Permit CI TY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00382
II ° COMMUNITY DEVELOPMENT DATE ISSUED: 8/10/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AA -09700
SITE ADDRESS: 12587 SW 68TH AVE ZONING: MUE
SUBDIVISION: PP1996 -024 LOT: 001 JURISDICTION: TIG
Project Description: Tenant Impvovement
11/28/06 changed address (from 12585 68th Ave)
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: 30 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: $ 73,000.00
Owner: Contractor:
MARK NIELSON HORIZON RESTORATION SYSTEMS
7150 SW HAMPTON 7301 SW KABLE LANE
STE. #228 SUITE 100
TIGARD, OR 97223 PORTLAND, OR 97224
Phone: 503 - 582 -5777 Contact #: PRI 503 - 620 - 2215
FAX 503 -624 -0523
FEES Reg #: LIC 160672
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/10/2006 $596.61
[TAX] 8% State Surcha 8/10/2006 $47.73
[BUPPLN] Phi Rv 8/10/2006 $387.80
[FLS] FLS Pln Rv 8/10/2006 $238.64
Total $1,270.78
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 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.
[)rnmercial Tenant Improvement
• Building Permit Applicati � l L 9 � � � � IOR orric1: lass ONE.,
City of Tigard p ate/ g j /0 db ,e. Permit N. • c9 O.. — as .5 d -
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
' C • Phone: 503.639.4171 Fax: 503.598.19 i� 2006 D ,
Inspection Line: 503.639.4175 Other Permit:
TI GAIN)
5 Date Ready/By: See Page 2 for
Internet: www.tigard - or.gov Notified/Method EMI Supptemeotat Information
'l i 3' 4Jk i 1u.�'H�i�,�.�i�
TYPE' b iv ii&T." :1°'1 TT( 'a, 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
Er 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 j2rCo nunercia1 /industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder /~'" ❑ Other: Number of bathrooms:
/ JOB SITE INFORMATION t AAND LOCATION Total number of floors:
Job site address: / cslxi f<Q Cj1" h Ave,. New dwelling area: square feet
City /State/ZIP: T/14.0,1.-_ og 97 „2„2.3 Garage /carport area: square feet
Suite/bldg. /apt. no.: v 1 Project name: 13,•456 n Covered porch area: square feet
Cross street/directions to job site: Co K i h /4„, ,,„n-b / 1 - Deck area: square feet
J 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.
Pen ede I /90c64e 1KValuation: $ 7 3 Oo0
Existing building area: /5b0 square feet
New building area: square feet
VI PROPERTY OWNER I ❑ TENANT Number of stories: I r
Name: /V(\ lie N e (C) I% t _ Type of construction: � pD t t e f lu j t e • 5 13
Address: l � 7/ 5-0 <�w „vim �, � Occupancy groups: r to A A elll' Z
4-0 City / State/ZIP: I r t � o g Q 7U 1- 3 4 / Existing: C1 e n 'F • 320--
Phone: (5' ,3) AA S7 7 7 Fax: (S'O3) pl.1t' to O W / New: �d
co APPLICANT ❑ CONTACT PERSON NOTICE
Business name: t; • 1 2.45p Re S415 ra4- t0 A All contractors and subcontractors are required to be
Contact name: ` C licensed with the Oregon Construction Contractors Board
J tYj.l a )I rh� 1'I> 11 under ORS 701 and may be required to be licensed in the
Address: 7 } / cS W Kai) / at. G I C � /00 jurisdiction in which work is being performed. If the
City /State/ZIP: - l f pia q gi2 y r * applicant is exempt m licensing, the following ing reasons
`-t apply: jwri .6; `
Phone: ( 6,2
) o 0-2i 5- Fax: ( (Oo7q -6"A S 35-7.7_ O
E -mail: V cau'l�,.S F� I-6 Ty K
A GS4OKt .4 /OA •COrvt'. o�aD•&1
(f CONTRACTOR '!yam 73
Business name: ri '� On 2es4o �,. n BUILDING PERMIT FEES*
Address: QQ (use refer to fee schedule)
City /State/ZIP: V P- L • Structural plan review fee (or deposit):
Phone: ( ) F es: ( ) FLS plan review fee (if applicable):
CCB lic.: /100 're .-- I9a Total fees due upon application:
/ Amount received: 1 a '7C),7Ci
�
Authorized signature: At This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: � C am . �/ S wry l S . D ate: • Fee methodology set by Tri-County Building Industry
Service Board
' 1:\Building\Penmits\BUP -TI -fermi pp.doc 0323/06 4404613T(1 I /02/COM/WEB)
° Building Division
Plan Submittal Requirement Matrix
T i G A 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 #: BUP2006-00382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/29!2006 TIME: 7 :04AM PAGE: 28
SITE ADDRESS: 12587 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP1996 - Q24 LOT #: QQ1 TYPE OF USE:
PROJECT NAME: NEILSON
DESCRIPTION: Tenant Irnpvovement
11/28/06 changed address (from 12585 68th Ave)
OWNER: NIELSON, MARK PHONE #: 503.582 -5777
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503-620-2215
Inspection Request Scheduled For: Date: 11/29/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 040384 -01 503 -793 -5546 Y
Corrections /Comments/ Instructions:
f
00-#461E:p..
4')
k
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI AL EES ASSESSED
Inspector: Date: t
r
1 06 Phone #: (503) 718
CITY -a- TIGARD
BUILDING DIVISION PERMIT #: BUP200&130382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 A lt ..
INSPECTION WORKSHEET FOR DATE: 11/27/2006 TIME: 7:05AM PAGE: 25
/zsS7
SITE ADDRESS: 1sSW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP 103&•024 LOT #: 001 TYPE OF USE:
PROJECT NAME: NEILSON
DESCRIPTION: TI Neilson
OWNER: NIELSON, MARK PHONE #: 503 -5132 -5777
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503-620-2215
Inspection Request Scheduled For: Date: 11/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 040236 -01 503-793.5546 N
Corrections /Comments/ Instructions:
____. A 7
1LVG -- ®i 110 WY
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL Fs:.' INSPECTION ❑ ADDITIONAL EES ASSESSED
Inspector: Prilirif Date: (�( Phone #: (503) 718- v
p `�'
CITY OF- TIGARD
BUILDING DIVISION PERMIT #: BUP200S -00382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2/2006 TIME: 7:02AM PAGE: 31
SITE ADDRESS: 126 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP1996 LOT #: 001 TYPE OF USE:
PROJECT NAME: NF
DESCRIPTION: TI Neilson
OWNER: NIELSON, MARK PHONE #: 503 - 582 - 5777
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503. 6202215
Inspection Request Scheduled For: Date: 11/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 039198 -01 ( 503- 793 -5546 Y
Corrections /Comments/ Instructions:
f ► ( Se-D 3M- 0
o F , Rt V
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
Inspector: Date: Phone #: (503) 718- LZ�
CITY='TIGARD
BUILDING DIVISION PERMIT #: BUP2006.00382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/10/2006
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 °TI I ..
INSPECTION WORKSHEET FOR DATE: 10/12/2006 TIME: 7 :01AM PAGE: 27
laSVI
SITE ADDRESS: 12S85 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP 1596 - 024 LOT #: 001 TYPE OF USE:
PROJECT NAME: NEILSON
DESCRIPTION: Ti Neilson
OWNER: NIELSON, MARK PHONE #: 503. 582 -5777
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503-620-2215
Inspection Request Scheduled For: Date: 10/1212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
285 Drywall nailing 038097 -01 503-793-5546 Y
Corrections /Comments /Instructions: G L.(— t..
Lf --
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: I, �/ Date: Z d Phone #: (503) 718 - Z \TZ
CITY,-OF TIGARD
BUILDING DIVISION PERMIT #: BU P2006:00382
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1012006
Phone: (503) 639 -4171 4,9
Inspection Requests (24 Hrs.): (503) 639 -4175 s ° L
INSPECTION WORKSHEET FOR DATE: 10f6/2006 TIME: 7: 03AM PAGE: 22
/58
SITE ADDRESS: 12 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: PP1996.024 LOT #: 001 TYPE OF USE:
PROJECT NAME: NF_ILSON
DESCRIPTION: Tl Neilson
OWNER: NIELSON. MARK PHONE #: 503 -582 -5777
CONTRACTOR: HORIZON RESTORATION SYSTEMS PHONE #: 503621? -2215
Inspection Request Scheduled For: Date: 10/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 037812 -01 503 - 7936813 Y
Corrections/Comments/Instructions:
I 16-
CiNt_c__ &€
— CaOU fU 1' a;--17$ EX1 TO DOZM
�Il
, IIP _,
a..�. A 1. i'
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FS INSPECTION ❑ ADDITI.DNA FEES ASSESSED
Inspector: A�1 Da k
Ins !, ft Phone #: (503) 718- � Z
p � _ � > 7 7
'S
A