Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00150
� DEVELOPMENT SERVICES DATE ISSUED: 4/2/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114BA - 13600
SITE ADDRESS: 16300 SW COPPER CREEK DR
SUBDIVISION: COPPER CREEK STAGE 4 ZONING: R -7
BLOCK: LOT: 101 JURISDICTION: TIG
REISSUE: ,(K. FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: KID D 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: UNK 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: $ 6,500.00
Remarks: Underpin and stabilize NW corner of foundation
Owner: Contractor:
SHORE, HARVEYAAND LZB INC
BETTY JO 619 SE 12TH AVENUE
16300 SW COPPER CREEK DR PORTLAND, OR 97214
TIGARD, OR 97223
Phone:
Phone: 503 - 235 -4625
Reg #: LIC 76450
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 4/2/04 $62.50
[TAX] 8% State Surcharf 4/2/04 $5.00
[BUPPLN] Phi Rv 4/2/04 $40.63
Total $108.13
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 800 - 332 -2344.
Issued B : /
Y � ' y, &A)
Permittee / "V Signature: v tj� • 1 '
Call 639 -4175 by 7 p.m. for an inspection the next business day
04/02/2004 10:15 FAX 5035981960 CITY OF TIGARD @1001 /001
Building Permit Application , n rc It t)l l i1 cr USE ON
City of Tigard D iU�i 'i �ii " - t )/
13115 SW Hall Blvd.. Tigard, OR 97223 Plan Revit OsMr Perrot:
Phone: 503.639.4171 Fax: 503.598.1960 '' „, ,: DetrJB '
' �..� l,' Date Re .4y/Ry: El see Aaattuvt Checklist for
InSpeCt n Line: 503.639.4175 _ �`'� Supplemental Intormatton
intoerner, www.ci.tigard.or,us Natifietl/Method.
L i a. 1 r'Ir Y' :! 53t:1f ^ ,e �.'p'I' P " 1. 1i,, 41 i rrr'. �!n1r;a. '.';I!i lt1011-2∎ 1 ;11.1 ?.{ Q D BEAT 1r=i11 i • 1 i' 4 . ;, ,A � ' ii . . 1 t r ;' i'e i •:� ; ;di 9r 4; „ 1. . 1.' - .., . It... - e . , . .
I � I i�I 'Y,:!i I !! 'p :�5 ` • J[ �d {{v'hr ' ,.I; 'I .��d'of IftY +, '�4, ". ri: �.; .... �.I'.I n' r:l
IS .i :':''rh ll�:l "':'4NA •fit d�``i•I'V4 !,.'44 �t'I ; "��, ' .Ill tt
Demolition Permit fees' are based on the value of the work performed.
❑ New construction D Indicate the value (rounded to the nearest dollar) of all
ofit for the
13 Addition/alteration/replacement �thcr • ✓ equipment � on this application
I •11 -� .' Y i ' C"t.,.*Ni:.rar i 1 � • :: ,k 7i ,,i M 4 _ -
`' �{� �•?'' .9.1pi 'i +i. 9s'rN,`t1t�l rE•'•'�':•r GO� i'•u lJ, 101�bi'�_, ,� t,�YY�E ",i'' r�i� (.
.N tl i. n1 �5 �11 ' 4�1V'i�. ` •Air•i'''� "I "' + "`• \1 .Lt: ��Y "; ! • 1, '��
rd F�•� ' . r a Valuation:
4 F. 1- and 1-family dwelling 0 Commerciallindustnal
Number of bedrooms:
❑ Accessory building 0 Multi-family
( Master builder 0 Other: a Number of bathrooms:
.. m n" ,6 ,, ,a, : r. , ,. , -;. . u; _ : �• I:i . �,'f,[ .+I oral number of floors
K ., 'i' = ' I 1 . .1f a ii -.5 )
1 �' t //' 1 St At ; rr a��`ir; :g '' ., , `'� " , ' �5� . 7�:� y a,,,, : :I �I,..'�,'I�'A 1 t ° i i .r, 1 _ —
, ��p ' ".,,�C�.���'Ji�: �LlG al Iw:,e r iHwr.= ,r'4FT.`,t,:� •.a I ... n r. •., r'
New dwelling area: square feet
Job site address: . OD 1A) C p � at p
City /StatcZlP: • l/ _, el Q✓ 7i- ' Garageicarpott area square feet
St»teJbidg- /apt. no.: Project name: f . , S 11,o
Covered porch area square feet
Coss street/directions to job site: Deck area: square feet
Other structure area: square feet .
�p n � I q .J _ m { I ..
Subdivision: 1 Lot no.: Permit fees are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) o f all
I� n oel no.: equipment, materials, labor, overhead, and the profit for the
_ W ,� r,e . - da 'r-•f'1111 ?Fg':: - c: .!t��'�'{i ? "''1 work indicated on this application-
- .r , :�.;A:.15. Jr. 'i' p �I�ti` - ��� 1'.11 I . t', :;
� ?II 9�t•.. 's�$,I�t ^br!�f i 'v y i ,r t• ,� t y;, ; ?l, �,i y -• •vt`W.iI r.Y . F9 'E<', �!ti l . G c T a n . ' .. 4�p '1•_L �' Iy . + " �1� n
" = � Valuation. 4
' ' t+! n ■ r I S 1OLL Zt, IQ 1,0 C Or Yom/
^"3, • ri 11, sr, u) / Existing building area: square feet
New building area: square feet
L, ° .Cdw .r dIN ',,a b'1 j":• 2 q.'dF.6;,IL'•: 7•rsjl t i I''�`i!
{ '1:,'I Vii ;" S':" i ' N umber of stories:
o � I .'1 ' #'s I��7 Q', :fl';r iI , 1, E;' .1 '" -.> K1VT'_ " ?'
ik;1a;' ^,I���'Qa� m.«TIt � . ,�,,. aa��� " !'�`:I:]t�: xhLilF ; ".,._..1 • ..���..!.�: .ti ,t. �Iti;': , Curd
Name: • ¥_ Type of construction.
Address: I ( • ♦ CI) ► • ' ✓ 1_.a .
Occupancy groups:
City/State/ZIP: • At / r ✓ / . Existing:
Phone: (933) ` OC( • -3, a ; New:
� 1 , `e -.m r .L -I � 1 '0/4" rl -91 .1; I Y;,,'} . I `"r ^IT': :' '.r ' r i ; 'aY.......' i . qi. N , . f., . • ' •, . ., , flt' i . ' , ' •
p"f t , 1 _q !t ,r, i,.1L� 3f' f `I1. o t , „� I; s; ° .'uII �� I I t; ; •,'',NO ,. ; .
��` � , .N�'t � 9 F�t��r.6 t - '�M,' ;,' . , - 9� �' �� ,� t . ��' � . �1 I, II r. .•� -. , ,., „I�� �° u ii +��'' „• ,,.....,, s; , : ;,,
u � _I , �:tt•J.,�1�'� zl•i,'. °r, LAY. I: ••i �r:�) .
'd ' AB contractors and subcontractors are required to be
Business name: LG� //1� (yt.ge4 !:L[`' ew �NL' CJ!'s A
licensed with the Oregon Construction Contractors Board
Contact name: p / �-�� under ORS 701 and may be required to be licensed in the
Address: t q t. Z ° jurisdiction in which work is being performed. If the
�O applicant is exempt from licensing, the following reasons
City/State/ZIP: Po v CV
,. apply:
Phone: ( , 3) , — 42 Fax: : (563) . - 2
E -mail:
( t, I I 1tii'LN ✓I la q .. •':w:n=..., tq h r.,�,� CWRI,', ": ii..;,.: jjk i i icae1p l:�
'A {i!➢ I. 15 F,i :: r' ll-� ' '+ %t I t T ' y ' A ' I. '4 " " k \ it' ' ' .0: f . ' ''' Jr-
,� t 1 ' P i . R;an . ` t��� ' Ir � n � !:', 1„ , - , ' h, . l et, , k• I. , S �1 )..,A • t 1 I
A Ali / i�.';J1 :
"iI;.",lii'R}a•'l i II:x1 ,, ;■0E ' -
Address: 6 / i2 Please refs to fee schedule.
City /Stare/ZIP: I1.1 ., r1 ' • Fees due upon application
Phone: • ) . i• Amount received
CCB lie.: —7 (e Li e) _, Date received:
Authorized aig atura This permit application expires if a permit is not obtained
4 1
within IBO days after it has been accepted as complete.
Print name: ....L-- °�`��yl Date C) a Fee methodology set by Tri -County Building Industry
�1 Service Boa* /J
: xault•n.a�rermnnevr•re�asxpn.a� zeros sao<suTCttroveorerw6at � J� �� — i'/
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST CO) 4 SK)
Received 0,3 Date Requested 4 AM PM BUP
Location /630() MEC
Contact Person / ' • ( 503) 2 36 4/6 2SPLM
Contractor , Ph ( ) SWR
BUILDING Tena 0 er 4 /ALi1, ELC
Footing
o undati Access: ELC
n ,` ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation r ®A ' 60 QtkraelfM14
Drywall Nailing ,,��,,//��
Fire wall ° N5 D 6(\ �11.JNzrf AfipPta0 j k.
Fire Sprinkler
Fire Alarm
S,usp'd Ceiling ' C N K
oof
ther:
Fi
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRIC AL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA f �, I, (
Approach /Sidewalk Date ` 0 + - Inspector \� lam`- Ext
Other:
Final DO NOT REMOVE this inspection roc from the Job site.
PASS PART FAIL