Permit f
.
.11,, ,
-30 -03
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00079
viii DEVELOPMENT SERVICES DATE ISSUED: 2/28/03
W -"' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10270 SW KATHERINE ST PARCEL: 2S102BB 00600
SUBDIVISION: GREENBURG HEIGHTS ADDITION ZONING: R -4.5
BLOCK: LOT: 017 JURISDICTION: TIG
REISSUE: // -x'12 FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: N � 1 _ 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: U1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 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: $ 17,420.00
Remarks: Construct 300 square foot shelter.
Owner: Contractor:
CITY OF TIGARD ROBERT GRAY PARTNERS INC
13125 SW HALL BLVD PO BOX 1000
TIGARD, OR 97223 SHERWOOD, OR 97140
Phone: Pli
Phone: MBL 793 -8520 r ED
Reg #: 692 -4675 65424 gggg
FEES MET REQUIRED8INSPECTIONS
Description Date Amount Foot/Found Insp
Framing Insp
Roof nailng Insp
Total Structural welding final reps
Final Inspection
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: 0; 7 / / . or
Pe nn ittee
Si gnature: CZ.-Z....)::: _ - -
Call 639 -4175 by 7 p.m. for an inspection the next business day
/ i
1 BuiA ing Permit Application FOR OFFICE USE ONLY
/ Received Building /
Date /By: Q� �� 4 Permit No.: /11 G/ ,&_.5
City Of TIQ `sad Planning Apo oval Other `
Y b Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.: p
Phone: 503- 639 -4171 Fax: 503 -598 -1960 / mudlip 1 Post- Review Land Use
Date /By: Case No. ` I' ` �-/ 0� 00
Internet: www.ci.tigard.or.us 6- Contact Juris.: See Page 2 for
24 -hour Inspection Request: 503 - 639 -4175 Name /Method: Supplemental Information /
^' t t<$y u' ,; a a`� : c '. - ,a w f .,._ a:,� 4 ._ . . :� *" ". , f .'; D M A - r^- sr '� - ,
4 ,.
�_ �a� TYPOFtWORKr _..� . __ _REQUIRED T ` : v
❑ New construction ❑Demolition
As. ii ea 2 F - DWELL ,
❑ Addition/alteration/replacement ❑ Other: ` _ `° �W "
, C I:0-0 iY O,F-10,QNS-TRIICT>ON -. AI ,. AIni Note: Permit fees* are based on the total value of the work performed. Indicate
❑ i & 2- Family dwelling ❑ Commercial /Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
Master Builder ❑ Other: Valuation S
, , „_JOB SITE INF i i TION and LOCATION No of bedrooms: _ No of baths:
Job site address: /0R70 41.43 04-Ike), E.K.C. be-. Total number of floors
New dwelling area (sq. ft.)
Suite #: Bld, . /Apt. #: Garage /carport area (sq. ft.)
Project Name: WOOD R fi—b WI 11,14 N' EjZ i=i< Covered porch area (sq. ft.)
C ross street/Directions to job site: Deck area (sq. ft.)
/6/0 Sr, /d /�i 1dr NL Sr Other structure area (sq. ft.) a
r
exr erid q ,�,4' tI/ /• a Ott Y , i -. ,z� 'S " " m a �s .�
(/ ,,'e- s RE QUIItED i DATA
,�* a�,t� .�, � " � , e; .:. � x �>t \ fib,
COMMERCIAL - USE
Subdivision: Lot #: , . •��_, ' -� 5 m� _ ,... m.�. s - � �. .�._.
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
k ` kV 'p ,a I)ESCRIPTI_ON O ' W®RK", "° �- the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
dnSr S / .s/ fee. / /`/l Aupd I- . f' 17 y�
L Valuation $
Chi e,''llcto+5 9- co C /•t -/�G 670 ') , ��/7Cr ¢.T�G �JGc'� 1 I
Existing building area (sq. ft.)
47-e 4/�aS7 -, alve-41" 4✓vc"cl "-f/ 717714 -/l 0 . 46 :'," New building area (sq. ft.)
Number of stories
ffl a; PR OPERTYY.OWNER ; 1.TENANT 1 `; K E " , .,,; , Type of construction
Name: C I T' 2-j or Coo /Zt> Occupancy group(s): Existing:
Address: 1 31 A 5 6a. 1 r3 (-jr New:
City /State /Zip:1 0,44.1D 0 k. 9 7 9• a 3
Phone: Fax NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
APPLICANTR°N, iCQNTACtPEROJN provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
:, a BUII.DING PERMIT * ` �4
E-mail: `� ��� FEES � �
l . `, � . �,,
, Please refer t ee se edule ' 1 `'..
,� ��" �'�4 •` >,�" .... 1YTR�AC�T�OR'= N . ' ,� ����t� .1;:: ,a ._ � „ a �:t..44. ,�,�si � .:...:�, �� I'�
Business Name: / t n4,a1' f . /t1 14 jj/ -IA/C. Fees due upon application $
- Address: PO 6 /IOL7
City /State /Zip: 5"J, 0.,.W / O4. 9 2 / / 0 Amount received $
Phone: c5 vJ X92 - i 'WFax: sa3 691 912 Date received: '
CCB Lic. #: 6 5' 4/ a , f .
Authorized
Signature: �` Q� /".� .3 180 af r it has ap pl i cati o n
e e d a complete.
a permit is not obtained within
C Date: � 180 days after it has n accpd as c
- a–/' *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name) .
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
.y
� Commercial Plan Submittal
Requirement Matrix
City of Tigard
T YPE F SUBMI TTAL'S o o f�Pla'ns
V (Ip,cludes New, Additions or Altera ;Re q u ired ate <<
Site Work 4
(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.
is \dsts \forms \COM- matrix.doc 9/24/01
s . ij
CITY OF TIGARD - 24 -Hour .
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3 a do
Received Date Requested a 'D AM PM BUP
Location / 70 l fit" A Suite • MEC
Contact Person ,C PJZ.lJ Ph ( ) 7 -- �5 ? PLM
Contr. Ph ( ) SWR
UILDIN3 Tenant/Owner ELC
Foundation ELC
Access:
Ftg Dr ELR
Drain ��' ���
L Q%> Inspection Notes: I�'h SIT
= & B eam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing •
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fin -
Ow" '' PART FAIL
Ai wa.' PART
.
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 inspect - no access
Fire Supply -
ADA '/'? 0/0
Approach /Sidewalk Date C� Inspector Ext
Other:
Final • DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lirle :_.(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
,r. BUP 3 —00 77
Received j — Date Requested 5 BUP •
Location / Q . Suite MEC
Contact Person 1 L •• Ph ( )� 7.S PLM
Contractor Ph SWR
B _ G . Tenant/Owner r/ ELC
n �'E
ELC
Nom• ' n Access: U s y 7 C4 i
Ftg Drain 3 ( 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 Ceilin����•(�
Roof '
Other:
Fa
P 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
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: Ei Unable to inspect — no access
Fire Supply Line
ADA �.
Approach /Sidewalk Date o/ Inspector \ Ent
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL