Permit C ITY OF TIGARD PERMIT PERMIT
PERMIT #: BUP2005 -00547
A
��k DEVEL R9 ICES -639 -4171 DATE ISSUED: 10/11/2005
PARCEL: 2 S 102 BA -01100
. SITE ADDRESS: 12220 SW GRANT AVE ZONING: I -P
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 058 JURISDICTION: TIG
Project Description: Change of use confirmation to issue C of O. (This permit replaces expired permit BUP2003- 00399)
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR 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: 20 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED c ?
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:
Owner: Contractor:
JOHN HADLEY OLSON & JONES CONSTRUCTION INC
2656 FAIRMOUNT PO BOX 19563
PORTLAND, OR 97201 TIGARD, OR 97280
Phone: 503 - 297 -7670
Phone: 503 - 244 -7467
FEES Reg #: LIC 54065
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/11/200` $62.50
[TAX] 8% State Surcharl 10/11/200: $5.00
Total $67.50
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 Cen -r. Tho- i u les . - et forth in OAR
952 -00 - 010 t •ugh OAR 952 - 001 -0100. You may obtain a copy of hese les or a -ct • - eons to OUNC by
callin 503 - 246 -66 °9 o -:01- 332 -2344. /
Issue By: . . . � . Lt a Permittee Signature: •A .� /'
0
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.
Buildii,� -PE'Prit Application FOR OFFICE IISE.ONLI'
City of Tigard N - ( Permit No � dAto CND
13125 SW Hall Blvd., Tigard, OR 97223 Plan R . /�
■ Plan Review
v ,1, Other Per
Inspection Line: 503.639.4175 OCT 11
Phone: 503.639.4171 Fax: 503.598.1960 r " P'�'' Date/By. ...A.91; - II. Date Ready/By:
� See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: ,w Supplemental information
rsTY OF TIGARD
TYPEetiSLt REQUIRED DATA: '1 -.AND, 2- FAMILY DWELLING .
❑ De molition Permit fees* are based on the value of the work performed.
❑ New construction Indicate the value (rounded to the nearest dollar) of all
Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
- " , CATEGORY RC
_GORY F 'CONSTRUCTION work indicated on this application.
ID 1 -and 2 -family dwelling C ommercial /industrial Valuation: T ,
❑ Accessory building ID Multi-family Number of bedrooms:
ID Master builder ID Other: • Number of bathrooms:
JOB, SITE _INFORMATION AND • LOCATION--„' ' .7;7 ':" "' := Total number of floors:
Job site address: l I New dwelling area: square feet
City /State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ,.'`- _ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet •
----L-C9-140---(1-0 Other structure area: square feet
' ',REQUIRED DATA :, COMMERCIAL-USECHECKLIST .
Subdivision: • I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
^ '. DESCRIPTION O WORK'. work indicated on this application. •
_ ....� � /! - N - - - — - - - Valuation:
Existing building area: fg,kb square feet
New building area: z square feet
• -❑ PROPERTY OWNER • I .. • ID _:; ` - , ', - " ` Number of stories:
Name: J � �Ci A a 5 ( sr• , C I �_ Type of construction: (A/evo 4 ," _94
Address: j Z,ZQ) Occupancy groups: lg
City/State/ZIP: � 6 .,.`,, (J Existing:
Phone: (,[ ) °r()(0 I d LC Fax: ( ) New:
❑: APPLICANT ❑`CONTACT PERSON:;:- ;,,.:.: •
• <<. . NOTICE, ,; :'
Business name: OLSo x j Z,I) ®S 4.,c1 All contractors and subcontractors are required to be
Contact.name: G i _ _W C� licensed with the Oregon Construction Contractors Board
�— under ORS 701 and may be required to be licensed in the
Address: , b / J( `( (^) "> jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: _ . a 0 2 i
apply:
Phone: <15) oZtF 7(46-7 Fax: : ►aS) 67 `'/
E -mail: GQ4' I'! , i id ._.., .
CONTRACTOR...
Business name: iru
• BUILDING PERMIT. FEES*
Address:
Please refer to fee schedule.
City /State /ZIP: .
Fees due upon application *497
Phone: ( ) Fax: ( )
Amount received
CCB lie.: $ .
Date received:
Authorized sign. , - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: I 4 2, 1 ¢ Date: /0-, a , * Fee methodology set by Tri- CountyBuilding Industry
( !rte Service Board.
i:\Building\Permits\BUP -TI- PermitApp.doc 12/03 440.4613T(1 l /02 /COM/WEB) •
CIT M F TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00f47
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 kAl I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: $111 24QOsa TIME: 7:03AM PAGE: 100
SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: (RED INK INC OFFICE ADD. )
DESCRIPTION: Change of use confirmation to issue C of O. (This permit replaces expired permit BUP2003- 00399)
OWNER: JOHN HADLEY. PHONE #: ' 503- 297 -7570
CONTRACTOR: OLSON & JONES CONSTRUCTION INC PHONE #: 503-244 -7457
Inspection Request Scheduled For: Date: 11/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 50$ -891 -5491 N
Corrections/Comments/Instructions:
OF Paa-----
Afas
AN
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
'' wi d •
Inspector: r Date: t 17 (' JPhone #: (503) 718-
CI;T�Y TIGARD
'� BUILDING DIVISION PERMIT #: BUP2005 -00547
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2005
Phone: (503) 639 -4171 Gnimnitik a ?1a
�
Inspection Requests (24 Hrs.): (503) 639 -4175 . =,I � i
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 127
' SITE ADDRESS: 12220 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 058 TYPE OF USE:
PROJECT NAME: RED INK INC OFFICE ADD.
DESCRIPTION: Change of use confirmation to issue C of O. (This permit replaces expired permit BUP2003-00399)
OWNER: JOHN HADLEY, PHONE #: 503 -297 -7670
CONTRACTOR: OLSON & JONES CONSTRUCTION INC PHONE #: 503 - 244-7467
Inspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description • Confirm # Contact # Message
299 Final inspection 018078 -01 503.442=5253
/OP',
Corrections /Comments /Instructions: LGA1/1�
��k 473 6) /
/ k c C r' .ix i ' / i ja I / • 0- , �4i i.
h &44 91/ 4 41i-di,eV ii5e"Xlifignit( -
(e tO X LI 2_ 6
, ,
•
❑ PASS P<C PARTIAL APPROVAL
❑ CANCEL ❑ NO ACCESS
n FAIL ❑ c LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I Date: /0// Phone #: (503) 718-