Permit 411,, city O F T I G A R D PERMIT #: BUP2003 -00057
DEVELOPMENT SERVICES DATE ISSUED: 2/6/03
�I!I BUILDING PERMIT
13125 SW Hall Blvd.. Tioard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13855 SW PACIFIC HWY PARCEL: 2S103DD -00900
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: 5:. E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 1,000.00
Remarks: his NANAr rib ' Al ilfg. / 4 a c ». Ly of *' I irMioP. Abo
Owner: Contractor:
COMMUNITY OF CHRIST CHURCH OWNER
5321 WINDSOR TERRACE SIGNED RESPONSIBILITY
WEST LINN, OR 97068 FORM IN FILE
Phone:
Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection •
[BUILD] Permit Fee 2/6/03 $62.50
[TAX] 8% State Tax 2/6/03 $5.00
Total $67.50 .
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
952-001-00111 - • •: • •AR 952- 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ( e ) 246 -6699 or . -800- 332 -2344.
Issued = y: • _ 1 /. rJ% as
Permittee / / o
Signature: ('
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application _
'' -'j��'i° City of Tigard F t1 ved; i4'4 Permit no j ket5 -OW5 " 7
oject/appl. no.: Ex ire date:
Address: 13125 SW Hall I
City of Tigard phone: (503) 639 -4171 / �. mate issued: 'E� may -'' - Receipt no.:
Fax: (503) 598 -1960 ' tdgoo rase file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
IEEIMIIIIIIIIIIIIMIIL—. 111111111111111111111111111111111
❑ 1 & 2 family dwelling or accessory ❑ Commercial/ mu,. -. ti- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement 0 Tenant improvement U ri,,; sprinkler /alarm ❑ Other:
;. JOB SITE INFORMATION- '-. . -
Job address: /3 S$$ S l'aed ke; /;/w'/ Bldg. no.: Suite no.:
Lot: 900 I Block: subdivision: / I Tax map /tax lot/account no.�,f /d,1 Dl?
Project name: Cp/!7/f7Lg/1 1i (77 ext,i Sf
1 n
Description and location of work on premises /special conditions: ALA - - L4>_ (,! � � t L'1y r
., DINNER FOR SPECIAL INFORMATION, : USE; CHECKLIST
_
Name: O As,Ai&A; 07e eA/"iS •, (Floodplain;septiccapacity, 1)lar, etc.)..'.:
Mailing address: 7 p . tg vx I & 2 family dwelling:
City:7 j a .a I State: 04 ( ZIP: Q j�t�/ Valuation of work e
Phone:(Qt 642 er Fax:e.so G,9/,r E -mail: No. of bedrooms/baths
Owner's representative: A S` Total number of floors
Phone. S7 - Fax: &or O E -mail: A. . e a,V. ;mildew dwelling area (sq. ft.)
. APPLICANT Garage/carport area (sq. ft.)
Name:
/94/1 (5X0/10" Covered porch area (sq. ft.)
Deck area (sq. ft.)
Mailing address: S3a i t(Ji/)ar T rr�te�
City: ij e/ deehh State:OR I ZIP: 97,74,g Other structure area (sq. ft.)
Phone F E- ommercianusriamu- family: m � "'Y9 a�iSo - c6ut . a @ - � . �� l/idtl/ltl il i ()
CONTRACTOR a uation of work � /
i ;' _ , :.:.' Existing bldg. area (sq. ft.)
Business nat p c 4e _ _
New bldg. area (sq. ft.)
Address:
Number of stories
Ci., • 1d State: 1Z! Type of construction ti/
Phoneme 'Fax: I E -mail:
CCB no.: Occupancy group(s): Existing: edi Lt N1G
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.: .
Phone: Fax: E -mail: .
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied wi hether spec' hgryin or not. Credit card number: / /
Expires
Authorized signature: Date: /J /o Name of cardholder as shown on credit card
Print name: Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within,180 days after it hag heen nr,•n..•u,t ..- -omplete. 440-4613 (dooicoM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
2 BUP 3 00°5- 7
Received Date R- . uested _ 3 --- -3 AM PM BUP
Location rs i. &......— . .uite MEC
Contact Person Ph ( ) 5mot' 1 (-fa (D PLM
Contractor Ph ( ) .o S 7 LI-9 7 SWR
G Tenant/Owner ELC
Footin,
ELC
ndation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection NotesQo c g 137 SIT
A Post & Beam !/
Shear Anchors •
Ext Sheath/Shear t - - - _...../.e..30 `'d
Int Sheath/Shear . - (A4-11A-
Framing 1
- --
Insulation - •
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Other:
Y
•ART FAIL
P U 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 S • -\f/
,..-L" ......'7
Smoke Dampers
Final cir
PASS PART FAIL
ELECTRICAL
(C
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
ADA Date 3/3/b ? I ns
Approach/Sidewalk p ector
l Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
, INSPECTION DIVISION Business Line: (503) 639 -4171 BU 2-W
Received Date Request AM BUP
Location / .3 8 ,i C ( / Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
..1) NG Tenant/Owner _ ELC
ELC
Foundation 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
�1l PART FAIL
• -.i,rr ING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Man ole
Storm Drain
Shower Pan
Other: T <
Final ` J
PASS PART AIL
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
ADA ?/ Approach/Sidewalk Da ( ) Inspector ( aThTh Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL