Permit CITY Or TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00559
DEVELOPMENT SERVICES DATE ISSUED: 10/19/2005
'` �.�I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AB -01606
SITE ADDRESS: 07357 SW BEVELAND RD 100 ZONING: MUE
SUBDIVISION: CLARKE BUILDING LOT: 017 JURISDICTION: TIG
Project Description: T.I.
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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 42 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: $ 60,000.00
Owner: Contractor:
TOM CLARKE SEQUOIA WOODS DEVELOPMENT CO
7355 SW BEVELAND ST 12439 SW 22ND AVE
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
Phone: Phone: 503 - 293 -1226
FEES Reg #: LIC 162554
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/19/200E $525.50
[TAX] 8% State Surchari 10/19/200`. $42.04
[BUPPLN] Pln Rv 10/19/200E $341.58
[FLS] FLS Pln Rv 10/19/200E $210.20
Total $1,119.32
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. These r s are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the e rul s o dir t estions to OUNC by
calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By:'p Permitt Signature: / Lr
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 MA RV
, FOR OFFICE USE ONLY
City of Tigard Received
{� (� (� �!� d Permit No . if - ,
13125 SW Hall Blvd., Ti ard, OR 9722
g �:J�� ✓ �ou� Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �!vn 3fj•A Date/B : Other Permit:
Inspection Line: 503.639.4175 5 r Date Ready/By: ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
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 her: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. •
El 1- and 2 -family dwelling ;EVmmercial /industrial
Valuation:
El Accessory building" ❑ Multi- family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
` JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: . std, rg, „. s r- r , New dwelling area: square feet
City /State /ZIP: . 7 C9tLr -&. ov1 Garage /carport area: square feet
Suite/bldg. /apt. no.: 9 I Project name: 6fvF Sr`- POf' Fe. 12 l_b Covered porch area: square feet
Cross street /directions to job site: '7 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 WORK work indicated on this application.
Valuation: S
?(A1 \Q S '1 1,AC6 (bw►i+T rL ` ` 1 L✓ LL �d I
h.)(7010 214 C/ C'fN..&T S /e 4Lp ROk2O 1 ®vd i2 cal 1)4 C1 Existing building area: square feet
IVl 1g 6vshfir- 3 s3A- ( New building area: square feet
❑ PROPERTY OWNER ❑ TENANT' Number of stories:
Name: 'TuvvV (' ,t . Type of construction:
Address: t 2y'' Stu 22 1/3 v Occupancy groups:
City /State /ZIP: 1Cc= cr,lltl•iJ&1 e) 6.2. e Existing:
Phone: (565) -t <Ci-,Z Fax: K 21 New:
LICANT 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: 5/A 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: � S'[';)u(p, h.. I AA c)�+ �vAJ�I' BUILDING PERMIT FEES*
Address: c�l'1ll 1' A1'S A 30a, `''
Please refer to fee schedule.
City /State /ZIP: Fees due upon application
Phone:( ) Fax:( )
Amount received
CCB lic.: -
Date received:
Authorized sig atu e: � t`M� CC � This permit application expires if a permit is not obtained • within 180 days after it has been accepted as complete.
Print name: Date: Qo, dye 3 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\BUP- TI- PennitApp.doc 12/03 440- 4613T(lI /02/COM/WEB)
4
Building Division
°4ryitil��` 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.
i:\ Building \Permits\13UP- TI- PennitApp.doc 12/03 440-4613T(I1 /02/COM/WEB)
CITY pF TIGARD .
BUILDING DIVISION PERMIT #: 60 i�? S-6p5ji •
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 Az r r�yp , v�p81t�i�� ,
Inspection Requests (24 Hrs.): (503) 639 -4175 -�!� i
INSPECTION WORKSHEET FOR DATE: 0 TIME: PAGE:
t
SITE ADDRESS: -7%.".5 � CLASS OF WORK:
SUBDIVISION: X LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: %AAA PHONE #:
CONTRACTOR: e —E.— PHONE #: 2`t - 1Z2
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Z. 'ICI' F-1
Corrections /Comments /Instructions:
W41'
...
1w
I ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
c
� / (? Inspector: Date: Phone #: (503) 718-