Permit .•
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00135
i4. DEVELOPMENT SERVICES DATE ISSUED: 8/27/2004
'�J I - 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 13680 SW PACIFIC HY PARCEL: 2S102CC -01100
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: b FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: 10 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 10 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 0 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 110 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: $ 15,000.00
Remarks: New cell tower, 100 feet in height
Owner: Contractor:
TIGARD LODGE #207 MONTI ELECTRIC
PO BOX 230184 PO BOX 30478
TIGARD, OR 97281 PORTLAND, OR 97294
Phone: 503- 625 -4084
Phone:
Reg #: LIC 135326
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 3/25/2004 $187.30 Foot/Found Insp
[TAX] 8% State Surchari 3/25/2004 $14.98 Reinforced concrete final n
[BUPPLN] Pln Rv 3/25/2004 $121.75 Bolts in concrete final repo
[CDCBLD] CDC Bld Re 3/25/2004 $125.00 Final Inspection
(additional fees not listed here)
Total $616.93
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.
Issued By:
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
03401/2004 15:28 FAX 5035981960 CITY OF TIGARD g1002 -
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voic1537
Building Permit . ii , .1 , ' In FOR OFFICE USE ONLY
City of Tigard t 1,0%1k
0 g‘ V e k ' Permit No.: h l e: 2 00
13125 Sw Hall Blvd., Tigard, OR 9721ga plan Revie
Phone: 503.639.4171 Fax: 503.598.1 vGisS /. ': - ':' , :",::'''N . :' Dattalr: 1 Y: " *MAO Other Permit
Inspection Line 503.63.417 • : 95 ,...j 1 ' ‘‘ I \S\ ° LIU: -- 'i I Date ReadY I '
Internet: www.ci.tigard.or.us \ % • • 4 •• •0 -- — No ' &teased: kris s B See At far
rie l‘s ' 06 '.
• .; : .
,::....:„ .... • r ''1" . i.:q4.,- : '::..... :.';:
TYPE OF # • ... ' s .... ' . , :•... 1 .• • : 'ReopAgo Dii.r.A4-.N+yr 7 • .-
)2Ilew construction El Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Atkliticm/alteration/replacement 0 Other equipment, materials, labor, overhead, and the profit for the
::'• I !t/• 'I I g ;' . • C . OF CONSTRUCTION • • •.' •: • !.• .. • .! ;:. • • .,-:: - work indicated on this application.
I: ... '- ' "IC. • *. r •.:- • • . .. • . ... ...t. .: .. - .: • ...:i....r....., I; 1...:::; E ''' - - .....*7
Valuation: $ I S I
0 1- and 2-family dwelling ,ErCommercial/industrial
D Accessory building 0 Multi-family Number of bedrooms:
O Master builder 0 Other: Number of bathrooms: l
;•:; i ;,..• •••„...:.. ... I:1;16 s101iFFitE 1 1 4 kiiiiii#A1100, Pf!qi1 ..,.. l iti, L.4..iiillq'':iii.■.; Total number of floors:
Job site address: 1 W.0.50 14.4.7 FbCACAC! 141•44 New dwelling area: square feet
City/State/ZIP: "Til i Q . 9122:2> Garage/Carport area: square feet
Suite/bldg./apt_ no.: Project name: a b c 9 Covered porch area: square feet ■.„....
Cross street/directions to job site: Deck area: square feet
\( Stot2 F‘e. -0C Si-- Other structure area: square feet
w.,)(Driln OS MC4Ck./0/(C1 'CU 0 14?:e. OC- 3c
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map/parcel no.: Zs it77— GC 0 I ‘00 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
: ::::''.. ;...i' - 7.2 _. ',:, 1 pig .4010N bp 4.;. i.i
, ;!..,: : .:..;,,;:, , ,; : -...,:itfilsill- , , , work indicated on this application.
I UST*% I WICO•AiZ cit•Ct 1 hl -C74.3 / kaYelfliich) Valuation:
£ Mo p( F ryN,QAt
) :
Existing building area: square feet
s i
a' a ,
New building area: square feet
. -
-Arl O I' . . T . E144Rfe:' . ..LY.'.!....; t.'. Number of stories:
Name: % WO cs, II ik 7c71 Type of construction:
Address: R7 Box . 250% . . Occupancy groups!
City/State/ZIP: 0,)2.j>rvo oe . 9120 I Existing:
I Phone: 617 . 4 Far.( plcu mt13,..2 New:
le)''.' : .. -APP1:11CA142“2;61.•1V':.-:.4.1:CONTA,OOPI:$01(.Mk ....1==.i.Nottek:''..%
Business name:Ua ck„,...e:AccuAV t kla.la4E5 i f It All contractors and subcontractors are required to be
rs licensed with the Oregon Constmction Contractors Board under ORS 701 and may be required to be licensed in
Contact name: Da%) e F-IsHiEe_. prc5. AAA, .
the
,
L Address:( Scit2 1.X.. IAA Otv 5) ire.- mr jurisdiction in which work is being performed. If the •
al.A.* I Ole
1 City/State/ZIP1 applicant is exempt from licensing, the following reasons
, i7cg • 4 1 4 1 2 S 2- apply: _
. Phi:11 ) 21401- al% I Fax: - 1"No - 50%4 .
A E j14_. fishor 42, t- trbos Ia.. coil
- :1,... .:.. . • :.F . .....,i '1.!!''! . P ..... - : : ! .. - ..i. ' ....: ! .
tbd Business name:
::1 ...1 .:: ..: JU-MT'' -■-. 4:1: ! :
Address:
Please refer to fee schedule.
City/State/ZIP: .
Fees due upon application
Phone: ( ) I Fax: ( ) . .
_ Amount received
CCB lic.: • _
• Date received: •
Authorized signature: This permit application expires if a permit is not obtained
Within 180 days after it has been accepted as complete.
Print name: AWE_ ,P51,4 Date: Zaoci wi
• Fee methodology set by Tri Building Industry
Service Board.
sAlluildirdearAABUP-PernicApp.doc 13/D3 440461 11/02/COMAVER) •
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP aLI>� UUl3,�
Received Date Requested o — 7 AM PM :
Location /,36 Suite MEC
Contact Person C Ph ( ) 9 1c -35 PLM
Contractor Ph ( ) F SWR
BUILDING Tenant/Owner ELC
Footing '�- - `"n Q ELC
Foundation Acces
Ftg Drain t Ce F�( Z 2-5? ELR
Crawl Drain � -7— /\
Slab Inspection Notes: SIT Z —'f 0
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler - ,
Fire Alarm gs 4
Susp'd
Roof •
Other ,(.cam
�N -
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 $ requir o next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call r rein - • ection RE: Unable to inspect - no access
Fire Supply Line
ADA 7 (9
Approach/Sidewalk Date ` Inspector Ext
Other
DODO NOT REMOVE this Inspection record from the Job site.
S PART FAIL
•