Permit CITY OF TI CARD . BUILDING PERMIT
PERMIT #: BUP2004 -00237
f l l DEVELOPMENT SERVICES DATE ISSUED: 5/21/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135DD-03703
SITE ADDRESS: 11624 SW LOMITA AVE C -1
SUBDIVISION: PLAZA GARDEN WEST ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: 5: E: W:
OCCUPANCY GRP: R1 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: $ 70,000.00
Remarks: Fire restoration to Units C -1, C -2 & C -3.
Owner: Contractor:
DALTON MANAGEMENT HORIZON RESTORATION SYSTEMS
8417 SW BEAVERTON - HILLSDALE HW 7301 SW KABLE LANE
PORTLAND, OR 97225 SUITE 100
Phone: 503 - 297 -4665 PORTLAND, OR 97224
Phone: 503 - 620 -2215
Reg #: LIC 46081
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 5/21/2004 $580.20 Insulation Insp
Insp
[TAX] 8% State Surcharl 5/21/2004 $46.42 Gyp B Final Innspsp d ecttion ion
Total $626.62
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 (50 • • ::'• •r 1- 800 -3344. C eeaftotiat Issue = 1 4
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Received Mi Permit No : • MM — • /CD- 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 0441 i l I Date/By: Other Permit:
Inspection Line: 503.639.4175 4 �J, • Date Ready /By: J 0 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: ! ((, Supplemental Information
ia4• . °�'r<. „ � '3.<. :•< . .; ;.;;,, szp�"c, .. .,:,';; ..- ; ";� '° a., ,, ;rasaw'• °�• +;� „�:.; :-. :' .;'a��..
L ,,. ; , '� -� z
`?R 1
T,YPEOF- WORK ;z RE UIRED DT A;1 "SAND ZFAMILY- D WEL IN G
❑ New construction ['Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration /replacement ® Other: Fire Damage Repair equipment, materials, labor, overhead, and the profit for the
- ;;AEG , „,,,,; ,, ; ,, work indicated on this application.
, CATEGORY;. OE CONSTRUCTION ;r
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building Z Multi - family Number of bedrooms:
❑ Master builder 1=I Other:
Number of bathrooms:
JOB NFORM O 0,.;.3 Total b f floors:
r” SITE °I ATI N.,,AND`L; CATION ;�'
number o
Job site address: 11624 SW Lomita Ave New dwelling area: square feet
City/State /ZIP: Tigard,_Oregon 97223 Garage /carport area: square feet
uite/bldg. /apt. no.: C1,C2,C3 Project name: Lomita West Covered porch area: square feet
_ - - • • le: Lomita & 90 ave Deck area: square feet
Other structure area: square feet
;FREQUIRED„DA A °'COMM I IA �E;t� S -••
T L= USE.GIiECKtiIS'I''
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, a nd the profit for the
W DESCRIPT1ONtQF`�WORI{- :;t::;; re, `‘ : , ` �,, ° work indicated on this application.
r,
Unit C -3 Remove and replace roof trusses,sheeting and roof. R & R drywall 2” floor. Valuation: $$70,000.00
Restore to original before fire.>Fire damage repair
Existing building area: 1050 square feet
Unit C -2 Remove and replace roofing. Paint interior >Fire damage repair
New building area: o square feet
Unit C -3 Remove and replace roofing. Paint interior >Fire damage repair
���• ' " Number of stories: 2
, ❑ - °TENANT ^i;
Name: Dalton Management Type of construction: Wood Structure
Address: 8417 SW Beaverton - Hillsdale Hwy Occupancy groups:
City /State /ZIP: Portland Or. 97225 Existing: yes
Phone: (503)297 -4665 Fax: ( ) New:
A APPLICA
NT:
Business name: Horizon Restoration All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Tom Armour under ORS 701 and may be required to be licensed in the
Address: 7300 Kable Lane #100 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /Z1P: Portland Or 97224 apply:
Phone: (503) 620 -2215 Fax: : (503) 624-0523
E -mail: toma @horizonrestoration.com
Business name: Same as above
Address: Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone: ( ) / Fax: ( ) Amount received
CCB lie.: 46081 11497,4 Date received:
Authorized signature: ✓ �t This permit application expires if a permit is not obtained
• within 180 days after it has been accepted as complete.
Print name: CA..tigb L • tratiR,t, Date: * Fee methodology set by Tri County Building Industry
Service Board.
i. \Building \ Permits \BUP- PermitApp.doc 12/03 440- 4613T(1 I /02 /COM /WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTIIO DIVISION Business Line: (503) 639 -4171 MST
BUP 4 / -60 e237
0 at
Received ` Date R quested /✓ -°` f AM PM BUP
Location //( 4 / v"� Suite c - MEC
Contact Person Ph ( ) 73 7-5 9c PLM
9 r Ph ( ) SWR
Tenant/Owner ELC
ing ELC
Foundation Access: �Z, `
Ftg Drain / A O1 _ �t / gO ELR
Crawl Drain G ca
o/
Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling J 11 Roof
Other:
r 44 - FART FAIL
Ik i".141114
- ING 1
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 ,..11■11 �� L � .. / iii 7
Low Voltage
L ge --•■■■■����
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: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL