Permit 4' CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 00028
r; DEVELOPMENT SERVICES DATE ISSUED: 1/28/04
" „- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11643 SW PACIFIC HWY B PARCEL: 1S136CA -01800
SUBDIVISION: ZONING: C -G
BLOCK: LOT: 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 CONST: 2N : sf N: S: E: W:
OCCUPANCY GRP: H2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 0 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:
VALUE4 700 • DO
Remarks: TI: New walls for auto repair.
Owner: Contractor:
MILNE REAL PROPERTIES, INC RICK L. RUSSELL
P 0 BOX 2740 PO BOX 397
PORTLAND, OR 97208 COLTON, OR 97017
Phone:
Phone: 503 - 824 -2557
Reg #: LIC 51846
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 1/28/04 $110.50 Susp Ceilng Insp
[TAX] 8% State Surchari 1/28/04 $8.84 Final Inspection
[BUPPLN] Pin Rv 1/28/04 • $71.83
[FLS] FLS Pln Rv 1/28/04 $44.20
Total $235.37
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: g A_oeeGc,
Pe mt ittee
Signature: X
CaJ39 -4175 by 7 p.m. for an inspection the next business day
BUricring Permit i FOR OFFICE USE ONLY
414 \ 4 > Received •
City of Tigard !JAN ;,f ` c i' i O ' Rec Rec e ive d O S -04/ i s Permit No.73 iRaOQY/ -- ai ∎ •
13125 SW Hall Blvd., Tigard, OR 97223 � i
g 1 ' Plan Revie �/
Phone: 503.639.4171 Fax: 50 "' • ' , ∎�• # -4� G z, ' / ii,, f1 Date/By: 7 b 7,3� J Other Permit:
Inspection Line: 503.639.4175 ` � %- Al- Date Ready/By: funs . El . See Attached Checklist for
Internet: www.ci.tigard.or.us BURIN !- B I ION Notified/Method: Supplemental Information
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*:. n . i3 - "". : =, ' F': v�r•- , c; ' ` R E ,- D DA - AND l -FAMII Y DWELLING
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
gl Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
.4 , y', �,;;� ;' a i 1 "r- : „;. :: work indicated on this app
application
�;, ;:x: .. •, , - ..... � .,. .. .. ... y r- = �;;�':
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El 1- and 2- family dwelling ,�Commercial/industrial ' Valuation: $
1:1 Accessory building ❑ Multi - family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
K' : -. em u' ;; - K ' Total number of floors:
f..? t; . , ,• = JOB <SLTE` IPEOg .T . QN: a I3UCATIbN ` r g, t `:``' °• „ :r > -, . : - ;
Job site address: / /6 Y % J'' a/ ` A e_ (,C /L lie(/ 5 . • New dwelling area: square feet
Cit / ( aAd ,2 / O i. 972 2 5 Garage/carport area: square feet
Suite/bldg. /apt. no.: ig.AM Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
••= REQY.IIR)?D DATA: ciiviMERCTAt- IfSE
Subdivision: 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 no.: equipment, materials, labor, overhead, and the profit for the
' - ;-• ';, " :. *: ''' ;” $- - - DESCRIPTION' OF _WORK, - i work indicated on this application.
7- eivAiY _T ig!z[7 t/071E41T Valuation: $ '70069. A 0
Existing building area: square feet
New building area: • square feet
k= , * gill YPROPERT'rOWI ER : :—.• ;, ,t= TENANT , - ,.: - ■ M - Number of stories:
Name: ` , _9_. t 11 X 5 4 Type of construction: — N
Address: Occupancy groups: / / - z-
City/State/ZIP: Existing:
Phone: (&)4 > '. 3 5 (o C7 Fax: ( ) New:
s a: l94P LI ANT 5 Q CONTACT PERSQIYr +• -L , ..-• , '.4'- '`
t :' v , k5'- Y
: •=rio k• _._. .. r.._r+�. � .x - � +i ` -r' t ,NUTICE' �
Business name: L 64 /14C/-/ ,tu 7b ,i E 4'"i ,,Jje... All contractors and subcontractors are required to be
Contact name: 7 �/ �(� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: / / 6 91 f _� /J /F ,ritiy jurisdiction in which work is being performed. If the
City/State/ZIP: -- 7 — / 6 ,4� o 4- 97Q v 1 applicant is exempt from licensing, the following reasons
_ £ �� t 4 Q apply:
Phone: (4) 64,1_4; / I Fax: : ( " 7(/ e) `
E -mail: •
.
Y4, .r ; � .. .' S. , . z ,L :CONTRACTOR - • ,- "I• i 7+� ;! :, - . Y • , '
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_n � . -. . . . // , , '•4.t.w, • .. p . '�`.. . ` ; ; >.h' f � ... ... -.
Business name: (Z / G � , . iZ ei d f� � L L . r •
�i 3,� .:,r �'� i ` ' ` ' <� 'BUILDING FEES";
Address: g. t� I"7 Dx 3 9�
City/State/ZIP: C I2Z � N O� 6/70/7 Please refer to fee schedule.
Ci l�
I' Fees due upon application
Phone: (472;) I Zi c? Fax: ( ) Amount received
CCB lic.: 4 • ,L — f 3 -lJ J
Date received:
Authorized signature: F , l This permit application expires if a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print-name: /AA/ • C,//t; Date: • Fee methodology set by Tn -County Building Indu ' //
Service Board. poi T .1> I i C . ',.3-0 f \ /
i:\Buitdf \Permits \BUP- PermitApp.doc 12/03 440- 4613T(1 I /02/COM/WEB) �x � 7 '
CIT OF TIGARD 24 -Hour
. 'BIhLDING Inspection Line: (503) 639 -4175
INSPECTION DIVISIO Business Line: (503) 639 -4171 MST
UP — Odd 2 -i(
Received Date Req ted AM PM BUP
''"Location / /l e � 3 ci '��C --- Suite r MEC
l/
Contact Person Ph ( ) . T - sO e PLM
Con acts Ph ( ; )� SWR
UILDIY Tenant/Owner a i,: /`/ . �='' ALL_ _At ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: / — SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
O l er:
•
li 1 PART FAIL
P ' ' BING
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line 2
ADA Date v / /JO/ I ns I nspector Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL