Permit ' ` BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2003 -00391
,11 DEVELOPMENT SERVICES DATE ISSUED: 8/13/03
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: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ADD FIRST: 2,066 sf N: S: E: W: 2HR
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: N S: N E: N W: Y
OCCUPANCY GRP: A3 TOTAL AREA: 2,066 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 255 BASEMENT: sf AREA SEP. RATED: 2HR
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: 1
VALUE: $ 83,000.00
Remarks: Addition of 2,066 sf to sanctuary.
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:
Reg #: LIC 153225
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require Final Inspection
[BUPPLN] Pln Rv 6/24/03 $423.35 Electrical Permit Required
Plumbing Permit Required
[FLS] FLS Pln Rv 6/24/03 $260.52 Framing Insp
[BUILD] Permit Fee 6/24/03 $25.00 Roof nailng Insp
[BUILD] Addl Permit 8/13/03 $626.31 Insulation Insp
(additional fees not listed here) Shear Wall Insp
Firewall Insp
Total $1,387.28 Gyp Board Insp
Bolts in concrete final repot
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 -00 a • • ■ ' R 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling • ) 246 -6699 or 800 -330 4.
Perm' :-
Signature: y. i s. ,pr
I` Call 639 -4175 by 7 p.m. for an inspection the next business day
I /.3 5.v Phc, /awy
Building Permit Application FOR OFFICE USE ONLY
Received q 'Q, Building
. Date/By:`� ) Permit No. Up ev3-0D3`7� 7
i
City of Ti and Planning Appro .1 Other
g 6 _ Date/By: Permit No.:
13125 SW Hall Blvd. " ' %, : , Plan Review Other
Tigard, Oregon 97223 ° . . , Date/By: Permit No.:
Phone: 503- 639 - 4171',. Fax: ,503- 598 -19601 GV� d, �� Ili- Post Review Land Use
Date/By: Case No.
Internet: www.ci.tigard.or.us = ^� 6'1!.. Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA: '
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
[X) Addition/alteration/replacement ❑ Other: —
. CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling Ni 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 El Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: s s- Sal Put11 ;G J'of�•
Total numbnr area floors
New dwelling area (sq. ft.)
Suite #: I Bldg./Apt.#: Garage /carport area (sq. ft.)
C'
Project Name: wvni,e,uty ,f1' '/S7 L 46/ Covered porch area (sq. ft.)
Cross street/Directions to job site: / Deck area (sq. ft.)
11%'m of Cck irCefJ eir aorar ei0 Other structure area (sq. ft.)
7 REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I Lot #: /j oa O&
Tax map /parcel #: oZ S t 05 1) 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 all equipment, materials, labor,
overhead and profit for the work indicated on this application. g3,000 , o
,dd' / /ON Di ad 6 6 P SdI►nCiaa rl y
Valuation $ J
Existing building area (sq. ft.) 6' .236.
New building area (sq. ft.) a &C.
Number of stories Dbt!
® PROPERTY OWNER I ❑ TENANT gli4re // Type of construction
Name: CO/ft�'JIA./4i7 D/ [.dl"'.dT A Occupancy grou Existing: d20.
New:
Address: PO Box f: 73 1 /42,...
City /State /Zip: 7 Q 'p / /�/e q 72- ? )
Phone:dtl3 %/6(18 NOTICE: All contractors and subcontractors are required to be .
Fes licensed with the Oregon Construction Contractors Board under
❑ APPLICANT ® CONTACT PERSON 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: /-//I 7 kcA,, --f from licensing, the following reason applies:
Address: 4 LU /ndsar TGNrnGe.,
City /State /Zip: (�,g f /# !7A, 17,66 ie
Phone: ,44 - 974 I Fax: D - 4%2 i 7
// BUILDING PERMIT FEES*
E-mail:
S�i 0 Y' t Q7'�b/•• CO, Please refer to fee schedule.
CONT'•CTOR —
Business Name: I 1 ' _r ' , , • _, C' - ' Fees due upon application $
Address: 460(7 f . -- A f, 4
City /State /Zip: VFt$'i'J" Q " Cig(tiQ3 Amount received $
Phone: 30 & 1 nd" 1 7 I Fax: Date received:
CCB Lic. h. . , , ►R 5 2
Authorized
�/ A iI !Da te: I Notice: This permit application expires if a permit is not obtained within
Signature: �/ / i / b J0 0 180 days after it has been accepted as complete.
V I, 01<,e I) , l (. 14k *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) . p_ L 3. a R '7. 7O El
i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03 FL5 a` (OO , S 2
3 ‘ 0 - 6 90 -1// y 0 0-,6,
Plan Submittal Requirement Matrix
/A
4 Commercial & Multi- Family
City of Tigard New, Additions or Alterations
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
1
Site Work 4 ,
(must include location of all accessible parking)
i Plumbing - Site Utilities 2
Building 1*
•
Fire Protection System 3 **
k 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.
•
is \dsts \forms \PlanSubMatrix.doc 2 /27/03
EXISTING SITE PLAN . - / ..
—
A
i
Accessible Route "' _ • ,
/ .
.. «..».«. »... «.»».«...«Y.. « N....» ••••••••••••••••••••••••••• -
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0 0 / 1 0 0 ■\ v a" Aecef. t � i < I / 1<
0 a a / /
a 1 /
0
a a a o
a a o a (___________
0
N. N.
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108 min Aisle 72 min or 96 min for VANS • Is'f 1 4c c �05
__ __ _ ••• l
t tfa eerr�re ss rmismrt a .* . - - _ ��r..� -r �1+ �rs7 ss-+mt sir _ Q. '—�
z XTG. CHAIN - 1 90�rO� EXISTING SIDEWALK � `
INK FENCE 9 _ � �
)
1 1 ;
I
1! 1 4:12 4:12 1
•
� XISTING - �
= 1• DSGAPING
+
EXISTING HOUSE �I..AN tf
9 ( PROJECT SITE
rito - • TAX MAP: 28103DD
c4 d i 0 EXISTING BUILDING PROPOSED ADDITION TAX LOT: 900
to (
F N v 7 •/ 4:12 4:12
- t a 0
'6''. - 1
\ ....... ... .". 366.41'
XISTING ' SIDEW� fxlc P� �'�ASI° XISTING SIDEWALK 221 4�'
EXISTING HOUSE 35 / 104 0 _
e
I
NORTH PROPOSED SITE PLAN
-J
C-1 1" ° = 30'
C.I
0
In
cn
i ,2,kt",200.5— 0639' I 1
eki
I
/ 3 $ � 5 944:7fre(-- may
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
I II DIVISION Business Line: (503) 639 -4171 NY' MST
IiF ) WO 3 ci
Received Z? 7`= Z 3 Re uested ` / / '/ AM PM BUP
1 -
Location /?)(e5 S i Suite MEC
Contact Person `i 1441 (5 O b - '4 ?9PLM
Contractor Ph (, 3) Cq 7- 40 l SWR
BUILDING Tenant /Owner f (-1444.14 . ' ELC
Footing f
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: , T SIT
Post & Beam Gf ?/t ' / 07/1/J •
Ext Sr ea Anchrs
th /SSh ear C ,30 � Q ,0/1.17,&-L Ext Sheah/h
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall - 15-
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
C
S PART FAIL
• • •∎ 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
ADA
Approach/Sidewalk Date 3 Inspector Ext
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
INSPECTION D1VIS ON Business Line: (503) 639 -4171 MST'
. DDO Si 3
Received Date Requested 9 / 7 AM PM 77 0 00 3 C M
Location 25S .litJ P 60 �- - . %: y,• .�. MEC
Contact Person C -1L.. 1 Ph ( 1M ) . 1 PLM
Contracto - • h'Ph (5) _ 5- '7- 4C974{SWR
ILDI Tenant/Owner CSVIA M - 01.A.A..dk" ELC
Foo ing
Foundation ELC
Ftg Drain Access: ci F .5.__ ELR
Crawl Drain
Slab Inspection Notes:. sc > ,� �p , / to SIT
Post & Beam /}� _
Shear Anchors " f'AA&&.. •t Z4.u.. *11) •,J C(ACCA, ..
Ext Sheath/Shear .
Int Sheath/Shear
Frami
Drywall Nailing r . , ,,� ,_
ire !sprinkler O 'lr"C' � Ot ; �� �,�
Fire Alarm ' G° C I 1
Susp Ceiling •
Roof ., ( H t �
z ' •
Final (
1 FAIL -`
• MBI .' _
_. :eam /419 /2 /7 a/j /U 0(2,ACle
Under Slab
Rough -In q g it9 , .
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pa /! - / 2.57 J- f XI , /4 x' d� /'t TAU Ki
er114 - :9k w q &it Ts I
'_ � -' PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final At g - Atc / c- S)1-) S iTh C 6� P-sf %
)
PASS PART FAIL
ELECTRICAL Col pet2 f /X TZ/2 cc-5 0 ,...(� Cvv r•
Service
Rough -In (-y . 7 r cr. tcS , ) E C Cvv 6.4.4 'fl
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
ADA
Q
Approach/Sidewalk Date / 3 Inspector f Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL