nailing 036865 -01 503 - 519-9682 Y Corrections /Comments /Instructions: 6Ji % I E _., ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718 - CITY OR TIGARD , BUILDING DIVISION PERMIT #: gUP2006 00435 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2006 Phone: (503) 639 -4171 emu: tipvin i Inspection Requests (24 Hrs.): (503) 639 -4175_ 611. INSPECTION WORKSHEET FOR DATE: 9/18J2006 TIME: 7 :01AM PAGE: 4 SITE ADDRESS: 09780 SW SHADY LN 110 CLASS OF WORK: SUBDIVISION: SHADY LANE OFFICE LOT #: TYPE OF USE: PROJECT NAME: EDGE FINANCIAL DESCRIPTION: 11 EDGE FINANCIAL. OWNER: LEWIS, GLORIA M +, PHONE #: CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503 -228 -9413 Inspection Request Scheduled For: Date: 9/18/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 036717 -01 503.519 -9682 V Corrections /Comments /Instructions: (,,..t 1—(.., F 7A 1 11W i awl �,l r • w • 1 � bi���r 1...._i...r■ -- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • CALL F R INSPECTION ❑ ADDITI NAL F ES ASSESSED Inspector: frr Date: `(J Phone #: (503) 718 - 2S CITY .OF TIGARD BUILDING DIVISION PERMIT #: BUP2006-00435 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/7/2006 Phone: (503) 639 -4171 Arb4PVICit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/15/2006 TIME: 7:06Am PAGE: 37 SITE ADDRESS: 09780 SW SHADY LN 110 CLASS OF WORK: SUBDIVISION: SHADY LANE OFFICE LOT #: TYPE OF USE: PROJECT NAME: EDGE FINANCIAL DESCRIPTION: TI EDGE FINANCIAL OWNER: LEWIS, GLORIA M +, PHONE #: CONTRACTOR: RUSSELL CONSTRUCTION INC. PHONE #: 503-228 -9413 Inspection Request Scheduled For: Date: 9/1,,5-,/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 275 Framing 036603-01 503-519-9682 N Corrections /Comments /Instructions: HiV (T kpeizo-ve s _T ___ ...A. 4 3 . rwa/L1—..r• _ IL I '-'■ _■. (11/101L 4:■ M.' gliv C P Y i M ' 20 / a)le - <F,�LFei _ rp_ v L-__, WA p iTa 1 r w io IF - . ,g1 a iltAri, • Mja ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED I !1 0 / Inspector: © Z pector: Oil V Date: Phone #: (503) 71 S -