Permit .,.
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00387
DEVELOPMENT SERVICES DATE ISSUED: 9/4/03
� I — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15750 SW 98TH AVE ADM. BLDG. PARCEL: 2S111CD - 00300
SUBDIVISION: ALDERBROOK FARM ZONING: R -
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW FIRST: 2,875 sf N: NR S: NR E: NR W: NR
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: N S: N E: N W: N
OCCUPANCY GRP: B TOTAL AREA: 2,875 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 44 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 21 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 330,800.00
Remarks: New administration building. Phase 1
Owner: Contractor:
TIGARD CHURCH OF GOD SHADLE & OMUNDSON INC
15670 SW 98TH AVENUE 16855 SW 129TH AVE
TIGARD, OR 97223 KING CITY, OR 97224
Phone:
Phone: 503 - 804 -3903
Reg #: LIC 128509
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require Shear Wall Insp
[BUPPLN] Pln Rv 6/23/03 $1,066.75 Electrical Permit Required Gyp Board Insp
[FLS] FLS Pln Rv 6/23/03 $656.46 Sprinkler Permit Required Reinforced concrete final rE
Plumbing Permit Required Structural welding final reps
[TIF - IS] TIF - Instit 7/30/03 $855.00 Foot/Found Insp Final Inspection
[TIF -MT] TIF Mass Tr 7/30/03 $198.00 Post/Beam lnsp
(additional fees not listed here) Masonry lnsp
Framing lnsp
Total $4,983.45 Roof nailng Insp
Insulation lnsp
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (50 ) -6699 or 1- 800 - 332 -2344.
Issued B • i 7 .∎ - C Q- 4'4-&
Perm ittee
Signature: :`,J �i,, dot_ ! --L- -'
Call 639 -4175 by 7 p.m. for an inspection the next business day
/ ,$ ,FG OG 5W TOT'S Ti slow Ctivtzcr+ o�
. Ci01°,005 - 600 , ' oV ' -2 - 43 5k
y. Build''' g Permit Application 01 .1-1( E. l tit. ON EN
Date received 2 . ,-o Permit no_: 010 -09 .. 7
Fes 1 •+ J ._ City of Tigard Pro)ect/appl. no.: Expire date:
Ci o Ti and Address: 13125 SW Hall Blvd, Tigard, OR 97223
ty f S Phone: (503) 639 -4171 Date issued: Byyil Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
I I PE OF PERM I
❑ I & 2 family dwelling or accessory ❑Commercial/industrial ❑ Multi - family `New construction ❑ Demolition
Cl Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORM U ION
Job address: S756 5 ' ;Tel A Ve. U Bldg. no.: — Suite no.: --
Lot: Block: Subdivision: Tax map /tax lot/account no.: Z 5 III G n DD -..
Project name: . •M i 5T . TlDll f . /M&
Description and location of work on premises /special conditions: Ti Pgal %�X) N4t1/ AratIAL1 OM Bu/Li A/&
15 1,06,4 01 the S o Ut 1 .. A'5r SI t2 - OP 'frig UI UJLH
011; \ER FOR SPECI: I. INFORM -k LION. l!SE CHECKL15f
Name: '(lk/A• • Cit0gU4 QG 649 ( Floodplain , wink: capacit,solar,etc.)
Mailing address: 15 (,lt 5 g5nr 41/ 1& 2 family dwelling:
State: a 12,ffiniall. Valuation of work $
Phone: ,, A - if600 Fax: (039 - 1835 E -mail: to , . ' t . • f. 4io. of bedrooms/baths
Owner's representative: • , ' (Q/.( Total number of floors
Phone: 590 -585$ Fax: - E -mail: Tco- fGk • Od algt dwelling area (sq. ft.)
\PEI( \ I Garage /carport area (sq. ft.)
Name: f I ROO J( MI ' m4 Covered porch area (sq. ft.)
Mailing address: • 11 ibV WIZ I Deck area (sq. ft.)
City: p'( /' State: O , ZIP: g72.10 Other structure area (sq. ft.)
Phone: 2.2.. 8 Fax: 2i2 - by E -mail: ac.ti ' Ai 9ffir ir iauindustrial/multi- family:
EON IR IC I OR Valuation of work $ J 3O e DO
5 ✓��enl i M Existing bldg. area (sq. ft.) I I , 9 75
Business name: I OWN b5 O►� I t.l c • -JIM New bld area (sq. ft.) z $ 7 5
Address: , e5 j w t - TH *v . Ui✓ , , ' -i /
Number of stories ONE.
City: le..//4b airy State: C!2 WargiffEall Type of construction _W2-
Phone: . 0 - 3 ' ' Fax: b ZO- b9O3 E -mail: --
Occupancy group(s): Existing: A 2. I
CCB no.: 2.; ., • New: 17
City/metro lic. no.: c 131. 7575 Notice: All contractors and subcontractors are required to be
tRCH II ECI /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: f)cI M ■ : 550C-1AM provisions of ORS 701 and may be required to be licensed in the
Address: 0 , . G A d a & 9/I f 701 jurisdiction where work is being performed. If the applicant is
Ci S tate: t � ZIP:
ty: pa 77 ./0 exempt from licensing, the following reason applies:
Contact person: . /0, 12042 Plan no.:
Phone: u2 ..//0
il(er • ecvn
ENGINEER OFFICE l SL O\LI
Name: . • : - ,, ■ _ i (J - Contact person: JON Fees due upon application $
Address: 3(00 5w eog eery A E l`IOICDU - Date received:
City: -a- LAND State: OR, ZIP: 1720/ Amount received $
Phone: oz 7- 7 8 Fax: 22 - 773 I E -mail: b n e n , ' e.R. , e f 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 provisions of laws and ordinances governing this O Visa v MasterCard
work will be complied wi hether spe fied herein or not. Credit card number / Expires /
Authorized signature 41 Date: G - 23 03 Name of cardholder as shown on credit card
✓
Print name: 0- f t07 Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 4613 (6/oo /COM)
1t. �I Ole& •15
1=1,5 to 6(0' Lilo
L
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP c9). 3 — 643e7
Received Date Requested / AM PM BUP
Location ,S A . ■•■ uite MEC
Contact Person Ph ( ) 86 q - 3 ��
Contractor Ph ( ) // SWR
BUILDING Tenant/Owner / L.( A d ;`t- Can 7 % ELC
Footing 7
Foundation ELC
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
Other:
Final
P ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain -
Shower Pan
Other:
C PART FAIL
HANICAL
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
ADA
Approach/Sidewalk Date/ // D � Inspector f i r 7 /� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL