Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00546
i DEVELOPMENT SERVICES DATE ISSUED: 10/11/2005
A L 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102BA -01100
SITE ADDRESS: 12220 SW GRANT AVE ZONING: I -P
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 058 JURISDICTION: TIG
Project Description: Convert garage to office space. Enclose walls, add floors
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 3 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: $ 6,000.00
Owner: Contractor:
JOHN HADLEY OLSON & JONES CONSTRUCTION INC
12220 SW GRANT AVE PO BOX 19563
TIGARD, OR 97223 TIGARD, OR 97280
Phone: 503 - 906 -1015
Phone: 503 - 244 -7467
FEES Reg #: LIC 54065
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/11/200° $100.90
[TAX] 8% State Surcharp 10/11/200E $8.07
[BUPPLN] Pln Rv 10/11/200E $65.59
[FLS] FLS Pln Rv 10/11/200E $40.36
Total $214.92
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. A P ENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center Those r or are set forth in OAR
952 -001' . •ugh OAR 952 - 001 -0100. You may obtain a copy of the- - rul: or dire tions to OUNC by '
c ling 503 - 246 -66• • o 810 32 -2344. I ued By ...,„, ,/ < , . Permittee Signature. "�-
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.
1 Buirding Permit AppHe l lio FOR OFFICE USE ONLY' '
Cl Of TI and � Received 1
131 Hall Blvd., Ti ard, OR 97223 Daze /B . Q ARK 1��, _J
g Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 OCT 11 200 !��^'�t''r jl ..> Date/By. Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: ^ r�,.,/� Supplemental Information
P111I DING DIVISION L L &9r f 2
TYPE OF WORK REQUIRED DATA: 1 AND 2 FAMILY DWELLING
❑ 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' F CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ 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 2,Z,2:4°::, ���' l New dwelling area: square feet
City /State /ZIP: I ` 1 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: A.C spe 1 t , Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
7T -1 V44/0 ( U 0 Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: I 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. .
Valuation: $
u 6 — Ci .4-6-6 r', o c-h 9p �.� d e'
Existing building area: t6�0 square feet
New building area: 2 square feet
❑ PROPERTY OWNER I ❑ - TENANT Number of stories:
Name: �� W 454 440 (..Gel A a spec, t ie, Type of construction: A/00 ,- 4m8 _Sr
Address: , 2.Z2.o S 1
1' ""` •
Occupancy groups: $
City /State /ZIP:17 6 4 et ( � Existing: •
Phone: (,c-tA) yy / „,
, c - Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
• Business name: 0 L �� , 1 e S C / � All contractors and subcontractors are required to be
Contact name: G 1C , licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: i O. x ) Sloes jurisdiction in which work is being performed. If the
City/State/ZIP: ` n '72-00. applicant is exempt from licensing, the following reasons
T 1 G f� , ® 2 - ' apply:
Phone: (CO3) a g.t,t j 7 c.46. Fax: : :5)/7 t'/
E -mail: tar? �Qvcc,„, and i 0-ii
. CONTRACTOR
Business name: S,,4416 /ts at1_�u6 BUILDING PERMIT FEES*
Address: 'l � /� '
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB lic.: S" T 4
�� %) Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Lo Or , : ____ Date: /U -i a. . * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\BUP- TI- PermitApp.doc 12/03 440-4613T(1 1/02/COM/WEB)
•
• Building Division
Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigaiii -
Type,of Submittal :# of Plans •
(Includes• new, additions and alterations.),- . , Required at
Submittal
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 3**
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
. A
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Permits\BUP- T1- PennitApp,dae 12/03 440.4613T(I 1 /02/COM/WEB)
CITY OETIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00546
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 ��ti (I� _A ,
Inspection Requests (24 Hrs.): (503) 639 -4175 j L .
INSPECTION WORKSHEET FOR DATE: 11/21/2005 TIME: 7:13AM PAGE: 99
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: FA SIB _C� iALTIES
DESCRIPTION: — Convert garage to office space. Enclose walls, add floors
OWNER: HADLEY, JOHN PHONE #: 503-906 -1015
CONTRACTOR: OLSON & JONES CONSTRUCTION INC PHONE #: 503- 244 -7467
Inspection Request Scheduled For: Date: 11/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 021919 -01 503- 691 -5491 N
Corrections /Comments/ Instructions:
dif t
(,)
(L______ .
\ it,/
...,
PASS n PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS
n FAIL CA FO IN PECTION n ADDITIONAL F ES ASSESSED
■ Inspector: \ Date: �.V C� Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00546
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 h1/ 914=
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' 'I I..
INSPECTION WORKSHEET FOR DATE: 10/10/2005 TIME: 7:10A PAGE: 38
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Convert garage to office space. Enclose walls, add floors
OWNER: HADLEY, JOHN PHONE #: 503- 9061015
CONTRACTOR: OLSON & JONES CONSTRUCTION INC PHONE #: 503 - 244-7467 •
Inspection Request Scheduled For: Date: 10/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 018610 -01 603- 473 -5253 N
Corrections /Comments/ Instructions:
`- ,f, i
. ......---- r x ." , -.40
b0:6 1- [(05 7C)--itii\--
' I PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITION ° L F. • S ASSESSED
Cb -
'' d:W) Inspector: Date: Phone #: (503) 718
CITY • OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00546
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 // � m vu��lll rl
Inspection Requests (24 Hrs.): (503) 639 -4175 .191-
INSPECTION WORKSHEET FOR DATE: 10/14/2005 TIME: 7:02AM PAGE: 88
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: AG SPECIALTIES
DESCRIPTION: Convert garage to office space. Enclose walls, add floors
OWNER: HADLEY, JOHN PHONE #: 503-906-1015
CONTRACTOR: OLSON & JONES CONSTRUCTION INC PHONE #: 503- 2447467
Inspection Request Scheduled For: Date: 10/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 018363 -01 503.473.5253 N
Corrections /Comments /Instructions:
•
1 � �1 % 1M
1!a' PASS l I PARTIAL APPROVAL n CANCEL n NO ACCESS
7 FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� Date: I,' A Phone #: (503) 718 -