Permit s
i
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00233
Il DEVELOPMENT i
Tigard, SERVICES (503) 639-4171
DATE ISSUED: 2/1/2005 Hall 13125
SITE ADDRESS: 12630 SW GRANT AVE PARCEL: 2S102BD -00800
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND ZONING: R -12
BLOCK: LOT: 009 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS FIRST: 1,000 sf N: NR S: NR E: 1HR W: NR
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: N S: N E: N W: N
OCCUPANCY GRP: S1 TOTAL AREA: 1,000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 4 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 12 ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: N SMOK DET:N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING: 1
VALUE: $ 60,000.00
Remarks: 1000 sf storage building.
Owner: Contractor:
ROMAN CATHOLIC ARCHBISHOP OF LUCIUS VALUSEK HOME SERVICES
PORTLAND IN OREGON 12721 SW 131ST AVE
2838 E BURNSIDE TIGARD, OR 97223
PORT LAND, OR 97214
o
Phone: 503 - 780 -8837
Reg #: LIC 138761
FEES REQUIRED INSPECTIONS
Description Date Amount Footing
[BUPPLN] Pln Rv 5/20/2004 $341.58 Foundation walls
FLS FLS PIn Rv 5 /20/2004 $210.20
Shear r sheathing
[FLS] Exterior sheathing
[BUILD] Permit Fee 2/1/2005 $525.50 Firewall
[TAX] 8% State Surchari 2/1/2005 $42.04 Framing
(additional fees not listed here) Insulation
Final inspection
Total $1,488.32
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:
Permittee A
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
1213, .s w Gnif Ave;
Buil 2" ermit Application ;" , FOR OFFICEUSEONLY, ; 7.
City of Tigard „
Plan Review 1
t rd9(�` 97225 y Date/By 020 0 16 Permit No . , „A
13125 SW Hall Blvd.,
ED t 13 Other Permit
Phone. 503.639.4171 CO359 -er960 � ����� 1 111 �''I nate
+I B . `1 PS
Inspection Line: 503.639 4175 c' 7 ' •' I . Date Ready/By ji 0 See Attached Checklist for
Internet. www.ci tigard or us.,A (� ( � Supplemental Information
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PLIk tilv4s -4.. Permit fees* are based on the value of the work
------.- ------.- New construction � ;N ❑ Demolition * performed
P
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other• equipment, materials, labor, overhead, and the profit for the
7 .' x` '. ,. .; - M ,,`; ", , :. > s .i'.. " , < a a €-Ayi . t , :<. 7 : •t,. T: ' e�,..< work indicated on this application
�. ': z ,:,, ' . tos , .,'., C OF . (.ONSTRTT`GTION , ` r i.; ' a z t .1, ,- .,'',_. ; " % = `
❑ 1 - and 2- family dwelling El Commercialhndustnal Valuation: $
Accessory building ❑ Multi - family Number of bedrooms
❑ Master builder ❑ Other Number of bathrooms
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N z : ..,., r, >.,`;.;».� ".^y;-;° Total number
.;k :t d O13 ; lSITE IIYFORIVIATION ''ANA " L0C7ATC01 l t, 44 '' .. - " 'a„ = of floors.
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Ave '_ ° "��:� " `,m� �` �,
Job site address: ( '4 5 S \V Co g_e.nt1' A New dwelling area: square feet
City/State /ZIP: Tom", e_p , C4e a) 7 223 Garage /carport area. square feet
Suite/bldg /apt. no.: Project name Is 49.0D6`E35ep6 Covered porch area: square feet
Cross street/directions to job sitsvC, N , 1 ., s.r. Ca ' KT.mizS rAN Deck area: square feet
sec/ S \ \( M --1 . Other structure area: square feet
REQ J'IRED'DATA:'COMIVIER I eigE) HECLISKT.
Subdivision: Lot no.. m 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.: as 1 C:2 2-SD equipment, matenals, labor, overhead, and the profit for the
.. '" �' s` = *`'. „ „. work indicated on this application
', ? - " ; '„ '"� ._ ; ,1 . ,,4DES(a TI®N OF` WOR,K»§ u ; x, t PP on
Valuation: $ C'--12
C® 1.4 S'7 c?' 1 S 51 2 1✓ 9t.f 1 t
Existing building area: 0 square feet
New building area I O 0 e) square feet
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PLOPERTY ` a.O.WN RNA -'' '' ' " '` ”' y �uTENAN x �” ,
Number of stones:
Name: T egC...4r+.0t_ e$4 6ts, - P ecp.� , c.l2l 0 1i4 (NI Type of construction. NEN
Address: 2,3,F3 -F- , ' - rPt Occupancy groups: 5
City/State /ZIP: Fn Kp ) O) ° )7 Z 14-- Existing: '{Nlot∎M
Phone: (503) CO39 — 4.0 9 Fax: (56 4 a 4 23I-
_ New. 0`0I2-R3CeC.
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Business name: h �"',. . ,, ° "° � �'�_�- � � �_�� xrss.`°`x ° `
S , - Ft 't..j A,Qjsll All contractors and subcontractors are required to be
Contact name:T.�S F,+1 6°3 /5..0 --^7 (�(� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: °)5 S \V C -- 44.C1e.- - r jurisdiction in which work is being performed. If the
City/State /ZIP: -� .„ , G ' : .D-?P applicant is exempt from licensing, the following reasons
apply
Phone: (6 C . . . 3 1 : , — - 9 Fax:: C33) fn 24 a'36 .
E -mail:
�;., xi ;a "� �'. , _w§; ."= r ,'s�;ciFr» =%rte° , �N � s x'�. �.+� L. z . „ m. :..;€*."t< �, a 1 : m�'- , � �. <
Business name: —r.5 L_t_kc,At,1 ) A \t k, 0\\,.R. a1i.„-Q \l,`z-J `�'``' ' , ! , - Tiiivit- IlYG P R11II FEES* - -
Address • -
Please refer to fee schedule.
City/State /ZIP:
Fees due upon application
Phone. ( ) Fax ( )
CCB he.: Amount received
/ /y eA
Authorized received
Authozed signature. /f/ ` This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete. II
Pnnt name: ��g < 4 " Date. / 1 A (o4 * Fee methodology set by Tn- County Building Industy
Service Board
I \Buddmg\Permlts \BUP- PermlApp doc 12/03 440- 4613T(1 l /02 /COM/WEB)
:'7 �• 1 ,.;. ; Building Division
� 0 4 11 1 0 0,1 Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
•
,�f Ty�pe�.ofSubm><ttal, "E'3 ';:� #�' of PTans�r;`
(Includesnew addihionsrand:alter�ations,n '` " 'A;'. ry
) Requii -edat �
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 .\Buildtng\Forms \COM- PlanSubReq doc 12/24/03
Building Division
ti 'II � Accessibility: Barrier Removal Improvement Plan
City of Tigard
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities
unless such alterations are disproportionate to the overall alterations in terms of cost and
scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION: Total of all renovation, alteration or modification being done,
excluding painting and wallpapering: [1] $ '5 COQ
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ l 4
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given
to those elements that will provide the greatest access. Elements shall be provided in the
following order:
Q (a) Parking S y Oal)
(b) An accessible entrance: $ (5000
(c) An accessible route to the altered area: $ 1 6oO
‘90Q`) (d) At least one accessible restroom for each sex or a single unisex
restroom: $ /' OPC)
05-0 (e) Accessible telephones: $ Zsm
S ("Dr) (f) Accessible drinking fountains: and, $ 5 — m0
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $ (4-760
i.\Bmldmg\Forms\AccessImprvPlan doc 11/25/03
CITY OF TIGARD
BUILDING DIVISION . PERMIT #: BUP2004-00233
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/13/2005 TIME: 7:10AM . PAGE: 27
SITE ADDRESS: 12630 SW GRANT AVE CLASS OF WORK:
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT #: 009 TYPE OF USE:
PROJECT NAME: ST ANTHONY
DESCRIPTION: 1000 sf storage building.
OWNER: ROMAN CATHOLIC ARCHBISHOP OF, PHONE #:
CONTRACTOR: LUCIUS VALUSEK HOME SERVICES PHONE #: 503-780-8837
Inspection Request Scheduled For: Date: 4/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 004419-01 503-780-8837
Corrections/Comments/Instructions:
/IA
WriP
r P
PASS PARTIAL APPROVAL El CANCEL NO ACCESS
FAIL 11 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
1
Inspector: Date: 47 1 3 / OSPhone #: (503) 718-