Permit ,N, CITY OF TIGARD BUILDING PERMIT
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PERMIT #: BUP2001 -00200
k DEVELOPMENT SERVICES DATE ISSUED: 6/26/01
{�' I 1 3125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12325 SW KATHERINE ST PARCEL: IS134CC 01700
SUBDIVISION: MARY WOODARD SCHOOL ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: NEW 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: El TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 46 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 : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,000.00
Remarks: Installation of two class room portables
Owner: Contractor:
SCHOOL DISTRICT #23 JT WILLIAM SCOTSMAN INC
13137 SW PACIFIC HVVY 6107 N MARINE DRIVE #3
TIGARD, OR 97223 PORTLAND, OR 97203
Phon e:..503- 639 -5361 Phone: 503 - 285 -6165
Reg #: LIC 145907
FEES REQUIRED INSPECTIONS
Type , By Date Amount Receipt Electrical Permit Required
5PCT . CTR 6/4/01 $12.68 27200100000 Foot/Found lnsp
Final Inspection
PLCK - 6/4/01 $103.03 27200100000
PRMT CTR 6/26/01 $158.50 27200100000
FIRE CTR 6/26/01 $63.40 27200100000
(additional fees not listed here)
Total $653.61
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 issua or if wore is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules a pted by the 0 egon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 rough OAR $62 -OQ11 -198 . You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6 99 or 1 0 -3 .
Pe rm ittee . / MP'
Signature:
Issued By: . > ,
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Call 639 -4175 by 7 p.m. for an inspection the next business day
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Build
r• I Date received: Ade i Permit
:y.,ilii^ City of.___
Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1&2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm Qther: b 2i7\3 L !
JOB SITE INFORMATION
Job address: /23 ZS.5 ''Zt..Jr 5 -7 Bldg. no.: Suite no.: •
Lot: I Block: Subdivision: I Tax map /tax lot/account no.:
Project name: /NS7� - ,o (;. D CCASS7-0 YTfgi AzLe MA S _
Description and location of work on premises/special conditions: 31--064/,16 T t X66 -1A- 5 fly Se'i 7^-)
r.:.; OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: T/61 -7vA i ,-),J .�,t{Dc� t7 /sSzic -i ( Floodplain, septic capacity, solar, etc.)
Mailing address: 6960 5 ) SSA --2,t 2Ca 1 & 2 family dwelling:
City: - i-7 GA�„� State: p2_ IZIP: 9 7 Z 7-5 Valuation of work $
Phone: 431- 4 Fax: 43/ -4) ZZ I E -mail: No. of bedrooms/baths
Owner's representative: / ,. hiti . Total number of floors
Phone: 43/— 40 /8 Fax: 43/ -420 E -mail: New dwelling area (sq. ft.)
APPLICANT - - Garage /carport area (sq. ft.)
Name: - s-- e" Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industriallmulti- family:
CONTRACTOR Valuation of work $ /Z &' D
Business name: l/VI 4-L Sco�M /4•J Existing bldg. area (sq. ft.)
Address: f 2._
New bldg. area (sq. ft.)
61 D ] A 1 l '' },2 JN� Number of stories
City: Zli I State: I ZIP: 9 '7Z63
Type of construction
Phone: Z85 Xa,s I Fax: 2/3S -5o4 E -mail:
Occupancy group(s): Existing:
CCB no.: / 45 0 7 New:
City /metro lic. no.: 641642 • Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: • jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies: .
Contact person: Plan no.:
Phone: Fax: E -mail: •
ENGINEER
Name: Contact person: Fees due upon application $
Address: r' Date received:
City: (State: IZIP: Amount received $
Phone: Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined t •'s-.application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of la - s and • dinances governing this ❑ Visa ❑ MasterCard
work will be complied -wi • cifi• + herein or not. credit card number: Expires
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Authorized signature: �� D ate: b 7/b � Name of cardholder as shown on credit card
Print name: PU,.,4 ll� k� Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/0) /COM)
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-- TCOMMERCIAL PLAN SU'BMITTA - - =- - -
REQUIREMENT MATRIX
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 plan sets for distribution purposes (for Contractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Rescue).
s Total # of
aka .
171(i PE OF SUBMITTA� S b�mlttetl KEY:
S = Site Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
B (New, Add or Alt) 1* B = Building
F (New, Add or Alt) 3 ** F = Fire Protection System
M (New, Add or Alt) 2 M = Mechanical
P (New, Add or Alt) 2 P = Plumbing
E (New, Add, or Alt) 2 E = Electrical
New = New Building
Add = Addition
Alt = Alteration to existing
building
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3" technicians.
I: \dsts \forms \matrxcom.doc 10/27/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• BUF ZpL /- DU z-e-- U
Date Requested � - AM PM BLD
Location /7,5 Z� -Sw /'4 ) t o ri ;.-( Sa Suite MEC '-
Contact Person Ph irt)-5 - GG PLM
Contractor Ph SWR
BUIL Tenant/Owner ELC
Retaining Wall 0 ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: .
Slab SIT
Post & Beam
Ext /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
� r�
PART FAIL
0 BING
Post & Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
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Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector ■ Ext
Other 716i0
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.