Permit . .
O' ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00464
A DEVELOPMENT SERVICES DATE ISSUED: 9/14/2005
'° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25101 AA -06400
SITE ADDRESS: 12323 SW 66TH AVE ZONING: C -G
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 024 JURISDICTION: TIG
Project Description: TI - new walls
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM.. I SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 147 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 38,500.00
Owner: Contractor:
TING, ELON + SYLVIA JHC COMMERCIAL LLC
BY WILLIAM R SOUTHARD 11125 SW BARBUR BLVD
603 SE VICTORY AVE STE 100 PORTLAND, OR 97219
Pf0ion OUVER, WA 98661
Phone: 503 - 663 -9531
FEES Reg #: LIC 158061
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/14/2005 $388.30
[BUPPLN] Pin Rv 9/14/2005 $252.40
[TAX] 8% State Surcharl 9/14/2005 $31.06
[FLS] FLS Pln Rv 9/14/2005 $155.32
Total $827,08
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 stag- • ithin 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
r -• ires you to , low the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
• 2- 001 -0010 thro 1h •AR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
ailing 503 - 246 -6690 or " 0- 332 -2344.
4c:7 ,i6c:
-sued By: , / j £. Permittee Signature:
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.
E EC E 1 V ED - •,.1
Building Permit Application [[ >l t)li of l ic.l_'l,sl cowl y ,
4 2O�J tai Permit No. .., ���. _/
City of Tigard SEP Receive � i a
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review —
Phone: 503.639.4171 Fax: 503.598.16V OF TIGARD aN„ a,�, i:• Date/B Other Permit:
Inspection Line: 503.639.4175 BUILDING DIVI , 1, . I _I Date Ready/By: / ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method o f 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.
❑ 1 -and 2 -family dwelling El Commercial /industrial Valuation: $
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job siteaddress ° / ; P3 5)v £A/ i f r —e New dwelling area: square feet
City/State/ZIP:: 7._( CP/ 97- / Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: 4/ .�s/4„..t..,4,, 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`W_ORK". work indicated on this application. 4V-t ifee eve-Ger o4 Alc...Y.1-41, ....__ -Valuation - $ , 0 S4 ,9
�� rr 2EQ ; Existtrtg area: ;/ 3� 2 square feet
J� 3
New building area: square feet
0-PROPERTY OWNER 0 TENANT Number of stories:
•
Name::' � � �,,A n c a Type of construction: 7 � j � '
' Address: i' 20-ne_ QS' r ve Occupancy groups: Ta._
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
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) I Fax::( )
E -mail:
. -)
• CONTRACTOR
Business name: ✓ �-� H t /h BUILDING PERMIT FEES*
,Address: /// �T, ,g,..,' ,
Please refer to fee schedule.
City /State/ZIP: Hole-/-4,hd .D g. 9•7-p-/ 9'
/ Fees due upon application
Phone: (42),) ko 3 — 9S• / Fax: ( )
CCB lic.: i /"5-01:›G• / • Amount received
Date received:
Authorized signatur • This permit application expires if a permit is not obtained
3; within 180 days after it has been accepted as complete.
Print—name:- - '' r/t z _ Date: qi/� /, * Fee methodology set by Tri- County Building Industry
/ Service Board.
is\ Building \ Permits \BUP- T1- PennitApp.doc 12/03 440-4613T(11/02/COM/WEB)
•
Building Division
77.1 i Plan Submittal Requirement Matrix
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.
•
is Building \Pertnits BUP- 11- PertnitApp.doc 12/03 440- 4613T(1 l /02/COM/WEB)
CITY OF TIGARD i' 1
BUILt ING DIVISION PERMIT #: .� c
C
—O O T( y
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 4: \ V
�n
Inspection Requests (24 Hrs.): (503) 639 -4175 � &!J! !,,..
INSPECTION WORKSHEET FOR . DATE: TIME: PAGE:
SITE ADDRESS: / eZ 3 v - 3 f7 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 –2_3 ^ 0 (6 Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments/ Instructions:
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n P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL U CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
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� �`,/ l/ 0 ' ne #: 503 718 -
Inspector: 4 A i Date: Pho ( ) ' �T
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CITY ®F TIGARD
BUIL DIVISION PERMIT #:;iyF�: >Oi }E'
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: c ;/14/200!;
Phone: (503) 639 -4171 - °,,, : ( 4 +
Inspection Requests (24 Hrs.): (503) 639 -4175 ' A
INSPECTION WORKSHEET FOR DATE: 2/22/2006 TIME: 7:02Afdi PAGE: 1I0
SITE ADDRESS: •I2323 SW 66TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEDGI-1•FS LOT #: 074 TYPE OF USE:
PROJECT NAME:, FARMER'S INSURANCE.
DESCRIPTION: c- via • •
OWNER: TING, ELON + SYLVIA, PHONE #:
CONTRACTOR: &IC COMMERCIAL LLC PHONE #: 6.03,,663..f j o
Inspection Request Scheduled For: Date: 2i22/200$ Pour Time:
•
Code # ' Inspection Description Confirm # Contact # Message
276 Framing 027310 - 01 503 - 201 - 6037 N
Corrections /Comments/ Instructions:
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❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: 1"` Date: 440 •� Phone #: (503) 718 - c _ �
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.0046'1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2005
Phone: (503) 639 -4171 a pd ,
Inspection Requests (24 Hrs.): (503) 639 -4175 ' ' II..
INSPECTION WORKSHEET FOR DATE: 12/21/2005 TIME: 7:01AM PAGE: 73
SITE ADDRESS: 12323 SW 66TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 024 TYPE OF USE:
PROJECT NAME: FARMER'S INSURANCE
DESCRIPTION: TI - new walls
OWNER: TING, ELON •+ S°YLVIA, PHONE #:
CONTRACTOR: ,JHC COMMERCIAL LLC PHONE #: 503-663 -9531
Inspection Request Scheduled For: Date: 12/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
285 Drywall nailing 023807-01 503 -201 -6037 N
Corrections /Comments /Instructions:
411111M1=11111111%) 1.4 At -
•
i
f ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITION . L FEE ASSESSED
04, • 0-
Inspector: Date: Phone #: (503) 718-
CITY,_ OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00454
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/14/2005
Phone: (503) 639 -4171 (
Inspection Requests (24 Hrs.): (503) 639 -4175 ''-I
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 01
SITE ADDRESS: i2323 SW 66TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 024 TYPE OF USE:
PROJECT NAME: FARMER'S INSURANCE
DESCRIPTION: TI - new walls
OWNER: TING, ELON + SYLVIA, PHONE #:
CONTRACTOR: JHC COMMERCIAL LLC PHONE #: 503- 663-8531
•
Inspection Request Scheduled For: Date: 12016/2005 Pour Time:
Code # Inspection Description Confirm # Contact #' Message
275 Framing 023554 -01 503-201 -5037 N
Corrections /Comments /Instructions:
•
2111Wir SW=
n PASS APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ ALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
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Inspector: g;
Oil Date: (
l " / Phone #: (503) 718-
CITY OFTIGARD -P
BUILD' DIVISION , PERMIT #: C —C Tai y
13125 SW Hall Blvd., Tigard, OR 97223
4
DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / - 3 r)--- 3 I -� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - a- 3 - 0 'P Pour Time:
Code # Inspection Description Confirm # Contact # Message
5 3
Corrections /Comments /Instructions:
(/U5 - 01 - CC--4k - IT-CZA)
•
`a1
V PARTIAL APPROVAL E CANCEL n NO ACCESS
1 1 FAIL • CALL FOR INSPECTION [l ADDITIONAL F ES ASSESSED
Inspector: A NAL ! Date: ' ' #: (503) 718 2AT-'