Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00601
it DEVELOPMENT SERVICES DATE ISSUED: 10/6/03
=`-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114A0 00100
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW 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: El TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 60 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 15,000.00
Remarks: Relocate (1) 2- classroom modular unit.
Owner: Contractor:
SCHOOL DISTRICT 23J PAYNE CONSTRUCTION INC
13137 SW PACIFIC HWY 1835 NE 137TH
TIGARD, OR 97223 PORTLAND, OR 97230
Phone:
Phone: 257 -8221
Reg #: LIC 38215
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 10/6/03 $187.30 Foot /Found lnsp
[TAX] 8% State Tax 10/6/03 $14.98 Framing I
Final Inspecec
tion
[BUPPLN] Pln Rv 10/6/03 $121.75
[FLS] FLS Pln Rv 10/6/03 $74.92
Total $398.95
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 (50. 246-66° ‘' • r 1- 800 - 332 -2344.
Issue • By: ( !� �T I`j_
Perm ittee •
Signature:
• Call 639 17by 7 p.m. for an inspection the next business day
•
li
I. r /gOt� ,p •6.03 450
A Building Permit Application OFETCH:; USE • ONL\ • ,
.' �'��' Cl ' ®� Tigard Date received: /0 G 0°5 Permit no.: j,.0®6•O�'
�,•! P .ject /appl. no.: Expire date:
City of'Tigard Address: 13125 SW Hall Blvd, Tigar , R !'' 23
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 0 ' Case file no.: Payment type:
Land use approval: H D -000N 1 &2 family: Simple Complex:
TYPE 'OF PERMIT
0 1 & 2 family dwelling or accessory D Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm El Other: PORTtaa.G CL,.4$6.124:30T ,
JOB SITE INFORMATION .
Job address: '7000 ..564) s 0g/f L Bldg. no.: Suite no.:
Lot: Oa p Block: Subdivision: Tax map /tax lot/account no.: 2-5 4VJ 1I
Project name: T 16 44?-0 l-K(4H - .41. PO IZTAa(--e 2-C
Description and location of work on premises /special conditions: MOVE ANC Se7 Vp 2- - CLA45,040,P1 4 6.402_.
e vl t.DiN4 .
OWNER FOR SPLCIAI, INFORMATION, ,L .SE CHE ,
Name: 7/441W SC 06 D, Jr Gr T - ( Floodplain , septic eapacitv',solar,'etc.)
Mailing address: , 4', # 6 SA-/o/A; - . RP. 1 & 2 family dwelling:
City: 7(4 o State: 4. ZIP: 7 2.2 Valuation of work $ , _ _
Phone: -4 i' - 4eZ Fax: 6 ' No. of bedrooms/baths •
Owner's representative: CDN.f7E/,eri0N NIC,MT Total number of floors
Phone: 9:4-251 o 6 Fax:S03 2% - I$96 E - mail: New dwelling area (sq. ft.)
• ,.• APPLICANT Garage /carport area (sq. ft.)
Name: CORNE12STDh1E Cs'$s1Pl/CfilON Horn O81z'{A4 o'hm N Covered porch area (sq. ft.)
Mailing address: 5410 SIN IVIA AVE SIAM 2-0, Deck area (sq. ft.)
City: ' RTI ,p State: BCE.. ZIP: 97239 Other structure area (sq. ft.)
Phone:5Z.3- 2 Kepi 08 Fax: $b3 -Z99V % E -mail: Commercial/industrial/multi- family:
• ' • CONTRACTOR Valuation of work $ 1S; 000
Existing bldg. area (sq. ft.) NA
Business name: M `, — 1- / New bldg. area (sq. ft.) /630JF (3 .)
,�
Address: 35 �\ ' Number of stories I
IIEIVLMFMIIIIIIINMIII _ ZIP:
Phone: • '�" ���� Type of construction 5
X03 - ` ) �i : E -mail:
CCB no.: Occupancy group(s): Existing: al
r New: E
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
i
ARCHI I ECT /DI:SIGNL R licensed with the Oregon Construction Contractors Board under
Name: N(ODEIZN $U (.../M Ibr S`(S'rrr is INC . provisions of ORS 701 and may be required to be licensed in the
Address: P,0. BOX (10 • • • Pme.Tet2 , . , jurisdiction where work is being performed. If the applicant is
City: • UMSd1l l ti State: O O. ZIP: '1 yr exempt from licensing, the following reason applies:
Contact person: Kat RAW l)SSEN. Plan no.: 7Z3
Phone: ‘-03_741_- 9 Fax: -7,, .. , E -mail:
ENGINEER _ .
OFFICE LSE ONLY 1 1.
Name: see a , • 1e-e„ . Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions . f laws and ordinances governing this 0 Visa o MasterCard
work will be complied wi 1, w.eth •r specified herein or not. Credit card number: I /
Expires
Authorized signature: ■ t----a i-- Date: (a ' e" Name of cardholder as shown on credit card
signature
f ...*--
Print name: t kC. t t_ t1� }� ' -1.4..c.' Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (6i00/eont)
CITY OF TIGARD 24 -Hour .:
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP �3 — & D/
Received / ;7 fate Re uested _� ? ()C PM BUP
Location g671 Suite MEC
Contact Person ,c4 oit/1 Ph ( _ ) — )�1 /2 2.�j PLM
Contractor /�� Ph ( ' /) SWR
BUILDING Tenant/Owner ■---C_ t-G� /1—S ELC
Footing U
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 2 '_ SIT
Post & Beam =P��
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing � LCD,'j ,?
Insulation - u „ / J l ' c ,
Drywall Nailing
Firewall
Fire Sprinkler L �
Fire Alarm
Susp'd Ceiling
Roof 1� ok
Lktt
-- "1" 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
ELECTRICAL
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 ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line .
ADA 5- �
Approach/Sidewalk Date I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour . '
BUILDING Inspection Line: (503) 639 -4175 .41
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3 6"0 6 O
Received Date Re uested 0- (� AM PM BUP
Location • 00 O Suite MEC
Contact Person /1 Ph (3.(a) ) P 7a - D aZ 3 4 1 PLM
Contractor Ph ( ) SWR
Tenant/Owner ELC
Footing ELC
\ Foundati Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: . _ 2 SIT riltdre"ectie Post & Beam
I � �,
Shear Anchors - �1�� 6,
..
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
OtheRoof r: N /
e RT FAIL
G •
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
ELECTRICAL
Service
. Rough-In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - ❑ Please call for reinspection RE: Unable to i� iape t — no a.. G00
Fire Supply Line
ADA Date /c2/� /07/ OY Inspector 7071 Ext
Approach /Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL