Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2005 -00417
u4l1 i B
DEVELOPMENT R 503-639-4171
DATE ISSUED: 8/23/2005
PARCEL: 1 S 126BC -01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 550 ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: TI - walls
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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: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 31 BASEMENT: sf AREA SEP. RATED:
STOR: 5 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: $ 24,750.00
Owner: Contractor:
WYSE INVESTMENT SERVICES CO PACIFIC CREST STRUCTURES INC
111 SW 5TH AVE #1100 7233 SW KABLE LN STE 900
PORTLAND, OR 97204 PORTLAND, OR 97224
Phone: 503 - 294 -0400 Phone: 503 - 968 -8949
FEES Reg #: LIC 66915
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/23/2005 $283.30
[TAX] 8% State Surchari 8/23/2005 $22.66
[BUPPLN] Pin Rv 8/23/2005 $184.15
[FLS] FLS Pin Rv 8/23/2005 $113.32
Total $603.43
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 5 -246- 9 1- 0- 332 -2344.
Issue By: - Permittee Signature: AFL FL _
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.
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Building Permit Applicat FOR OFFICE USE ONLY
City of Tigard CE �% ill Rec eiv e d Q/ Perm No /; /405 : A)
13125 SW Hall Blvd., Tigard, OR 97223 Plan
Phone 503.639.4171 Fax: 503 598.1960 ���� ,i Lt t i�f�� Date/B view Other Permit
Inspection Line. 503.639.4175 ^'f l Date Ready/By: MI ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: i Supplemental Information
CITY OF TIGARD
BUILDING DIVISION
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
'ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms.
JOB SITE INFORMATION AND LOCATION Total number of floors:
Joh site address: 90 w 3\ . ti u» ... o G . R t *N N i New dwelling area: square feet
City/ State/ZIP: OAT Ll +\)b i DK _ of 722 Garage/carport area: square feet
Suite/bldg. /apt. no.: 55-0, Project name: Mur,)� OF OMAHA --C I. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
2 -1 7 To sc,N d u s - FG D f� 1 T) (2-&) .1 b 1}r Other structure area: square feet
Dk A Ht J bj1 I) so. R�, Q , (fi 1t- y SUU REQUIRED DATA: COMMERCIAL -USE CHECKLIST
�
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: j_ 3 :a_\&1 bEc. d 1s Co. 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: $ ZL1 150
(i) U i7 550 Existing building area: 1 2_,0 square feet
New building area: /V k square feet
y PROPERTY OWNER y� l/ ❑ TENANT Number of stories: 5
Name: ' YV Y I N YCSf - �.1� -+' IO . Type of construction: . A F
Address: „ I , .5 v. 5th A 4p ii do Occupancy groups:
City/State/ZIP: Pb - v_itz 1 b ` q 7� 4 Existing:
p I 111 g:
Phone: ( 1 I L.J-" 01-1 f DO Fax: 603) 227 ,.7 - -. O --
/ New:
❑ APPLICANT CONTACT PERSON NOTICE
Business name: (v. OP HA-G Kam 7 1.6 All contractors and subcontractors are required to be
Contact name: AN t v �p 0 �► 1 �� V C/ licensed with the Oregon Construction Contractors Board
V�/ C� 1 under ORS 701 and may be required to be licensed in the
Address: 10 • )( (P 9 Di owl o l YA , -p az f' C S T junsdiction in which work is being performed. If the
City /State/ZIP:1 -1 D I a q 7 2 v , f r dO s ' applicant is exempt from licensing, the following reasons
apply:
/a
Phone: 3 ) 9911 .15-70 / 0 � y�� �,� Fax: : 5 3) 2.2..--./.2...5-----
E -mail: n Yl! e) I/k1� -(`'`� V�-f'/'I�'�1-_' 6 101 1 •1
CONTRACTOR f ' (� 1 U �, y
Business name: TA. Fie __ 612z---r- 6"T /zv I`-'FJ�!
�
BUILDING PERMIT FEES*
Address: '7Z3 3 /. �/ aE /ANC 'Qv Please refer to fee schedule.
City/State/ZIP: ' 'T L AJ p v/ q722Lt
) / �� _ 7 / 7 ��2) 6/ 07- � Fees due upon application
Phone: 03 7 Fax: ((..�� �-E' ^
0 ti /� Amount received
CCB lic.: 0
Date received:
Authorized signature: �/� j1 14 n, This permit application expires if a permit is not obtained
N I v within 180 days after it has been accepted as complete.
Print name: Ask\ 9. 01 0-z.... t...k___ Date: 17 AO 6( OS * Fee methodology set by Tri-County Building Industry
Service Board.
i \ Building \ Permits \BUP- PermitApp doc 12/03 440- 4613T(11/02/COM/WEB)
Building Division
Accessibility: Barrier Removal Improvement Plan
City of Tigard
AUG 2 3 2005 VFIDED
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
CIS f (1) Every project for renovation, alteration or modification to affected buil A �
facilities shall be made to insure that the path of travel to the altered area and the resfrodtON
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: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ � [ 150
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ I 14
ELEMENTS: 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 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 be equal to or greater than line [2] of Valuation $
omputation):
aw /Ats A s ±v I)0T
xls1I f M ?LI4jvC .
i:\ Building \Forms\AccesslmprvPlan.doc 05/13/05
CITY Of TIGARD
BUILDING DIVISION PERMIT #: gUP2005 00417
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Ef23/200;
Phone: (503) 639- 4171y�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7:07AM PAGE: 71
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 555Q CLASS OF WORK:
SUBDIVISION: LoT #: TYPE OF USE:
PROJECT NAME: MUTUAL OF OMAHA
DESCRIPTION: TI walls
OWNER: WYSE INVESTMENT SERVICES CO, PHONE #: 503-294-0400
CONTRACTOR: PACIFIC CREST STRUCTURES INC PHONE # : 503 - 968.8949
Inspection Request Scheduled For: Date: 9/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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299 Final inspection 016436 -01 503- 805.440E N
Corrections/Comments/Instructions:
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I _A■
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI AL FEE ASSESSED
1 i' 71
Inspector: ' '' Date: #: 503) 718 -