Permit 'CITY CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00189
A DEVELOPMENT SERVICES DATE ISSUED: 5/6/2004
..� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11535 SW PACIFIC HY PARCEL: 1S136AD -04000
W
SUBDIVISION: VILLA RIDGE ZONING: C -G
BLOCK: LOT: 007 JURISDICTION: TIG
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 CONS: 5N : sf N: S: E: W:
OCCUPANCY GRP .\M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: '116 BASEMENT: sf AREA SEP. RATED: •
STOR:
HT: - tt _ 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: $ 5,000.00
Remarks: TI and change of use, coolers.
•
Owner: Contractor:
SMITH, EDITA M SPECTRUM (ALFONSO COTTON)
833 NW 170TH DR 47 GALE DR. UNIT 14 '
BEAVERTON, OR 97006 LAKE OSWEGO, OR 97035 _ _
Phone: 503- 245 -1864
Phone: 503 - 449 -8913
Reg #: LIC 157788
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 4/28/2004 $91.30 Electrical Permit Required
[BUPPLN] PIn Rv 4/28/2004 $59.35
Plumbing Permit Required
TAX 8% State Surcharl 4/28/2004 $7.30 Framing lnsp
[TAX] ! Gyp Board lnsp
[FLS] FLS Pin Rv 4/28/2004 $36.52 Misc. Inspection
Total $194.47 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: /1‘6"A-- .
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
04/20/04 TUE 11:40 FAX 5036293681 CITY OF TIGARD BLDG DEPT 10003
•
•
• Building Permit Application FOR OFFICE USE ONLY
City of Tigard 2�0 Y i f air ev g t tN..n Q (.
13125 SW Hall Blvd., Tigard, OR 972B' TY 0 I i ^,-,A,1 t ) Plan Review �� Other Pernrit:
Phone: 503.639.4171 Pax: 503.596M60 1 f^ ,- `" ' " I � ` Dat
�:, �a:� w, )EVuSs . A � ®See Attached Checklist mr
Inspection Line: 503.639.4175 !_ ^:�. Date Ready/By: jj
Internet: www.ci.tigard.or.us / Notified/Method: I (fL S�plemental Int'ormatbn
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,si isF:y .5 k,`�. , 1i ..,, y_H'.5 h'`.: - r- I ,, D• �B,� ITO t�
�pry S : ?k:, - -, � , v-o: ', . �$�F 1 :' ': 1: s r r it � ..i .,' ^r .� p. ,, :„. !i�' , 5` , ,.'°:"'?t ":.,,, E.' , •:, - ass:. � � � '�' �. � �� ':' ' � . a ..: x,} t ft at,. ,! - ;1.�I�' f :,::..- •.... �,1 ' � ,.0 INti�i� ski ���+;�'�at;' ,:MC 5•R�;.� e � .3',��. }''' ,�,; };.o- „C, r.. L.„ ,'.:+�' ...
❑ 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: kl& W a A 5 equipment, materials, labor, overhead, and the profit for the
,
oily_.- ,•<, s: ¢'p =i .:r'41Vg � wi1A - -g x ..4. ,•. i iii ::� tl :i *r` h � a ah163 i *: ; � work indicated on this application.
e C:L � "'�' �' "+r S J ,
1,5,...:,..,-- : = , S f t7 _;:.V: � -: . .'- '- " , t;.,. �cl' :'kk1V= -zt: • f 0 'i:4t, Valuation: S ��
� : r. -, ' .P d..i. 4 iti', +i:. T y=` •'� .i •.'n 1 hH N•:1 _
❑ l- and 2 -family dwelling IA Cotmnercialfndustrial
❑ Accessory building ❑ Multi- family Number of bedrooms: WI
❑ Master builder ❑ Other: Number of bathrooms:
�,.,_.t ,_� - + ; a mil Total number of floors:
l'; � r-141� j 1. h Wa 9 i , r ;$.35' y'1't % i, V , . .0.6:.S, Ib :A. •LA..
Job site address: 11 S 3S- 5 () ?t A C 1 F 1 C vi Wy New dwelling area square feet
City/StatefZIP: \ t v A_-__ b o IZ ck a a, 3 Garage/carport area: square feet
- Suite/bldg apt. no.: L Project name; E1P&A L Mt Pii A Ae.o. roof Covered porch area: square feet
Cross street/directions to job sit= Col v.e, f of A C i F tC- 1-11,3 y ' Deck area: square feet
•
0.v■ck St.3 "1 t
Q. • Other structure area: square feet
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel 11 o... equipment, materials, labor, overhead, and the profit for the
y , y„ . - ,r.Ftisc. t �.t= '_c„ + "✓= <.'i':i: =,� v -. t - a ", ' ,
f .�,. �' j t-0 ;:e $� ati .� r ,:. „ 4tr g iZAN : work indicated on this application.
C=wlY 4 - n, ; cs r A `9 ti c ,, . it .. , 0..:, , r ..r. 3S43r.; +',.;:r:, :rl!:,+• ,i,.3L ----- A Valuation: $ S" i
1•t c c ■ :A C l O f ! -c �'t h ° s l /ACLU i g p y g building area: / square feet 5 `1 $ O
C.-441°11 I.LSE -I- COO LEDs ,--
New building area: square feet S 4 3 O
a���� ti = ji ' �rcyt��^ tr":,°':-1 , f : stones: 1
#� �.,yy. ., y *5rt�{�'k�: �,., �a� , ,. a:. s,:�. �r }�J��iAan�i -:+ Number of st
5 (!'i.:. n�l!Ul Ff..n �':+A',�r ='�� :ST:VI� ':: 1'-{f. -`.3'' a �rh Ji
Name: iklUt g tO A C_ O kf) 1 Type of construction: Aaa i 9 ■ CA., � er tb r wcQU1
Address: , k to 0 -1 S LZ 3 ■ ' CA pc • Occupancy groups: ------ " • r f
City/StateJZlP: ' - r jr 1 oL v\ d b cll.). t is v Ex's 'jag — A A IL(-,—
Phone: (933) a H S' -1 $(o Nt Fax: (S�3) ° ( 71 - a' 3 S1 1 )( ti New taoa-Q p �o co
:i i, .'. ° ' i s °, :';1F i !�' t7( "' •- y y...a..", � " r .' r - ' .. 715;,'-' •fi n: , 1:: D.: - : v '
Lam : -- - --; 21' _ ' :4- : A ' ,; Y .. 2 , . 1 +" , y i .r.;, +•.::' i06,1:-. = ? r ",. ij;' r 1: ' r`7'
�., ` :141-- .�, _ ^ � i• :�y� t, i. a"i�r` J�:•k>Idi'Ttw .: i�+'- i. , ,; �.1� � ...�r � 1� M�, i��r -`� '' �r .� �� �' �,d�'ti t �� ,�� -�.'.. i.l ' ;. . :.1'. i {, ` _ .� �!
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_ � n '� -x� • - 1 �k �fi•#1,`� '�Fi�9e l!y�M'�.^ :'�+an... ::. 4'. " Lil ��Fi 'I.!�1�� lkJ: • Business name: 1-k A-LAI_ M C. AI al M ED . FD U L) All contractors and subcontractors are required to be _
Contact name: M Lot 5 I A } �� V ( licensed with the Oregon Construction Contractors Board
_ under ORS 701 and may be required to be licensed in the
Address: tk ko o 3 5 LA) "b i --1- d- jurisdiction in which work is being performed. If the
(Xty/5tate/ZIP: ? r( q Kt t 0 12 9 `]). l applicant is exempt from licensing, the following reasons
apply:
Phon= ( SD3) 'L L45 _ ( % (ptl I Fax: : ( SD 3)'t 1') — 23 S - .
E -mail:
• � , Y.. , , a,: : .:.is3�. U` t Y �''.': " y �.�+� 1,1�* s
t s ` -
3 ��+' luny -',`' a`5.wi�4i,'sl "raw �'�' -! , u a �. �'9^e�� i .r �:�M:t. -err 'ti @., h;J�r p �,�,
n r+ � Y a i J . i .k 4 . . tv' 7 igi, .r r i l cF : . ••
Business name: s Ke C rllt/��\ � A el) 5 '�, �` ,y %���t,�t�� gF,��•:;.'.t.,rt;;'- ••"”:"
.
T' 1 o C Co o ti'o h � `�`'�r :•�l V�� .i:: 4� -,
Address: 4 -i yh,p 1.. f r. -4 ` Please refer to fee schedule
City/Sm 1P' l / , 9 7 � Fees due upon application
Phon= (c. 4 .4 4 _ $ C 1 13 Fax: ( ) -
Amotmt. received
CCB lie.: % 5 i i $ ?3 `/ (/Q.
Date received:
Authorized sign - This p er lia If a m e
within 1 80 day c after h has expires been accepted perit is us not co mplete obtaind
.
Print nam=A/lti LC/ f,r j I Date: 4/ 12 7 /0y I • Fee methodology set by 7ti-County Building Industry
Service Board.
i 3u di ermts1BUP Pcrainawdoc 17/00 4404617111 n021CCIWIFB) q I ' '. °
• 30
CITY OF TIGARD 24 -Hour ' /�
BUILDING Inspection Line: (503) 639 -4175 /`v /�i�
INSPECTION DIVISION Business Line. (503) 71 MST
2, 20ct-- UU /<1"
Received Da Request /6 2.7 U AM PM BUP
Location 1/ 5 35 4 G ' C- Suite MEC
Contact Person Ph ( ) PLM
Contractoy Ph ( ) SWR
LDIN Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 1 ‹ j____—"c3 , ` o / \ ∎ / 6 ¥ ") A �
Framing V l T
Insulation
Drywall Nailing t S S kg ` Q
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
:= .
I i PART FAIL
ING
Post & Beam
. Under Slab ,
1 Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Cl / , ,
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: 0 Unable to inspect – no access
Fire Supply Line ` �I
ADA Da J 0/ z_ ` / a Inspector
v �' `''�
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL