Permit T CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00429
;, i DEVELOPMENT SERVICES DATE ISSUED: 7/15/03
°�J� 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 13855 SW PACIFIC HWY PARCEL: 2S103DD -00900
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: IJ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD I - FIRST: 2,066 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 2,066 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 255 BASEMENT: sf AREA SEP. RATED: 2HR
STOR: 0 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: $ 10,000.00
Remarks: Foundation only for 2,066 Sanctuary addition
Owner: Contractor:
COMMUNITY OF CHRIST MORELAND COMMUNITY BUILDERS
PO BOX 23462 4600 NE 24TH AVE
TIGARD, OR 97281 VANCOUVER, WA 98663
Phone: 503 - 684 -6620
Phone: 503 - 684 -6620
- Reg #: LIC 153225
FEES REQUIRED INSPECTIONS
Description Date Amount Erosion Control Insp 846 -8.
[BUPPLN] Pin Rv 7/15/03 $200.00 Foot Insp
Footing ng D Dr rain
Total $200.00 Reinf Steel Insp
Slab Insp
Reinforced concrete final rE
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 (50 : • = • 99 or 1- 800 - 332 -2344.
Issue. By: k 40 016 i)
Permitt- :
Signature: �e2QQ &^--
Call 639 -4175 by 7 p.m. for an inspection the next business day
/ .) 0 v J o r w rf V/ /!v l7 (/v 1
Building Permit Application FOR OFFICE USE ONLY
Received 9 ,a Building iI 11
Date/By:` � �
Permit �D 3 '�0 e�'2?
City of Tigard Planning Appro .1 Other
Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review 7— I c-0, Other _
Tigard, Oregon 97223 Date/By: (r L Permit No.:
Phone: 503 - 639 - 4171 Fax: 503 - 598 - 1960 "" i" (c Post - Review 7 _ / S, e3 Land Use
�"u . - �.' I Date/By: CPC. Case No.
Internet: www.ci.tigard.or.us Contact Juris.: ID See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information
!.E',/:!. ' ° TYPE OF WORK . - `r: - • , REQUIRED DATli9e', :8-'5
❑ New construction 1 ❑ Demolition V - 1 & 2 FAMILY'DWELLING:; . -
_
Di Addit ion /alteration/replacement ❑ Other:
. r ' - _ . , , ..CATEGORY OF CONSTRUCTION ... Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ® Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
. • _ .; JOBSITE INFORMATION and LOCATION ` No. of bedrooms: No. of baths:
Job site address: /gem' SW patehS Jhoy. Total number of floors
New dwelling area (sq. ft.)
Suite #: I Bldg. /Apt. #: L ,y Garage/carport area (sq. ft.)
Project Name: �p o , iS7 <e1U Covered porch area (sq. ft.)
Cross street/Directions to job site: , area (sq. ft.)
,
, , el 1l �rnGit'1 a Qaaeg,< e'99 Other structure area (sq. ft.)
REQUIRED DATA: V
• COMMERCIAL - USE CHECKLIST ; ' ._ . .
Subdivision: I Lot #: I) oQ ob
Tax map /parcel #: oZ S t 0 3 'D 0 Note: Permit fees* are based on the total value of the work performed. Indicate
' "'DESCRIPTION OF WORK ' the value (rounded to the nearest dollar) of Ott ° ^ - ' -k --
" overhead and profit for the work indicate
t //�
y
Valuation , [V, 06' v
* FO V
J -1-1 e v CJ ) 1 , v �1 Existing building area (sq. ft.)
l / New building area (sq. ft.)
J Number of stories t, A 5 z' Of r (v 'r
• ®- PROPERTY:OW.NER I ❑ TENANT Type of construction
Name: c.a/YImzill i 1 t al e`j/y s7 glierr- // I Occupancy group(s):
Address: po 80-2( „751/42_
City/State /Zip: Tc 'a,,/ (} Gj 7 2 ¢
` �66L6 Fax:
NOTICE: All contractors and subcontractors are required to be .
Phone:atl,3 -6TH -
❑ - APPLICANT I II CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: ,q,,,7 NY/dl--/ from licensing, the following reason applies:
Address: 4-32,/ LU /n4?.ro Tiert2
City /State /Zip: Ze,fat7L x{/1 e k, 97,6 E fe
Phone: ,44 if 974/ I Fax: 4ase) -da t 7 .
BUILDING PERMIT FEES*, ' s' ,
E -mail: s{, o y es P'a 6i • Com Please refer to fee schedule. - •
• •'- ' V ' CONT . i ' • .
Business Name: il 1 �� ' •
' ,
r� ►aL�� :�)t Fees due upon application $
Address: . 00 �. — A
City/State /Zip: V O N wk.- 6A W3 Amount received $
Phone: 30 6einS17 I Fax: Date received:
CCB Lic. h. , ,rR 5 2
Authorized t
Signature: l , / i i77, 1 / //' ! Date: I, /40440 Notice: This permit application expires if a permit is not obtained within
Si atu 180 days after it has been accepted as complete.
u t * C ( . *Fee methodology set by Tri County Building Industry Service Board.
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