Permit CI TY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00048
COMMUNITY DEVELOPMENT DATE ISSUED: 2/20/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S126DC-04800
SITE ADDRESS: 09495 SW LOCUST ST A ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 004 JURISDICTION: TIG
PROJECT: KLEIN DERMATOLOGY
Project Description: TI
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: BASEMENT: sf AREA SEP. RATED:
STOR: 2 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: $ 9,000.00
Owner: Contractor:
BAKER, JAMES + EXTREME BUILDERS LLC
9495 SW LOCUST ST. #G PO BOX 690
BAKER, DIANE R NORTH PLAINS, OR 97133
TIGARD, OR 97223
Phone: NA Contact #: PRI 503 - 201 -2996
FAX 503 - 647 -0619
Reg #: LIC 173315
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/20/2008 $112.55
[TAX] 12% State Surch 2/20/2008 $13.51
[BUPPLN] Pln Rv 2/20/2008 $73.16
[FLS] FLS Pln Rv 2/20/2008 $45.02
Total $244.24
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: , A Permittee Signature: `
� f _ J
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr• ject.
Approved plans are required on the job site at the time of each inspection.
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„ Building Permit Application
Comniercial FOR OFFICE USE ONLY Received `ji City of Tigard t E® Date /B — . ��Q D a 0 ' ,� - . s ' • oL� 1 114
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13125 SW Hall Blvd., Tigard OR 2 FCEt
Plan Revi
Phone: 503 F ax: 503.598.1960 DateB �E`i1 t w m, Other Permit:
T tG A R D Inspection Line: 503.639.4175 FEB 2 020 Date Re7+gr'7 Jung ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITY nF TIGARD
TYPE OFi)y(.; , t3 DIVI REQUIRED DATA: 1- AND, 2-FAMILY DWELLING
['New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
g Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. CATEGORY OF CONSTRUCTION ' , work indicated on this application.
El 1- and 2- family dwelling 1 Commercial /industrial Valuation: $
1=1 Accessory building ID Multi-family Number of bedrooms:
El Master builder CI Other:
Number of bathrooms:
` . JOB' :SITE INFORMATION AND LOCATION. l,' � ,. Total number of floors:
Job site address: q WS - Su.) LocuST Sr r E A New dwelling area: square feet
City/State /ZIP: 170 aTp ® 0( 61-7223 Garage /carport area: square feet
Suite/bldg./apt. no.: s, Project name: K'E 1>1 DERMATOWGY PIM Covered porch area: square feet
Cross street/directions to job site: 61z_egN (3vP6 fit Lb CuST Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Apt Lot no.: NA Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 'Ti S � / e I W ,56--e_ 23 b LOT '/g a V � go i Indicate the value materials, labor, to the nearest an d the profit of all
the
equipment, materials, labor, overhead, and the profit f
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 9 .00 0
i2 Erno .06 e... or EX /ST LA1 0 5 - F /oc 5 v /T€ . 4 Zgitl-
Existing building area: square feet
' S APPY , i 7 V s® yr , 1,10 1-on -> S 820\16
9 � '� New building area: A 17 ie square feet
PROPER C f � - � TENANT , , , Number of stories: 2
Name: K / E IA/ Dtkrii/47oLo6 y del5SCX, , Type of construction: gg_Aiem/ sp
Address: 94/9.s 5 �� ccit sr- s7- sTE A Occupancy groups: l3 §
City /State /ZIP: P r�4/® 0 0 Q72 / 2 3 Existing:
Phone: (53 Zf✓$ 2,4,4,5 Fax: (S43) 2 `/4 - 5963 New:
APPLICANT ❑ CONTACT PERSON , NOTICE°
Business name: E02_6.-,4--)E g(J / L ®e � S LLC, All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
St_ aT G d under ORS 701 and may be required to be licensed in the
Address: r d i9oX 49 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP:
4/0,e7-/./ / /iA /ir/S 42 7/33 apply:
Phone: ( 5 ) r,t ✓ . 96 Fax:: (S J) S'/7 d6 2 z
E - mail: f ., j3e.)/L,®N/2,S 4.7 �o> /G • ear-.-
CONTRACTOR'
Business name: E- 'T/2�®yfe- z30/1_, C) S L. C - BUILDING PERMIT FEES*
Address: Po aoX 6 9 ® (Please refer to fee schedule)
City/State /ZIP: Structural plan review fee (or deposit): ? (
�t/agrig Ply. IAL5 o2 9 7I �3 �So y
Phone: Fax: FLS plan review fee (if applicable):
(54 2 0 / -29Q6 (5 03 ) 6 �7 i i d 9-
CCB lie.: 733/5 ,--` :. - . ... • . -ton: (3 . S I
/ ' Amount received: .A0 .a
Authorized signature: : ...' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: G 7 Se...077' 6/2e60,1/1 Date: / .._/q.-p' * Fee methodology set by Tri -County Building Industry
'Service Board.
I: \Building\Permits\BUP -COM PermitApp.doc 2/23/07 440- 4613T(11/02 /COM/WEB)
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Building Division
Accessibility: Barrier Removal Improvement Plan
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] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $
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:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I:ABuilding \ Permits \ BUP -COM PermitApp.doc 10/30/07
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CITY OF TIGARD
BUILDING DIVISION a ,' PERMIT #: BUP2008-00048
13125 SW Hall Blvd., Tigard, OR 97223 / i ( ISSUED: 2120/2009
Phone: (503) 639-4171 ll 1- / bits
Inspection Requests (24 Hrs.): (503) 639-4175 ,..4 t'-i.
INSPECTION WORKSHEET FOR DATE: 3/1912008 TIME: 7:01AM PAGE: 5
SITE ADDRESS: 09495 SW LOCUST ST A CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRAM LOT #: 001 - TYPE OF USE:
PROJECT NAME: KLEIN DERMATOLOGY
DESCRIPTION: TI
OWNER: flAKER, JAMES .1', PHONE #: NA
CONTRACTOR: EXTREME BUILDERS LLC PHONE #: 603
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itopt
Inspection Request Scheduled For: Date: 3/19/2008 Pour Ti , -•
Code # Inspection Description Confirm # Contact # Mes ; t
ed te"
2o9 f 'inal inspection 066972-01 503-201-2996
Corrections/Comments/Instructions:
0
1 i \
1 p ,
c tit.p . SS pi PARTIAL APPROVAL El CANCEL 0 NO ACCESS
0 FAIL fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
__,--
DatX A 7 o cr 2_42_151
t,,,i1L____.... •
Inspector: Phone #: (503) 718-
. „
i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008-00048
13125 SW Hall Blvd., Tigard, OR 97223
6..------. DATE ISSUED: 2/2012008
Phone: (503) 639-4171 JiroliT\
Inspection Requests (24 Hrs.): (503) 639=4175 l
INSPECTION WORKSHEET FOR DATE: 3/1812008 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 09495 SW LOCUST SI A CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 004 TYPE OF USE:
PROJECT NAME: KLEIN DERMATOLOGY
DESCRIPTION: TI
OWNER: BAKER, JAMES 4-, PHONE #: NA
CONTRACTOR: EXTREME BUILDERS LLC PHONE #: 603.201-2996 ,
Inspection Request Scheduled For: Date: 3/1812008 __. Pour Time:
Code # Inspection Description Confirm # C. t-ct # essage
2'39 Final inspection 066817-01 503201-2996 N c -
V
Corrections/Comments/Instructions:
L = i/V4S5 It_
li 0 6 )7J__ - OL-
g l I PA El PARTIAL APPROVAL I] CANCEL NO ACCESS
KFAIL I I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
-----'
Inspector: VAT . Date: 7) I ,,iti.6 V Phone #: (503) 718- 24_24' _
CITY OF TIGARD
t •
BUILDING DIVISION / PERMIT #: i!1R200 00 48
13125 SW Hall Blvd., Tigard, OR 97223 / ' DATE ISSUED: 2/2012008
Phone: (503) 639 -41'71 / ii � Hiul�ii �//
Inspection Requests (24 Hrs.): (503) 639-4175 ° ..
INSPECTION WORKSHEET FOR DATE: 3/10/2008 TIME: 7:00AM PAGE: 33
SITE ADDRESS: 09495 SW LOCUST ST A CLASS OF WORK:
SUBDIVISION: 1,.CEMMANN ACRE, TRACT LOT #: 004 TYPE OF USE:
PROJECT NAME: KLEIN DERMATOLOGY
DESCRIPTION: TI
OWNER: BAKER, JAMES +, . PHONE #: NA
CONTRACTOR: EXTREME BUILDERS LLC PHONE #: 603 -204 -2086
Inspection Request Scheduled For: Date: 3/10/2000 Pour Ti >r' v
Code # Inspection Description Confirm # Contact # Mes �. -
287 S'nep nded ceiling 066387 -02 503- 201 -2896 `1 1
wilvrio Corrections /Comments/ Instructions:
00 ,1 6.&0 - 3/1:6(“- 5
S PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
I FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: V/ Date: Phone #: (503) 718- ' 2/k{
CITY OF TIGARD '; �' r
BUILDING DIVISION PERMIT #: BIJP2003 -00018
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2f20f.2O0;
Phone: (503) 639 -4171 opup,
Inspection Requests (24 Hrs.): (503) 639 -4175 'IL.
INSPECTION WORKSHEET FOR DATE: 2/2812008 TIME: 7 :00AM PAGE: 4
SITE ADDRESS: 09495 SW LOCUST ST A CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 004 TYPE OF. USE:
PROJECT NAME: KLEIN DERMATOLOGY
DESCRIPTION: Ti
OWNER: BAKER, JAMES +, PHONE #: NA
CONTRACTOR: EXTREME BUILDERS TIC PHONE #: 503 -201 -2996
Inspection Request Scheduled For: Date: 212812008 Pour Ti
Code # Inspection Description Confirm # Contact # Mes-.
� L�
275 Framing 065831-04 503-210-1299 401
Corrections /Comments /Instructions:
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(VIDAS...S %A PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL • CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: -------- Date: L—Cd b g Phone #: (503) 718 -L=-b r
s.