Permit ' CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00355
� DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005
A 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135DC-02000
SITE ADDRESS: 11865 SW 91ST AVE OFFICE ZONING: R -7
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT: JURISDICTION: TIG
Project Description: Demolition of (2) carport units.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DENS FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 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:*5D0 . CO
Owner: Contractor:
VILLA LA PAZ LIMTED PARTNERSHIP LMC, INC
BY COMMUNITY PARTNERS FOR 4915 SW GRIFFITH DR #301
AFFORDABLE HOUSING INC BEAVERTON, OR 97005
IJGARD, OR 97281
one:
Phone: 503 - 646 -0521
FEES Reg #: LIC 161282
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/28/2005 $62.50
[TAX] 8% State Surcharl 7/28/2005 $5.00
Total $67.50
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
requi Y •u • : •w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9. - 001 -0010 throug • OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 - 246 -6699 ► 4 332 -2344.
Issued By: I / .4; , /./ Permittee Signature:
— A ,
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.
•
, .,
Building Permit Application . FOR OFFICE USE ONLY ,
City of Tigard Received Permit No.
PG1 /9x605 / c 55
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 //%% *7 t ' riir ? ('��' >r D . Other Permit:
Inspection Line: 503.639.4175 -'I I� Date Ready/By: Juris: lil See Attached Checklist for
. Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK - A
REQUIRED DATA: 1ND 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 ID Other: • equipment, materials, labor, overhead, and the profit for the
CATEGORY. OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling El Commercial /industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
El Master builder ID Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: t/t i—.- i, lam' , b l sr / o, + New dwelling area: square feet
City /State /ZIP: �d-ARD D I? 7 7 f ! Z.3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: �RLgN3.cueG• of g - y / f - Covered porch area: square feet
Crossstr�eet /directions to job site: q 9 le To i e gu�c, Deck area: square feet
N/
/ " V / + V!J 6126.-e--/L)6../A26 --- L Gf T 0 A 9 /'S r Other structure area: square feet
/al/e REQUIRED DATA: COMMERCIAL- USECHECKLIST
•
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.
" m i-ls H 2- �1t 6 -r- o G C f' / a 0)21--c Valuation: $
Existing building area: square feet
New building area: square feet
ED PROPERTY OWNER 0. TENANT Number of stories:
Name: j//i4 L /9 LiD , O- - iji - w , P Type of construction:
Address: .r/&1 Di L� Z_
5'7 2- - Occupancy groups:
City /State /ZIP: / j) 6 ? t , m e y ti,p , 7,00• Existing:
Phone: C6 9 &,_8..... z r/ 24 Fax: (sv3) 51 - 9-3 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: ( ) Fax:: ( )
E -mail:
•
CONTRACTOR • .
• Business name: 2. 1 ! &- IA c, + BUILDING FEES* '
Address: I j '7 ( 5J 5, W 1 ( c?/ /7� ••D,� ? (� f� Please refer to fee schedule.
• City /State /ZIP: 6b.- fr e 7 0), G 9 6
/ Fees due upon application
Phone: ( s'63) 64tp -.05-2, f Fax: ( )
CCB lic.: i ( /62,47,:). Amount received
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: ,�/D 4 ' c Date: 7 - - Qs * Fee methodology set b Tri- County B ildin _ Industry
ervice Board. �;fj
i:\ BuildingTerrnits \BUP- TI- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB) Q
7 .
Building Division
h Ii el Plan Submittal Requirement Matrix
Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
Type of Submittal r # of PI_ans
(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 o f a
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
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i:\ Building \Permits\BUP -TI PermitApp.doc 12103 • 440- 4613T(I1/02 /COM/WEB)
CITY QF TIGARD
ti
BUILDING DIVISION PERMIT #: BUP2005-00355
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28I2005
Phone: (503) 639- 4171 "ai�uwii,
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/21/2006 TIME: 7:07AM PAGE: 28
SITE ADDRESS: 11865 SW 91ST AVE OFFICE CLASS OF WORK:
SUBDIVISION: GREENBURG OAKS APARTMENTS LOT #: TYPE OF USE:
PROJECT NAME: OREENBURG OAKS APTS
DESCRIPTION: Demolition of (2) carport units.
OWNER: VILLA LA PAZ LIMTED PARTNERSHIP, PHONE #: 503.968 -2724
CONTRACTOR: LMC, INC PHONE #: 503 -646 -0521
Inspection Request Scheduled For: Date: 6/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 032065.01 503-969-3279 N
Corrections /Comments /Instructions:
r • 41 , 11 ,
•
PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
,� I /fir
Inspector: Date: v L Phone #: (503) 718-