Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00467
` � 1 DEVE (503) R 639 -4171 DATE ISSUED: 11/18/03
SITE ADDRESS: 09095 SW BURNHAM ST PARCEL: 2S102AD 01300
SUBDIVISION: ZONING: CBD
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 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: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 61 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 296,000.00
Remarks: Remodel of existing storage building to office /storage.
Owner: Contractor:
WYATT, DEWEY EVERGREEN PACIFIC INC
c/o WYATT, EUGENE 5664 CARMAN DR
9095 SW BURNHAM LAKE OSWEGO, OR 97035 -3358
TIGARD, OR 97223
Phone:
Phone: 636 -5165
Reg #: LIC 41521
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require Gyp Board Insp
[BUPPLN] Pln Rv 7/31/03 $979.16 Electrical Permit Required Reinforced concrete final rf
FLS Phi Rv 7/31/03 $436 Sprinkler Permit Required Bolts in concrete final repot
[FLS] Plumbing Permit Required Structural masonry final rer
[FLS] FLS Pln Rv 11/18/03 $165.72 Foot /Found Insp Final Inspection
[BUILD] Permit Fee 11/18/03 $1,506.40 Masonry Insp
(additional fees not listed here) Framing lnsp
Roof nailng Insp
Total $3,208.63 Insulation lnsp
Shear Wall Insp
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: 0. 1 ■ / - V k/t6/C)
Pemiittee `
Signature: / .4‘1:11111■—____
Call 639 -4175 by 7 p.m. for an inspection the next business day
."_ * 95 cIk) &€A)/?49I1
. Building Permit m /1 r E FOR OFFICE USE ONLY
t _ Received Building /
Date/By: 7 ;/ dg PetmitNo.lear4O ,5°De7447
Cl of Ti and Planning Approval ' ° Other
g 1 Date/By: Permit No.:
u
13125 SW Hall Blvd. � 1 EC��GV `` Plan Review Other
Tigard, Oregon 97223 U Date/By: Permit No.: Z.
Phone: 503- 639 -4171 Fax: 503 - 59 8 -1960 4111���'�ry�4 t� Post- Review Land Use t
JUL 31-144.- ' � I Date/By: Case No.
Internet: www.ci.ti ard.or.us J 2_
g Contact �.1pri , ® See Page 2 for
24 -hour Inspection Request: 503- 638W:75J TIGARD Name /Method: //(A. Supplemental Information
BUILDING DIVISION .
."..`. �''.i - .- �^ ',4i Y - wk:, r.� nsiS:ti „5.;."..` _e rv. '-- :,; - ''� �$'?G ; '.. ,L":
�v^ the � "�:c ''3s� �
w.
4 .� TYEE�OFwWORK, �� : x' � .•� >�
_a.a. ..: s. .. .6. .. t _. .._ ... ._ . .. ¢x:V:�+ "'�. s � "id �`�.£!• - -- '"b un -: ^ �XP. �:='
'� � - �: " DATA :�r . � f ,
❑ New construction ❑Demolition °,L - :_ _ xa. i & 2i ?FAMIi Y : DWELL'ING t ,
i
;. % �'�•:°,'6.��s�,`?C >. ., ., . , a. ' °� 5�':.Y:�`i.' =e n �:Y.3 t - i ,
Addition/alteration/replacement 111 Other:
'i t' = - :.g .i `�= F ;.; =: O Note: Permit fees *performed. Indicate
' are based on the total value of the wor
� „ QF :,�,...�a� :_ ��_, P
❑ 1 & 2- Family dwelling Commercial/Industrial the value (rou sec' to the nearest dollar) of all equipment, mat- •als, labor,
overhead and pro t for the work indicated on this applicat .
n Accessory Building Multi - Family _ _ 6
El Master Builder ['Other: Valuation ”, dam✓:- $
`: ° JOB SITE INFO and;•LOtATION R 0 No of bedrooms �'� S: o,......708 j
Job site address: Q ��,,,�� // Total number of floors - - 4 ' • ,, /� ����� HOW Total
dwelling area (sq. ft.) '
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft. / ` ;
Project Name: � + r 1 e S Covered porch area (s . ;"
Cross street/Directions to job site: Deck area (sq. ft.
Other stru ,,,„44,.....A: •gje ���
s "a'�" "=ues; v:�.�a'i..i` a " "• " c _ .w< ' tt ":c+s :�•'s''.'n"�a '=^ u � ; :,'�' %�'Yy.'�"' =
'= : ;I , .. , F , ;; `a(REQI &lc I A A x° F . t o
• s 'x ° _� C ,MIV:d RC IA ;USE E C z I ..1_ s
Subdivision: • I Lot #:
�� � , .,� � O: � E . � �CH�,CKL ST .�� � � - .
Tax map /parcel #: 2-4 / d ,2. AZ - ® l eir, Note: Permit fees* are based on the total value of the work performed. Indicate
�,
.-? �`-x�'�g�`' ==~;g �' <•` iDESC'RIPTIONOF�WORIC� ai=? �= �� »'x ='i� = =;'� '.,, a`r "� the value (rounded to the nearest dollar) bf all equipment, materials, labor,
A4)( , 7/ ` ,// overhead and profit for '' . 1. the work indicated on this application.
I ���
Aiir re 0 i� Valuation em . 1 ;�- /�
;` Existing building area (sq. ft...� . J.
ii�� New building area (sq; ft.) 1
..;:::;:c Number of stories �
< = =t, ._. �s°, �...:, > �,_::.°..° t,. Type of construction -�-,r M
lC. �', �` 1PRQPERTI '.UWNER "'°�'..�.���(> ®�TENAIVT Ran '� = T �F-, �!�?f'.�/.I ..
Name: > )j J , to >ATT' Ca y` 97,1 Occupancy group(s): Existing: IP /r v
Address: 10 � ij - si * IM .. f- F 2-- - New: 'F2
City /State /Zip: 1 P( • of'72-
Phon'` ) —11.9 Fax: / � Z -"Z�o— 1.. 1 NOTICE: All contractors and subcontractors are required to be
.,... licensed with the Orego Construction Contractors Board under
AAPPL'IGANTv4 - r „ " CONTACT'EERSON ;�a tir provisions otf ORS 701 and may be required to be licensed in the
Business Name: Affil.trfZi44.4 kfn,C 775r—rty /,4.C- jurisdiction where work is being performed. If the applicant is exempt
Contact Name: j 1 772 UM from licensing,.the following reason applies:
Address: 2e ✓E3 Hai/ • l r z A. 7 S - •
City /State /Zip:` �'7 ,:: ' 7-z/'o
r 1 �-o3 r
Phone: ax• 5 ? ^D 6? •, r ',v , ,x -t
/ / ;�- �'t�;x ?�^'^ >�r°; �"`;;`.�'�,'�,�y�" .: 7c: �a: ���` i.' E:+' P! ii'.^ a�' " � °:��e� =:..,'�:r *.`.�`_.,..? =:.
J .,; .. *' x ' . v asp -
r ; =BU ITiD IN G PE +FE „.- :?� - ,• 4 -
E- mail: ° ° }� ,� �� .� �. -��: ;-� . � , � ...� .;k:��:�� :. � -����- :r ,�-� � ;.s =
. 7 ve;,s t 7kal- , .N 4 Plea s e^refer o fee schedul v .” ` R ''i: r '_
.;� = MGQNTRACTOR.'i >,. '" eF .,,� _ '<.R a:.
Business Name: fi ozi� Atic, Fees due upon application $ // 4/6 , .
Address: eo¢- �s vV ` -(24 A-70 ort t
City /State /Zi.: ii /g, , i' , 4. ...0- '743. Amount received $
Phone: ) 66.-G (4dS Fax: 1.3 0 , -- 071i Date received:
CCB Lic. #: ' SZi _
Authorized / p II'NI' ���i ^ ( 4 p ( 4 Notice: This permit application expires if a permit is not obtained within
Signature: ijj a t e: 180 days after it has been accepted as complete.
1 / Il 0 1-N fJ *Fee methodology set by Tri- County Building Industry Service Board.
1 (Please print name)
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
•
DATE: /v ] % r� 1 PLANS CHECK NO.
PROJECT TITLE: \ T
COUNTYWIDE (,{) Cue, 9, (irf c_c 0v
. TRAFFIC IMPACT FEE
WORKSHEET APPLICANT:
(FOR NON - SINGLE FAMILY USES) MAILING ADDRESS: cif / 9 ` S, , '
CITY /ZIP /PHONE:
•
TAX MAP NO.:
SITES NO.ADDRESS: \ r
LAND USE CATEGORY RATE PER TRIP (�/ ` J;u�
RESIDENTIAL $ 253.00
BUSINESS AND COMMERCIAL $ 64.00
OFFICE $ 233.00
INDUSTRIAL $ 244.00
INSTITUTIONAL $ 105.00
PAYMENT METHOD:
CASH /CHECK
CREDIT
BANCROFT (PROMISSORY NOTE)
INSTITUTIONAL ONLY:
DEFER TO OCCUPANCY LAND USE CATEGORY DESCRIPTION OF USE WEEKDAY AVG. WEEKEND AVG. TRIP RATE
TRIP RATE
BASIS: egredao ) V1L'2 a 171 !'I " "I "
N A C -C)
0 f o A --- a Ce..,
(
Sao (3f
CALCULATIONS: e rec:e. s __ /),0
co
• 6Lif-&-Y 02 /6 •
•
ob
6. LID x /6.31 : 99. pi?z•
q 1-" PROJECT TRIP GENERATION:
F [ ' �/ �a x OC ) 33 a 57. 3 5 1 FEE: if
FOR ACCOUNTING PURPOSES ONLY
ADDITIONAL NOTES:
0 actddl - Ti F 9t
/ I, /J O��.a , k ROAD AMT
I � 1L'(' l �(/� TRANSIT AMT.:
PRAPARED yge ��
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 _
INSPECTION DIVISION Business Line: (503) 639 -4171 MST t /
BUP — 60 51 7
Received Date Requested 3 -3 AM PM BUP
Location A Q' fl } Suite MEC
Contact Person 6 4fr Ph ( ) . 7 / 1 — gI 8' 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
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 ' 1313‘5 Susp'd Ceiling ,
Roof ��
o ek
Other: 165
D
,
�j�::, 'ART FAIL 01 .1, 1 V` _
Win ING _ • r
Post & Beam /' } � S l0 � I
Under Slab T'
Rough -In
Water Service P I ° * c y(\
Sanitary Sewer t\'' c , I A vet
Rain Drains
Catch Basin / Manhole / t I 0
Storm Drain
Shower Pan
Other: I
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 El Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - 0 Please call for reinspection RE: lil Unable to inspect — no access
Fire Supply Line / /�
ADA Date 1 L /J 5 1. v'V e- Ex
t ae / Ins ecto v G�
Approach /Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL