Permit CITY OF TIGARb BUILDING PERMIT
PERMIT #: BUP2005 -00519
z41 DEVELOPMENT SERVICES DATE ISSUED: 10/20/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S1106C -10000
SITE ADDRESS: 12494 SW WINTERVIEW DR ZONING: R -7
SUBDIVISION: THORNWOOD PARTITION LOT: 001 JURISDICTION: TIG
Project Description: 108sf deck
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: L/1 FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 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: 40 psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: 15 ft REAR: 15 ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,000.00
Owner: Contractor:
ISSAC BACKLUNG RICK'S CUSTOM FENCING
12494 SW WINTERGREEN DR. 4543 SW TV HIGHWAY •
TIGARD, OR 97224 HILLSBORO, OR 97123
Phone: 503 - 921 -1762 Phone: 640 -5434
FEES Reg #: LIC 50088
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/3/2005 $62.50
[TAX] 8% State Surchari 10/3/2005 $5.00
[BUPPLN] Pin Rv 10/3/2005 $40.63
Total $108.13
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rul-,•:re set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or dir • - tions to OUNC by
calling 503 -246 9 1- 800 - 332 -2344.
•
Issued By: Permittee Signature`1/ ^ /
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
j Building Permit AD l TersR t !VE® t
FOR OFFICE USE ONLY
City of Tigard Received No
13125 SW Hall Blvd., Tigard, OR 97223 CT 0 4 2005 Plan R ev le V " O � 66, ,O 005-y? Phone: 503.639.4171 Fax: 503.598.196 / ' ../ I `�• Date
1 �R'�
0...-I$ ^D� Other Permit: Inspection Line: 503.639.4175 _ii ' ! Date Ready/By �`� / . El See Attached Checldist for
CITY
Internet: www.ci.tigard.or.us Y OF TIGARD "- . � /o /Pa 5 Supplemental Information
BUILDING DIVISION E ' "'/ � J t
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY LLING
❑ 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.
faro �- and 2-family dwelling Valuation: S 0 6
y g ❑Commercial /industrial
❑ 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: 19.2-1? 5-w (Ni✓v7%2 vrsitay.. OR, New dwelling area: square feet
City /State/ZIP: :pi, k y o Q 6117z-7 y Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: square feet
Cross street /directions to job site: (- 5 h- Deck area: square feet /0 B
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
AO 5 4 A ."1 (c,,,Itn..? Valuation: $
Existing building area: square feet
New building area: square feet
JELPROPERTY OWNER I ❑ TENANT Number of stories•
Name: tc>c7A_ L ackfvi. Type of construction:
Address: Occupancy groups:
City /State/ZIP: 7 61- 0 4 e Existing:
Phone: (Cfp fit — I 94 Z 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 exempt from licensing, the following reasons
City /State/ZIP:
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR
A. r
Business name: (C. K 5
BUILDING PERMIT FEES*
Address: Y5 3 S Eli, Please refer to fee schedule.
City /State/ZIP: 1+:1 4 0 k 7 / L)
Fees due upon application
Phone: ( ) 6 ( — 5Z,t 3 y Fax: ( )
y Amount received
CCB lic.: y0008
/� Date received:
Authorized signature: !!!/// C This permit application expires if a permit is not obtained
within ISO days after it has been accepted as complete.
Print name: I Date: * Fee methodology set by Tri-County Building Industry
Service Board.
i \ Building \Permits\BUP- TI- PetmitApp.doc 12/03 440- 4613T(11 /02/COM/WIB)
Building Division
" " I `111'1 Plan Submittal Requirement Matrix
,L -I Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
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 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 \ Building \Pennits \BUP- TI- PermilApp doc 12/03 4404613T(I 1 /02/COM/WEB)
,
CITY OF TIGARD ,_, ' "
BUILDING DIVISION - PERMIT #: BUP2005 -00519
13125 SW Hall Blvd., Tigard, OR 97223 DAT ISSUED: 10/20/2005
Phone: (503) 639 -4171 hm
4 -'( f ib
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/25/2005 TIME: 7:10A PAGE: 77
SITE ADDRESS: 12494 SW WINTERVIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: BACKLUNG
DESCRIPTION: 108sf deck
OWNER: BACKLUNG, ISSAC PHONE #: 503 -921 -1762
CONTRACTOR: RICK'S CUSTOM FENCING PHONE #: 640 -5434
Inspection Request Scheduled For: Date: 10/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 019172 -02 503 - 539 -4242 N
Corrections/Comments/Instructions:
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OPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k/0 Date: V Zqo < Phone #: (503) 718-