Permit ,CITY OP 1'IGARD BUILDING PERMIT
PERMIT #: BUP2006 00071
l �
DEVELOPMENT SERVICES DATE ISSUED: 4/26/2006
Ali 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 BC -02600
SITE ADDRESS: 10310 SW CANTERBURY LN ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 005 JURISDICTION: TIG
Project Description: 911 tower pole & 10x20 equip. shelter.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: 200 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: S2 TOTAL AREA: 200 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:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 112,000.00
Owner: Contractor:
CITY OF TIGARD PCR INC
13125 SW HALL PO BOX 630
TIGARD, OR 97223 BEAVERCREEK, OR 97004
Phone: 503 - 639 -4171 Contact #: PRI 503 - 632 -2012
FEES Reg #: LIC 134134
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 2/1/2006 $514.22
[BUILD] Permit Fee 4/26/2006 $791.10
[TAX] 8% State Surchari 4/26/2006 $63.29
[ERPLN] Erosn Pin Rv ( 4/26/2006 $20.80
(additional fees not listed here)
Total $1,474.21
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 da s. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. These rules are set forth i. 1 tr
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules o direc questions to •U /', /by
callin 03 -24 •656999 1 0- 332 -2344. Al /
Issu d By: // * ik 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.
!
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B P ermit App •
- : I OR OI I ICE USE ONE1
Received
City of Tigard Date /s . _3 _ �` . r Permit No.: % p o pt, Ri r
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ��� C�V
Phone: 503.639.4171 Fax: 503.598.1960OCT 1 005 iia . � �? I " Date /B . t_! \yf�%b Other Peimit: . ii a«o3 .�,00 I u
Inspection Line: 503.639.4175 r• 1 D ate Ready :y: Seel age 2 for
Internet: www.ci.tigard.or.us Notified/Method: 7 I- t ` Supplemental Information
CITY OF TIGARD:
. . BUILDING DIVISION S e .A.- w R� 1 A ,
TYPE OF WORK REQUIRED DATA: 1. AND 2- FAMILY DWELLING .
M 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
• ❑ 1- and 2- family dwelling R1 Commercial /industrial Valuation: $ /0-, 000
El 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: t 0 3 10 S LA) eet„AtA New dwelling area: square feet
City /State /ZIP: bp9 9g 9732-3 • Garage /carport area: square feet
•
Suite/bldg. /apt. no.: Project name: ep,J /„ J ✓ Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
5w 103"4 / y V 1, ciatv4ri bttry z",1 ,9 Cozy Other structure area: square feet
WA pill) gfq Tl REQUIRED DATA:=COMMERCIAL -USE CHECKLIST'
Subdivision: l 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.
WRSh 1t�,4t9i✓ c o• 911 /owee 5)-1-e. Valuation: $
Existing building area: square feet
New building area: /5 square feet
❑ PROPERTY OWNER' • Et TENANT . Number of stories:
Name: U.43e / /o,L„,'y L✓n; ! r„� y s VI es Type of construction:
Address: 0// L 9t �
v /t Ve; / 7 Occupancy groups:
City /State/ZIP: gAt/e - ka,t.? Existing:
Phone: (56 ) '' j b -.GI O to Pax: ( ) New:
• APPLICANT ❑ CONTACT PERSON NOTICE
—
Business name: peA /AI C., All contractors and subcontractors are required to be
Contact name: J z G �. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: /?v lox to 3D jurisdiction in which work is being performed. If the
Cit /State /ZIP: applicant is exempt from licensing, the following reasons
Y $rAVerrveek 0 R - % 7'004
/- / apply: . /D
Phone:( 623Z _Zore_ Fax: �a 3 7 ° t
E -mail: ;212 ?L2 e /4(,/. C�''� � J •` '
' CONTRACTOR T 3•az
Business name: n /t/ fe PP /Soy 4 3 0 /g'9 J ��� r p
��lh > t 9 700 BUIL PERNIIT F ,
Address:
Please refer to fee schedule.
City/State/ZIP: 'T v � (0th Q 0 • 6) 01 .._l} a(il � / o j
Phone: (D3) G 32 (9.0/ F ( )34°' b 6 ) 46a i/ 7/ D
Amount received
CCB lie.: / 34> 3d/ 3/707
Date received:
I
Authorized signature: / � ( This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 3 lic C Date: /o // 7,/ 7 * Fee methodology set by Tri- County Building Industry, '
Service oard.
J . 1:\ Building \PemutsWPS- PennitApp.doc 12/03 440- 4613T(I1 /02/COM/WEF 6 i � • C' i i
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City of Tigard: Fire Protection Permit Che l st
' Page - 'Supplemental Information • r.
Describe work to be done:
1.) J[ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review re ired.
❑ Repair
'-
Number of sprinkler heads: (�
Additio 'a1 description of work:
Comm . - Fac✓c2
Type of S stem (Complete A, B, C or D as applicable):
A.) Comme ial Sprinkler
❑ Wet .❑ Dry
AdditiI nal Standpipes
Informat q n: Hazard Group
Density
Design Area
K. Factor
Sprinkler Proj t Valuation: $
B.) Type I _ ; Hood Fire Sup ression System -
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Batter . alculations ❑ Yes
include: Indiv'dua omponent ❑ Yes
Cu heets
Fir. Alarm Project Valuation: $
•
D.)' Residential Sprinkler (Sta i d. Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee:,' $
FLS Plan Review 40% of Per„it _' $
. • t. TQTAL: : $; • a . f
• rte ,L • l :y ,, j.' i':r ' i - 4 44 ,f71 .4
Plan review requires a completed applicatd 38sktgt',plaIsat, �rittal. Plan review fees are required at •
submittal. .
"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\FPS- PermitApp.doc 2
•
CITY OF TIGARD --
BUILDING DIVISION PERMIT #: BUP200&- 00071
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 4/2612006
Phone: (503) 639 -4171 x iii
Inspection Requests (24 Hrs.): (503) 639 -4175 � ' j .J
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE: 59
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 911 MONOPOLE TOWER
DESCRIPTION: 911 tower pole & 10x20 equip. shelter.
OWNER: CITY OF TIGARD, PHONE #: 603 - 639.4171
CONTRACTOR: PCR INC PHONE #: 503 -632 -2012
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 053925 -01 503 -632 -2012 N
Corrections /Comments /Instructions:
1 C i
r
, /
, /
)A I l PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: \ 4/ \ Date: V /1 7 0-7 Phone #: (503) 718- 2- /
b-
CITY OF TIGARD
BUILDI DIVISION PERMIT #: BUP2006.00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2006
Phone: (503) 639 -4171 / aupOil
Inspection Requests (24 Hrs.): (503) 639 4175 '�z!�i
INSPECTION WORKSHEET FOR DATE: 0/1/2007 TIME: 7:03AM PAGE: 53
SITE ADDRESS: 10310 SW CANTERBURY L.N CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 91 MONOPOLE TOWER
DESCRIPTION: 911 tower pole & 10x20 equip. shelter.
OWNER: CITY OF TIGARD, PHONE #: 503 -639 -4171
CONTRACTOR: PCR INC PHONE #: 503 - 632 -2012
fr 1^/1
Inspection Request Scheduled For: Date: 0/1/2007 c i 9., Pour Time: e A,0 V"
Code # Inspection Description Confirm # Contact # Me . ge , f
299 Final inspection 053150 -01 503 - 329.0309 (" pi.,
, 4
Corre tions /Comments /Instructions: 4 9 3- �3L J 201 e,
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❑ PASS n PARTIAL APPROVAL 10 CANCEL fI NO ACCESS
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: ° r _ Date: �'( 1 3/ 6) Phone #: (503) 718 - Z
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CITY OF TIG�►R® 268 (I) — 61)01
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ,� m���i�1t
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: • e
SITE ADDRESS: ) b 1 I b J j/V f CLASS OF WORK: 2:: 1 al
SUBDIVISION: LOT #: TYPE OF USE: /
PROJECT NAME: I
DESCRIPTION: ,
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OWNER: - I0 : / PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Descri tion Confirm # Contact # Me sage
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Corrections /Comments /Instructions: /�� // ^� �� pp , //�
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 13UP2006-00071
• 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/10/2006 TIME: 7:02AM PAGE: 42
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 911 MONOPOLE TOWER
DESCRIPTION: 911 tower pole & 10x20 equip. shelter.
OWNER: CITY OF TIGARD, PHONE #: 503-639-4171
CONTRACTOR: PCR INC PHONE #: . 503
Inspection Request Scheduled For: Date: 5/10/2006 Pour Time: 10:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 029615-01 503-329-0309
Correetions/Comments/Instructions:
• ' 11r 111 1OM I A .6111■MYM■
OFItA> ezfrP,)(P-f
• .07-0- PCP
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ASS 0 PARTIAL APPROVAL I I CANCEL I I NO ACCESS
FAIL 11 CALL FOR INSPECTION ADDITIO AL FEES ASSESSED
Inspector: 410 Date: (M 4 " Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION ' ' A
PERMIT #: BUP2006-00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2000
Phone: (503) 639-4171 kt
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 5/9/2006 TIME: 7:01AM PAGE: 24
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: T1GARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WC-CCA 911 MONOPOLE TOWER
DESCRIPTION: 911 tower pole & 10x20 equip. shelter,
OWNER: CITY OF TIGARD, PHONE #: 603-639-4171
CONTRACTOR: PCR INC PHONE #: 503-632-2012
Inspection Request Scheduled For: Date: 5/912006 Pour Time: 200
Code # Inspection Description Confirm # Contact # Message
205 Footing 029546-01 503-329-0309 Y
Corrections/Comments/Instructions: C.. — J H "1/
ev c90/A. 1 ' 100 p ni,
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Inspector: 0 Date: ' Phone #: (503) 718-22_
_ .
CITY OF TIGARD , -� =�
BUILDING DIVISION PERMIT #: 13UP2006- 00071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/200€
Phone: (503) 639- 4171�y
Inspection Requests (24 Hrs.): (503) 639 -4175 ��' "AIL.
INSPECTION WORKSHEET FOR DATE: 5/3/2006 TIME: 7 :08AM PAGE: 99
I
SITE ADDRESS: 10310 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: WCCCA 911 MONOPOLE TOWER
DESCRIPTION: 911 tower pole & 10x20 equip. shelter.
OWNER: CITY OF TIGARD, PHONE #: 503 - 639.4171
CONTRACTOR: PCR INC PHONE #: 503 -632 -2012
Inspection Request Scheduled For: Date: 5/3/2006 Pour Time: 11:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 029101 -01 503.329.0309 N
Corrections /Comments /Instructions:
--(73 � - .
`16+0,
K T.:i VO
,
I PASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIO AL F , ES ASSESSED
., � 1 :i Phone #: (503) 718 -
Inspector: Date: _ . ( )
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