Permit C ITY OF TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT PERMIT #: SIT2006 -00026
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 2/20/2007
PARCEL : 2S103DD -01201
SITE ADDRESS: 13920 SW PACIFIC HWY ZONING : C -G
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT: JURISDICTION : TIG
PROJECT: GOODWILL INDUSTRIES
Project Description: New retail /donation center.
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: 97,350.00
EXCV VOLUME: 1,500 cy LANDSCAPING ?: Y
FILL VOLUME: 1,500 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 47,215 sf
Owner: FEES
GOODWILL INDUSTRIES Description Date Amount
1943 SE SIXTH AVE [BUPPLN] Pln Rv -Valu 12/15/2006 $476.68
PORTLAND, OR 97214 [FLS] FLS Pln Rv 12/15/2006 $293.34
[BUILD] Prmt Fee -Valu 2/20/2007 $733.36
[TAX] Valu 8% State Surcha 2/20/2007 $58.67
Phone: 503 - 238 -6190 [ERPRMT] Erosion Control 2/20/2007 $120.00
Contractor: [ERPLN] Erosn Pln Rv CWS 2/20/2007 $39.00
[EROSN] Erosn Pln Rv COT 2/20/2007 $39.00
LCG PENCE CONSTRUCTION LLC [WQUANT] Water Quantity 2/20/2007 $4,950.00
2720 SW CORBETT AVENUE
PORTLAND, OR 97201 Total $6,710.05
Contact #: PRI 503- 252 -3802
FAX 503 - 256 -3684 REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Reg #: LIC 153167
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notific- -titer. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or d' ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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,
Issued = y: _ � �L' Permittee Signature: A .
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_zL ) 39acl s� r4c rF c- FilAJy 0V02006-o
Site•Work
Building Permit Application ___IIMMIMIINMMIMI
Received
City of Tigard Date/B : Permit No.:
13125 SW Hall Blvd., Tigard OR 9 � CEIVED
C / Phone: 503.639.4171 Fax: 503.598.19yQ•. 1 s Ih \04) i , / ZCC
I i G n K D Inspection Line: 503.639.4175 L1 CC 1�. I �`*"� `"� "r
z o OS
Internet: www.tigard- or.gov CITY OF TIGAHD Plan Revi= •
BUILDING DIVI$!ON Date/By: l/y ? Other Permit:
Date Ready/By: lunc: See 2 for
Notified/Method:, A Q ((! Supplem ental Info
Type of Work CCB lic.: 15316'
New construction X Demolition Authorized signature:
Addition/alteration /replacement Other:
Category of Construction I Print name: t!1"'64.4.. RCS
1- and 2- family dwelling Commercial/industrial x Required Data: 1 - and 2 - Family Dwelling
Accessory building Multi family Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Master builder Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
JOB SITE INFORMATION AND LOCATION Valuation: $
Job site address: I3Ro Sty) PAu G
1" Fl 1416NLi►alf Number of bedrooms:
City/State/ZIP: •r' AR7 O '«1
1 �7 � a Number of bathrooms:
Suite/bldg. /apt. no.: I Project name: eli'DteKd.. ItdOt►ynIC1es
Cross street/directions to job site: Total number of floors:
' �� „son New dwelling area: square feet
Garage/carport area: square feet
Subdivision: I Lot no.: IZo I Covered porch area: square feet
Tax map /parcel no.: Z s 10'3 Do Deck area: square feet
Description of work Other structure area: square feet
Re -0 eve-ber4E•f'>r o r lArt• peo eJLarec stTE FOR A Required Data: commercial - use checklist
14t" RtTMl_I DoNivrtoN cr .. - cltttc.tt . tu41*-u 114'EJ Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
Property owner )4 I TENANT work indicated on this application.
Name: Valuation: $ q o
C7000 1,+t<u.- ttichn E S 7 3 sc� . 0
I
Address: 14144 3 se 5ileTM A Existing building area: — square feet
City /State/ZIP: ?Ciarrta en ea_ grIZ q New building area: 2 l 45- square feet
Phone: 05e3 . e 38.614ito Fax: O 5b3. Z'Scy • rfoS Number of stories: '
Applicant Contact person Type of construction: V g
Business name: re f fe u4 14 ; 4645 A Occupancy groups:
Contact name: 9,644,..414.4._ tZ lt<acs Existing: _
Address: 3B si,L.IE 9i'• 5+,tTe E New: M / S. t
City /State/ZIP: Soixt•t al-- ii3a I Notice
Phone: O Fax: S�� •SeS• 0222 O 563 •$QS • ';13) All contractors and subcontractors are required to be
E -mail: raw, d al l �a - a�� • coo.. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Contractor jurisdiction in which work is being performed. If the
Business name: 4 e6 p a wS , jeC , p fi' G[.�
applicant is exempt from licensing, the following reasons
Address: 2 i Csr3 t .
AO
.�
City /State/ZIP: PisrL'(LAN 0e 577 2
Phone: O J I Fax: () .2 %. 368Y
I tC'II Ic1 75. 3052
L:\BuildingWermits \SIT- PemtitApp.doc 06/26/06
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: SIT2006- 00026
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20 /2007
Phone: (503) 639-4171 A �f�l,
Inspection Requests (24 Hrs.): (503) 639 - 4175 .' F : _..
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 8
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: New retail /donation center.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503-238-6190
CONTRACTOR: LCG PENCE CONSTRUCTION LLC PHONE #: 503-252-3802
Inspection Request Scheduled For: Date: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 050955 -01 503-209-3586 N
Corrections/Comments/Instructions:
•
/
PASS IN 'A APPROVAL ❑ CANCEL El NO ACCESS
Li FA L I* C' L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: i `, e.2 Phone #: (503) 718 - Z6.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20/2007
Phone: (503) 639- 4171 �a 1 .� ±�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/8/2007 TIME: 7:01AM PAGE: 21
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: New retail /donation center.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503 - 238-6190
CONTRACTOR: LGG PENCE CONSTRUCTION LLC PHONE #: 503 -252 -3802
Inspection Request Scheduled For: Date: 6/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 049879.01 503 - 209 -3586 N
Corrections /Comments/ Instructions:
I G-&- S
-fl 1 t-/ reN�' IZ
❑ PASS I RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL 15 A FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 6 g/ Phone #: (503) 718- z6y7'
CITY OF TIGARD •
BUILDING DIVISION ft .• _ PERMIT #: SIT2005 -000 26
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2012007
Phone: (503) 639 -4171 v ,�
Inspection Requests (24 Hrs.): (503) 639 -4175 VW'
I..
INSPECTION WORKSHEET FOR DATE: 3/23/2007 TIME: 7:03AM PAGE: 21
SITE ADDRESS: 13920 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: New retail /donation center.
OWNER: GOODWILL INDUSTRIES, PHONE #: 503.238 -6190
CONTRACTOR: LCG PENCE CONSTRUCTION LLC PHONE #: 503 - 252 - 3802
Inspection Request Scheduled For: Date: 3/23/2007 Pour Time: JL
Code # Inspection Description Confirm # Contact # Mes
420 Sprinkler supply lines 045311 -01 503- 209-3586
IV
Corrections/Comments/Instructions:
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7,00 4:1 - .;:. _,. c _
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MA irinJ /L 2 Rt) APL/ hikic
_j _1 r s , i Q i
fM . PASS d •ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ , IL % , L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - _ Date: Z 0 Phone #: (503) 71816: Y
CITY OF TIGARD c.. •
BUILDING DIVISION r PERMIT #: SIT2006-00076
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7J20/2Q07
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 U i ;
INSPECTION WORKSHEET FOR DATE: 3/1/2007 TIME: 7 :00AM PAGE: 43
SITE ADDRESS: 13920 SW PACIFIC HIM( CLASS OF WORK:
SUBDIVISION: GOODWILL INDUSTRIES CENTER LOT #: TYPE OF USE:
PROJECT NAME: GOODWILL INDUSTRIES
DESCRIPTION: New retail/donation center.
OWNER: GOODWILL INDUSTRIES. PHONE #: 503-238 -6190
CONTRACTOR: LCG PENCE CONSTRUCTION LLC PHONE #: 503 -252 -3802
Inspection Request Scheduled For: Date: 3/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # M/ - tikPC
470 Sprinkler supply lines 044162 -01 503 - 209-3586
NI
Corrections /Comments /Instructions: .■---------
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.111111.11.1 N411111111 1111.1111. 11.1111111.111 'IMIIIIIIIIW 114111111111111W
❑ PASS
VEARTIAL
APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL 4 • LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector Date: z _ Phone #: (503) 718- G