Permit li 4 4t CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00297
DEVELOPMENT SERVICES DATE ISSUED: 7/31/2006
�'u' - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 109DA -11300
SITE ADDRESS: 12972 SW BLACK WALNUT ST ZONING: R -
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT: 102 JURISDICTION: TIG
Project Description: 397 sf deck.
REISSUE: CUSTOM FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: U2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 7 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: $ 6,573.00
Owner: Contractor:
KATHERINE CHENG OWNER
12972 SW BLACK WALNUT
, TIGARD, OR 97224
Phone: 503 - 968 - 6990 Contact #:
FEES Reg #:
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 7/13/2006 $84.31
[BUILD] Permit Fee 7/31/2006 $12.48
[BUILD] Permit Fee 7/31 /2006 $98.02
[TAX] 8% State Surcha 7/31/2006 $8.84
(additional fees not listed here)
Total $242.17
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 P ermittee Signature:/ �
/P APP
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.
li
• y a,, • IC ". J. Ire • • e t u Permit Application r.
RECEwE® roil OFFICE IJ SE O
Cl of Tigard Receive�pp
City g Date/By: �� � i i � Y f i i l i f i f l � � i - 2 a 2 7 ci
. 13125 SW Hall Blvd., Tigard, OR 97223 U L 3 Z006 Plan Revie 'l g Oh
C
Phone: 503.639.4171 Fax: 503.598.19601 1 Date /By Other Permit:
R:'l7 Ins Line: 503 Date ReadyBy: / t`" RI See Page 2 for
T l. G A
Internet: www.tigard- or.gov CITY O� TIGARD No ' d/Me t hod: �I v / I ( Supplemental Information
BUILDING DIVISION/ /.
• .rot: ✓ i . %�.Li_.
TYPE OF WORK b R QUIRED DATA AN 2- FAMILY DWELLING
❑ New construction ❑ Demolition. Permit fees* are based : the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
61 Addition /alteration/replacement ❑ Other: . t equipment, materials, labor, overhead, and the profit for the
CATEGORY OF ,CONSTRUCTION work indicated on this application.
Valuation: S Le (i0 v� f `
El I - and 2 -family dwelling El Commercial/industrial ` �n�7�•�n
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: i ti.4 a 31.3 WILL Ot(,t t" New dwelling area: square feet
City /State /ZIP: r't(a r (r2 �I --2_z4 Garage /carport area: square feet
Suite/bldg. /apt. no.: f Project name: aligm etEI` Covered porch area: / square feet
Cross street /directions to job site: f f e)r n �P? i 1 Ov
J k_ V(IYx i rpyy e. Deck area: "b1:}20-,7C1 lfJ square feet '
ail Or\ ±) Mtif l-- 140414 • Other structure area: square feet �
REQUIRED DATA COMMERCIAL -USE CHECKLIST
Subdivision: &UM illtr kcvl 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.
t '1 ` 6 t .- Yr P L Valuation: $
I�l�tGl { 1 Existing building area: square feet
New building area: square feet
g PROPERTY OWNER ❑ TENANT Number of stories:
Name: CLVILP M f IA ,) ' - ( � 1 /61 ( 14:—. Type of construction:
a
Address: ( p NA ) L cia c i I (4 , 0 -,f- Occupancy groups:
City /State /ZIP: 17710/0. X I 3- -a -ILI Existing:
Phone: ( ) at _ �4qo Fax: ( ) New:
® APPLICANT CONTACT PERSON • NOTICE
Business name: All contractors and subcontractors are required to be
r licensed with the Oregon Construction Contractors Board
Contact name:
�l'� � under ORS 701 and may be required to be licensed in the
Address: 1 ULV Isle - if jurisdiction in which work is being performed. If the
City /State /ZIP: !! , t 4 app is exempt from licensing, the following reasons
(At t t A V ti �� apply:
- -Phone: )_- .._1'4_c
1 l Fax: : ( )
E -mail: Lade +tvk Ltd C9 h tvw .J . t".+00/\
CONTRACTOR
Business name: /1i, �� btr BUILDING PERMIT FEES*
"' (Please refer to fee schedule / 1
Address: 1M �,'�� ' ^ ���
Vv Structural plan review fee (or deposit):
City /State /ZIP: tZ''1 ae Q , X U4 —
FLS plan review fee (if applicable):
Phone: ) G . _ to C D I Fax: ( ) -
CCB lie.: Total fees due upon application:
�� 7 p3 lob Amount received: ' y . 2.
Authorized signatur T is mit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:( Date: �_ 5 -(J * Fee methodology set by Tri- County Building Industry
C" Service Board.
I:\ Building \Permits\BUP- TI- PermitApp.doc 03/23/06 440 -4613T( 1 I /02/COM/WEB)
•
Building Division
Plan Submittal Requirement Matrix
TI G A R D Commercial & Multi- Family - New, Additions or Alterations
. Type of. Submittal" • of Plans
(Includes new,Additions and alterations) Required at:,
• Stibmittal
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
SW BLACK WALNUT ST
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2 car gar. - LOT: 102 .;
' F.E. 432' DATE: 03/11/2005
PROPERTY: SUMMT-RIDGE
CITY: TIGARD ..„,
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117' SCALE: 1"=20'
PLAN No.: 170
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CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: "r . _: /
PLANNING DIVISION: Approved 0 Not Approved
Required Setba�s Q
Side: . S Street Side: /75-- Front. I< G ge Rear:
z r
Visual Clearance: Apps d 0 Not Approved
Maximum Building Height 3_ feet ,,,�
CWS Service Provider Letter Req (iced• 0 Yes U No
,;�ceived
B' : JLL4 t >ate: "2 7
ENGINEERING D - PARTMENT:
Actual Slope:_% 0 Approved ❑ Not Approved
Site Plan: P Approved ❑ Not Approved
B Date:
'10
CITY OF TIGARD . F.
BUILDING DIVISION PERMIT #: BUP200G -00297
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006
Phone: (503) 639 -4171 ./�i
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 10/13/2006 TIME: 7 :00AM PAGE: 28 -
SITE ADDRESS: 12972 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 102 TYPE OF USE:
PROJECT NAME: CHENG
DESCRIPTION: 397 sf'. deck.
OWNER: CHENG, KATHERINE PHONE #: 503-968-6990
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 038164-01 503 - 730 -7345 N
•
Corrections /Comments/ Instructions:
ASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: /7
Date: /0 --/ '3-0 rc Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: .BUP200&.00797
13125 SW Hall Blvd., Tigard, OR 97223 ,., DATE ISSUED: 7/31/2006
Phone: (503) 639-4171 + p 'ilit
Inspection Requests (24 Hrs.): (503) 639- 4175
INSPECTION WORKSHEET FOR DATE: 8131/2006 TIME: 7 : 00AM PAGE: al ;
SITE ADDRESS: 12972 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO.2 LOT #: 102 TYPE OF USE:
PROJECT NAME: CHENG
DESCRIPTION: 397 sf deck. /
OWNER: CHENG, KATHERINE PHONE #: 593 - 988 -5990
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8131/2005 Pour Time:
Code # Inspection Description Confir # Contact # Message
275 Framing 0358 12 -01 503 - 730.7345 )) N
Corrections /Comments /Instructions: 3 " /
`�7c ( /� �
•
•
PASS PARTIAL i' PR OVA L n CANCEL ❑ NO ACCESS
FAIL I CAL s' I S'1e -alW ADDITION~ FE ASSESSED
ZS a .3
Inspector: Date: Phone #: (503) 718-
r
CITY OF TIGARD - r •
BUILDING DIVISION PERMIT #: BUP200G -00297
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2006
Phone: (503) 639 -4171 , 011!" °
Inspection Requests (24 Hrs.): (503) 639 -4175 J . '.! .
INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7 :00AM PAGE: 51
SITE ADDRESS: 12972 SW BLACK WALNUT ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO 2 LOT #: 102 TYPE OF USE: •
PROJECT NAME: CHENG
DESCRIPTION: 397 sf deck
1
OWNER: CHENG, KATHERINE PHONE #: 503 - 9013 -6990
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/28/2006 Pour Time: 9 :00
Code # Inspection Description Confirm # Contact # Message
205 Footing 03562&01 503 - 730 -7345 N .
Corrections /Comments /Instru tions: I
N re‘ (/ 4 ,
q ., y?s 1 ► f c � --
pj1 ASS n PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: " ��'` C/ Date: ?12-0) Phone #: (503) 718 - -2-- � 2 1