Permit CITY OF TIGARD . BUILDING PERMIT
PE RMIT #: BUP2000 -00262
A DEVELOPMENT SERVICES DATE ISSUED:. 7/10/00
= — ref �! 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 -
SITE ADDRESS: 06909 SW PINE ST PARCEL: 1S136AD -02900
SUBDIVISION: VILLA RIDGE • ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: REP FIRST: . sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 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: $ 4.00
Remarks: Repair of foundation.
Owner: Contractor:
BLECKMANN, KEVIN N J AFFORDABLE HOME RESTORATIONS I .
6909 SW PINE 4134 SE 52ND AVE ,
TIGARD, OR 97223 PORTLAND, OR 97206
Phone: Phone: 771 -2327
Reg #: LAC 86828
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
PLCK DEB 7/10/00 $44.53 0003570 Final Inspection
PRMT DEB 7/10/00 $68.50 0003570 PI
5PCT DEB 7/10/00 $5.48 0003570 OR‘GN
Total $118.51
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987:
Pe nn itee ( O r /
Signatu . ■elim., '41 •
Issue By: A, r. /, N ` /.../!��!•'� •
• Call 639 -4175 by 7 p.m. for an inspection the next business day •
Mk r . IGARD Commercial Building Permit Application Plan heck#
131[5 HALL BLVD. — NP Recd
� - Date Recd 7 -/o -0c) TIGARD, OR 97223 5 -? OT ,' L / a I ,S b4— /p Date to P.E. 7 /0 —
(503) 639 -4171 Date to DST 77-/o- ov a,,,.
Print or Type Permit# /3f— Pi �°"T
Incomplete or illegible applications will not be accepted RelatedSWR# — ea 2io
Called
Name of Development/Project
Job Existing Building 0 New Building p
Address Street Address Suite
• 6 505 SLAJ Pi 4.4_. Building
Bldg # City /State Zip Data
7'54►•1i / Ok. . Existing Use of • ing or Property:
Name
Property He Uin la /e�.A. Us of Building or Property:
Owner Mailing Address Suite Proposed 9 rty•
6505' St,.w 7i -
e'' City /State Zip Phone
No. f Stories:
-
//s44 02 5 -7643
Occupant Name f Sq. Ft. Of Project:
Name Occupancy CI- es)
Contractor 4 C J.Ji, - 6, ,4,,. ,;,,, /A
Prior to permit Mailing Address Suite Type(s) • • 1 • 1
issuance, a copy y, 3 y Si- . 5 - z4•1 m--....
of all licenses
are required if City /State Zip Phone Will this project have a Fire Suppression , stem?
expired in AA 1, vie �, ? Zak ) 2 i _ 23 27 Yes 0 No •
database Americans with Disabilities Act (AD
Oregon Const. Cont. Board Lic.# Exp. Date Valuation X 25% = $ Participation
E S" a g / /O / Complete Accessibility Form
Name Project • $
Architect Valuation 4/
- ng Address Suite x 7 / 07-0
Plans Required: See Matrix for number of sets to submit
City/S . - Zip Phone on back
Engineer N ' - I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and
Mailing Address Suite that plans submitted - - in compliance with Oregon State Laws.
Si•natur of c. • ' ••e• Date
City/Stat Zip Phone ` 2 _ /d - 2ctuv
• ntact Person Name Phone
Indicate type of work: New 0 Addition O D ition O Y Z/ 7'_""' —2 7 / - 2- 327
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 FOR OFFICE USE ONLY
Description of work: Map/TL# Land Use:
Not ' /- , m i. , . Notes:
•
Parks: Estimated # of Employees TIF:
If the above figure Is not supplied at the time of application, the city will
calculate the fee based upon the number of parking spaces. '
Note: Site Work Permit Application must precede or accompany Building
Permit Application
i:\dsts \forms \comnew.doc 5/10/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
! BUP Av -GU0GZ-
Date Requested 7 `1 d AM - PM BLD
Location G y 0 9 t Suite MEC
Contact Person Ph 8/a 7 7 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
oot In. Access:
FPS
gain Poe (e): - / ' °�"` 34)
Crawl Drain Inspection Notes:
SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler C,\
Fire Alarm Q // -/ � �. / n / / Corn l
Susp'd Ceiling � G` �l�
Roof
Mi
RT FAI
P ' BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk / O)
Other Date l V Inspector ( Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.