Permit A L • M.
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00004
�I�, DEVELOPMENT SERVICES DATE ISSUED: 1/5/04
A= "' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09370 SW GREENBURG RD 205 PARCEL: 1S126DB
SUBDIVISION: PP1991 - 018 ZONING: C -
BLOCK: LOT: 001 JURISDICTION: TIG
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: 15 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: $ 24,750.00
Remarks: TI: New Wall - Pediatric office.
Owner: Contractor:
FRANKLIN COMMONS ASSOCIATES TRIANGLE CONSTRUCTION LLC
BY NORRIS + STEVENS 19393 SW TUALASAUM DRIVE
520 SW 6TH STE 400 TUALATIN, OR 97062
PORTLAND, OR 97204
Phone:
Phone: 503 - 638 -9968
Reg #: LIC 144370
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 1/5/04 $283.30 Electrical Permit Required
Plumbing Permit Required
[TAX] 8% State Surcharl 1/5/04 $22.66 Framing lnsp
[BUPPLN] Pln Rv 1/5/04 $184.15 Gyp Board lnsp
[FLS] FLS Pln Rv 1/5/04 $113.32 Susp Ceilng lnsp
Total Final Inspection
$603.43
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 1- 800 - 332 -2344.
Issued By: ;,,I ��� %`•,,, k (�//t�
Perm \ pR 1110 S ignature: '�,�� � ,---
Call 639 -4175 by 7 p.m. for an inspection the next business day
/
Bu Permit Application FOR OFFICE. USE ONLY
City of Tigard Date/B e
at /B �� c 3 . Permit No.: &) ?�� i 0001
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960
Agriorim414 � Ii DateB : 9 "0 ,� Other Permit: Inspection Line: 503.639.4175 - 4� I Date Ready/13y: El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
.s 'S: �:. :.'.d E','::
/ ' k , ; i y A os
T v , ` ' �` 'T �YPE`�ff''O F WORK € s :. REQUIRED D 1 A ND 2 FAMILY DWELLING
�d= �'+':9`w: "',�n'�:FF,ff�:s�eFv y ?C x..':'v'.in'�+�� �4��xi &... ..Vr�l`5,.e�ilN.l. (Ra 5;�4; ,9� .�VY'e `. ,. .. ;. '� 1J, > ... .. ,+:".sA, J .,,. ..,. , +u > - ,v e .t �
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
IR Additio alteratio eplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
• .r g uy O ; . ti p ' 1' .4-, ' , . work indicated on this application.
�E; "°Ae,!�ifr�.� " ':i�'� 'OF - .,* � r. �,�l` :+ i � ..ci.,
> �,r: ..� . „�� . ..... ..,. l;;�t:;'�,1., „,... ss�u . ,'�i "��.'�,w,, PP
;,,,> .. is , -N ., �Ce1TEGORY :CONSTRUC'CIONi; `
n,x�.� 3..� a... .>; a:�ex` ,�.��m�° �a;<;+a .re.�; �.�.ts�°r&`�h+:.:ne aFls�' ht�:4�
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial /industrial
1=1 Accessory building ❑ Multi - family
Number of bedrooms:
12 Master builder Other: "V G v\ V
l 4\,‘ Number of bathrooms:
� � � �, - t e-r ` �- " 'ls � t r „� r ai �9' 3 y s e � b �. t .t
W � 1 ai iTE I r
F O , R iVIA I ONi AN D' LOCATIO k'' ''� �x ;�� i ce, - _ Total number of floors:
Job site address: S ` \Vi`1 &V vtIfz \ New dwelling area: square feet
�'-'✓ lj S• � ( � �.�,�,� S� *s 4 7��
City/State /ZIP: Z Garage/carport area: square feet
Lite ldg. /apt. no.: 2 - Project name: D t w A , f_ Covered porch area: square feet
Cross street/directions to job site: (_,<'c t,n dL(^ k, \ \1 Deck area: square feet
Other structure area: square feet
UQ iq?, 1 R c; U SE i } GHEC'K LI ST;,4
Subdivision: 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
..x�,t -z " ,s ;'t- ° - 0 =i:, 3'i{.4"nN's <.:..;tJ '�"i } ^: �a +' ; Je $ >: - i::e�>'.;,
gi ` AMi �rz` ��DESCRIPTION OF. 4004. : ', work indicated on this application.
,- a rr } , _ a . , ,„h , ... . ..:.a ; A.�c.. +. ,,,ra ..� . ?t ; ,. ' {, :F'a ,.^ '
V11/(f,CZ � C M Valuation: $ '�l, 1 Cj (�
Existing building area: S square feet
New building area: 1J, /p, square feet
I v n '. Fz3 , i :&4 d„,..r -v¢ =i ,il° t s,^i �fi 4 d WOO Y �> 3 TEN 1+ >i " °` ^ e `�
® PROPERTY "OWNER 3� ` l ; �. : ,t Number of stories:
,i ,� ors - �a- s�:�:a_,...C4,a1,.u„ re.5 .����..,,�.,: �m�t .,,,.��z�... �. �r ,'i.>� :J�sw
Name: Q - 1 ___ w: C z _, k... k ._, Type of construction: c, yv`
Address: ` gZ e, „� l � L, k k.A5 - Dv_ Occupancy groups: o� C C
-
City/State /ZIP: �j f p,�f� �- - o r\ D y Existing: )
Phone: (. 0 3) -3,..ts (0 ! I Fax: ( ) New:
;.„ ,a � , : :0 1. - ,1 TyPERS0, , f . ..,, : ; ;; p;;; 1.-M , a ?.;
> ;` iA ICAN . + ? 74 7' i) s . w C ., v. G R ivy ...,. .. =., a . ., a �.,, `: s _ + i u . N OTICE
%��'W. ,F`. -k"5 a sk�k�i -,uL a' _tc v-- 3�'6 -.:v F d_. -, .il . «. . �
Business name: -C, AaGL,cC ■{lc.,-j , LL,, C All contractors and subcontractors are required to be
Contact name: --co licensed with the Oregon Construction Contractors Board
M T under ORS 701 and may be required to be licensed in the
Address: `[7) -z� 0) 3 L� �� `. \lam jurisdiction in which work is being performed. If the
City/State/ZIP: `` C) applicant is exempt from licensing, the following reasons
Ci
n ��sb,.. t_ I”- T \N l ),C `a) 0 zaZ apply:
Phone: ( 03) 6-5i 99 5 Fax: : (5 D 3) 1, -.5.7 "f") L
E -mail:
';,
+, .. ,. ;. r-' ,4,�M »:Y':`± "5 ' —'. 'A's : a €;:«' ".» •h's:3: .o ^ :e' �^; i?'.'s+ M ,is. : w, .,-
i �4,� ",w � ,a,' tCONTRA`CTORc.. -10- . r ,:' , ,k 'z .,�7� .. :,`. „, -,.,�' ` y gri
B usiness name: 5 A Q , `.,:; i , J -,.... ,��.,., ” .....,.,,....„. •
p"-NA, � � � ■ C Q. Yt�i ' ° =' o-e�a4 " '���Bi1ILDING PERIVIIT ;FEES *�
Address:
Please refer to fee schedule.
City/State /ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
� i Amount received
CCB lie.: \ 4� " "� ] v l _ C
Date received:
Authorized signature: � ��_
Print name: fi
This permit application expires if a permit is not obtained
�,rO within 180 days after it has been accepted as complete.
�
„ Q * Fee methodology set by Tri- County Building Industry
` t", A � \W\ L-1 "` ` �� �� Date: 1 Z\ -1,0\ �U\ 0 .3 111 Service Board.
i.\Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T( l l /02 /COM/WEB)
Building Division
Plan Submittal Requirement Matrix
�' Commercial & Multi- Family - New, Additions or Alterations
City of Tigard
4 m .;'K" ga,:- 5;ia> : ,5. q ,.:: } �.., ,. `.,�vr¢.:'-:,d '-�;r ;,; :,.' .4-'r"��t4; °
tt Type�ofSubuuttal # of Plans
1 � , ', ncludes new, additions and alterations) Required at
e�#yx; r i l h is t a !. t a .-s
nY �' 33i ' L. r ?- v 2cN
r-- 1 a,�,z. . ', S '. .:la m ° ,,,, :,°'. w..r ".m
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
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
a% 2 BU y — vvva�
Received / Date R quested —/' ! d "1` AM PM BUP
Location ?3 70 Suite Jr<e 20 p
Contact Person Ph ( ) PLM
Contactor Ph ( ) SWR
BUILDING Tenant/Owner &re- ELC
Foundation Access: ELC
Ftg Drain ELR
•
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
t viaa PART FAIL
ING
Post & Beam
•
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
Pod& �AL
Pos & B ` e ' ad
Rough -In
Gas Line
F fDampers
4 �
'ASS 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 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA ?j 2/0 O 7
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site:
PASS PART FAIL