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Permit
BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2005 -00005 A P� DEVELOPMENT SERVICES DATE ISSUED: 1/6/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC -00500 SITE ADDRESS: 13500 SW PACIFIC HWY 50 ONE HOUR PHOTO 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: B 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: $ 3,500.00 Remarks: TI, ADA restroom. Owner: Contractor: 13500 PACIFIC CORP CPS CONSTRUCTION INC BY CAP ADVISORS 12454 SW 114TH TERRACE 38345 W TEN MILE RD, STE 170 TIGARD, OR 97223 F RMINGTON HILLS, MI 48335 Phone: 503 - 579 -0148 Reg #: LIC 102248 FEES REQUIRED INSPECTIONS Description Date Amount Electrical Permit Required [BUILD] Permit Fee 1/6/2005 $72.10 Plumbing Permit Required [TAX] 8% State Surchari 1/6/2005 $5.77 Final Inspection [FLS] FLS Pln Rv 1/6/2005 $28.84 [BUPPLN] Pln Rv 1/6/2005 $46.86 Total $153.57 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 : 246-6. . 1-800-332- 44. Issue • = y: �d � � ' a -41 'L.f Permittee Signature: rid! , , 4 ` Call 639 -4175 by 7 p.m. for an inspection the next business day Building Permit'Applicaflt c oy _0 FOR OFFICE USE ONLY City of Tigard Date/B I D _� 13125 SW Hall Blvd., Tigard, OR 97223 t I Plan Review © O �a' Phone: 503.639.4171 Fax: 503.598.1960 JAN 6 � � r I ' ,'�II� Date/B : Other Permit: � Inspection Line: 503.639.4175 . Vi r -' Date Ready/By: IRI See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: EM Supplemental Information • CITY OF ivy TF T TIGA . TY I afiI> 14 o DIV ISION REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction Xl Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all p 1P[ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the . CATEGORY OF CONSTRUCTION ' , work indicated on this application. e-O El 1- and 2- family dwelling Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORtMATION AND LOCATION Total number of floors: Job site address: /3SOO Le.. !/ `0 (� / �Y� �4 \ New dwelling area: square feet City/State/Z1P: / 1 --t4> r / Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: .-p gA-0.A..... Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I 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, and the profit for the DESCRIPTION OF WORK work indicated on this application. T e - / Z /- Valuation: $ /`t'� dw� Existing building area: square feet New building area: square feet PROPERTY 044 ❑ TENANT • ' : ' • Number of stories: Name: ¢/7o l C c4i Type of construction: a JJ Address: pl r ,i,e c Occupancy groups: City/State/ZIP: 9 7 Z O V Existing: Phone: () ,2-2y/ —c 7 5 / Fax: ( ) New: APPLICANT ❑ CONTACT •PERSON NOTICE - " Business name: �1 //- �.,L, Cps S'1 - z. , �/ � �- � �-tc> c_ All contractors and . subcontractors are required to be Contact name: R�� kI e� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 96 2,5 sso 7 . jurisdiction in which work is being performed. If the City/State/ZIP: p`�_ C� , /r/ applicant is exempt from licensing, the following reasons (Fax::()) Q apply: Phone: () 3 -I8 „3 --- 0 73 E -mail: •' ,, CONTRACTOR Business name: < 'r "`x ° -, BUILDING PERMIT FEE S* Address: . Please refer to fee schedule City/State/ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lic.: /0 "2, 4 8 Date received: Authorized si re: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: tx 1 \ (eill Date: ' /) ( * Fee methodology set by Tri Building Industry Service Board. i:\ Building \Pernmits \BUP- PemtitApp.doc 12/03 440- 4613T(I1 /02/COMIWEB) v • Building Division �'` �' ' ^u�+ 1 I I Plan Submittal Requirement Matrix �'` Commercial & Multi - Family - New, Additions or Alterations City of Tigard Type of Submittal # of Plans (Includes new, additions and alterations.) Required at • . • Submittal, • Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) 2 • Building 1* Fire Protection System 3 ** Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue) * For over - the - counter commercial tenant improvements, submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03 CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTIJN DIVISION • Business Line: (503) 639 -4171 MST BUPoi_lodS DL Received Date Requested — a� A PM BUP Location / 3 so o �« � �� Suite MEC Contact Person Ph ( ); 0 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation A ccess: Q 1 Ftg Drain �,f — 1 N. J 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 Other: � TALVE LPL SS I NERT FAIL IMI i7A L . 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 D Please II for reinsp tion RE: 1 Unable to inspect — no access Fire Supply Line (( � ADA Ext Approach/Sidewalk Inspector Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL