Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2000 -00201
, ,, f,, DEVELOPMENT SERVICES DATE ISSUED: 05/30/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AA-00500
SITE ADDRESS: 08740 SW LOCUST ST
SUBDIVISION: TOWN OF METZGER ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 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:
Remarks: Demo existing dwelling and shed.
Owner: Contractor:
WINDWOOD HOMES OWNER OF BUSINESS
12655 SW NORTH DAKOTA
TIGARD, OR 97223
Phone: 503 - 625 -6526 Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Misc. Inspection
I PRMT GEO 05/30/200C $50.00 0002522 Pump /Fill Septic Tank Insp
Final Inspection
5PCT GEO 05/30/200C $4.00 0002522 --
EROS GEO 05/30/200C $26.00 0002522 EI ERPC GEO 05/30/200C $8.45 0002522 . C
(additional fees not listed here)
Total $96.90
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Pennitee _..-- ,j —
Signature: �'�
Issued By: A " �1.
Call 639 -4175 by 7 p.m. for an inspection the next business day
,`, . C� .'r �
;1 "tY TIGARD Commercial Building Permit Application Check #
Recd Plan Che he By
13125 SW HALL BLVD. Tenant Improvement Date Recd
fIGARD, OR 97223 Date to P.E.
503) 639 -4171 Date to DST
Print or Type Permit # 60 0 R0oac/
Related SWR #
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
Job 67 SW Lit etc I
Address Street Address 7 Suite Building
/ Sw�a S 7 / Data
Bldg # City/State Zip Existing Use of Building or Property:
160 r/ 9 '7.2..3
Name Proposed Use of Building or Property:
Property k.),PVIJ ndth r S
Owner Mailing Address / Suite
/?�SSSw0 / - No. Of Stories:
City/State Zip Phone
. / Or 91.223 G , s ,_ G s z Sq. Ft. Of Project:
Occupant Name' Occupancy Class(es)
/v /mot
Nam
Contractor eltC Type(s) of Construction
Prior to permit Mailing Address Suite Will this project have a Fire Suppression System?
issuance, a copy N O
of all licenses Yes ❑ ❑
are required if City /State Zip Phone Americans with Disabilities Act (ADA)
expired in C.O.T.
database Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
CD/9 -V3//°- Project $
Name Valuation
Architect Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and
that plans submitted are in compliance with Oregon State Laws.
Engineer Name
Signature of Owner /Agent Date
Mailing Add Suite
Contact Person Name Phone
i%2
City /State Zip ne IG j ? C■ Gr0
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition \t. Map/TL# -0D _ Land Qv:
Accessory Structure 0 Foundation Only 0 Alteration O 35 '"
Repair 0 Other 0 otes:
Description of work:
TIF:
11
real C/c.✓ N P1 u. e a ripe" I? rr/to-^t.
4dt‘er5 ���p � d
Note: Site Work Permit Application must precede or accompany Building
Permit Application ) y `. _
P/m r 71s.
1:1COMNEWTI.DOC (DST) 5/98 F!e Pc 'J cif- e-/
GR 05� `$ 4
T.S i
Date Rec'd:
CITY OF TIGARD Recd By:
COMMERCIAL TENANT IMPROVEMENT
APPLICATION /PLANS SUBMITTAL REQUIREMENTS
Applicants: Please complete
APPLICANT
1. APPLICANT NAME: PHONE #:
2. SITE ADDRESS: FAX #
1. SITE PLAN (Fully dimensional, drawn to scale) labeled with:
❑ map & tax lot #, ❑ project name, ❑ site address, ❑ site number,
❑ zoning, ❑ applicant name, ❑ phone number.
A. North Arrow
B. Scale (any standard, architectural or engineering only)
C. Street Names
2. See the matrix on back of application for number of plans required based on submittal type
(no redlines or tapeons accepted).
SIZE REQUIREMENTS: 24" X 36" (ROLLED)
ALL DETAILS LISTED BELOW SHALL BE INCORPORATED INTO THE PLANS
A. Floor plan(s)
B. Wall details
C. Reflective ceiling plan
D. Seismic bracing detail for suspended ceiling
E. Specifications & calculations
F. ADA barrier removal worksheet
G. Deposit - based on valuation of project
ildstsVorms■comtiapp.doc 10/30/98
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 NIST
CLUCCP'.66 OOH/
Received Date R neste / ' 2 / ° S AM PM BUP
Location 7 '1 �£UV Le( 1(..s fi Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Foundation ELC
Ftg Drain A ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear J/ (1-r. K, /
Framing !�
Insulation
Drywall Nailing /''' — �/L� -- ��
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
er: /
Final
S PART FAIL ✓
PL MBING
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 Li Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA 1 2�/
` 7
Approach/Sidewalk Date � ` - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL