Permit ,; ; � OF TIGARD BUILDING PERMIT
TY PERMIT #: BUP2002 -00051
� 4+ D EVELOPMENT SERVICES D ATE ISSUED: 5/2/02
°--�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 17005 SW 92ND AVENUE PARCEL: 2S114A0 01500
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW FIRST: 1,584 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: NONE TOTAL AREA: 1,584.00 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: 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: $ 25,819.20
Remarks: Picnic Shelter - Phase II, Cook Park Master Plan expansion.
Owner: Contractor:
TIGARD, CITY OF ROBERT GRAY PARTNERS INC
13125 SW HALL PO BOX 1000
TIGARD, OR 97223 SHERWOOD, OR 97140
Phone: Phone: 692 -4675
Reg #: uC 65424
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Foot/Found Insp
EROS BLD 5/2/02 $26.00 JE # Struc Steel Insp
Framing Insp
ERPC BLD 5/2/02 $8.45 JE # SMRF welds final report
ERP2 BLD 5/2/02 $8.45 JE # Final Inspection
Total $42.90
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Perm ittee
Signature: ; ,, Q A . dli �,, (d--✓
Issued B • _ —__ �. ∎ - 0 i L:
Call 639 -4175 by 7 p.m. for an inspection the next business day
tc�.e .1 Z��2, , ' z3 6'2
411, l' 'Building Per mit Application ` ' .: 'l ' : ':
Date received: A -y OA Permit no :1,./.45,00.49p5
��� ��, �'jyi" Cit o f Tigard
°�,, Project/appl. no.: E ire date:
City gfTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: ,By? Receipt no.:
Fax: (503) 598 -1960 Q Case file no.: Payment type:
Land use approval: CIA f - 600o f 1 &2 family: Simple Complex:
i . . z , .. ,, 7 ; . ' .
❑ 1 & 2 family dwelling or accessory ❑ CommerciaUindustrial Cl Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
N 4 ,p: , •3 , *-JOB SITE- INFORMATION i '
/ Job address: 1 ?O5" r5. ( , J . ' O - ` O E, Bldg. no.: Suite no.: '
Lot: Block: SSubdivisio :: /� I Tax map /tax lot/account no.:
Project name: i D / vA.k'.. /�„,.., �-�E, 1_'i97j, t L:)A) �� -'SE� _ // //
Description and location of work on premises /special conditio t, C . p "sL� / ( �� 2 J fi7
v " :, Ol'VNER , Z FOR .SPECIAL INFORMATION; IJSE'CIECKLIST r
C Name: -: ; (Floodplaiii se ptic capacity, solar, etc) �* ,�
Mailing address: ) 3 t .5 - ‘ All j Z (� D 1 & 2 family dwelling:
City: 17" - /4/ D 'State: 'ZIP: ��� Valuation of work $
Phone: (,3 1 1 f j 1 I Fax: I E -mail: No. of bedrooms/baths
Owner's representative: j(�j - Total number of floors •
Phone: „p Fax: &, r e -mail: 3 35 New dwelling area (sq. ft.)
s § , r < tr A ' A'PPLICANT, -, '. - Garage /carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.) -
Phone Fax: E-mail: Commercial/industrial /multi- family:
,' ; < 'CONTRACTOR , ;: , j; Valuation of work $ 16� GOO
Existing bldg. area (sq. ft.) O
ROBERT GRAY PARTNERS New bldg. area (sq. ft.) z 3
r ' i PO BOX 100 Number of stories
` SHERWOOD OR 97140 Type of construction
PH: 503- 692 -4675 CCB #: 65424 Occupancy group(s): Existing:
New:
Notice: All contractors and subcontractors are required to be
,' ' ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
Q�, ENGINEER .
Name: Contact person: Fees due upon application $
Address: Date received:
City: 'State: ZIP: Amount received $
Phone: 7 Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisio ' of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied wi i w) ther s 4 fled herein or not. Credit card number: I / •
II Expires
Authorized signature: • i �`. Date: c2 - I/ 42. Name of cardholder as shown on credit card
( Print name: s-JD, s,. Cardholder signature $ Amount
Notice: This permit application expires f a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00 /COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP — 60 5
Received Date Requested � AM PM BUP
Location / O �o Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner : � ~� ELC
Footing WAIF ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot - r:
PART FAIL
PLUMBING
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 $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line �]
Approach /Sidewalk Date Inspector f Ext
Other:
Final DO NOT REMOVE this inspectio record from the job site.
PASS PART FAIL