Permit " Z.:.
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00049
�; DEVELOPMENT SERVICES DATE ISSUED: 2/10/2005
1,L ��' I- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15298 SW ROYALTY PKWY LEGACY PARCEL: 2S110D6 -01300
SUBDIVISION: PP1996 -010 ZONING: C -G
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B 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: $ 65,000.00
Remarks: Structural repair of exterior column.
Owner: Contractor:
PARR - FRANKLIN LLC
330 SW LINCOLN
PORTLAND, OR 97201
Phone: Phone:
Reg #:
FEES REQUIRED ITEMS AND REPORTS
Description Date Amount Structural welding
[BUILD] Permit Fee 2/10/2005 $552.85
[TAX] 8% State Surchari 2/10/2005 $44.23
[BUPPLN] Pln Rv 2/10/2005 $359.35
[FLS] FLS Pin Rv 2/10/2005 $221.14
Total $1,177.57
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 (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By:
Perm ittee /
Signatur
Call 639 -4175 by 7 p.m. for an inspection the next business day
4• '.IL . A-r
Building Permit App FOR OFFICE USE ONLY
City of Tigard 14 tt E I V E r' Received , , pemtit N
13125 SW Hall Blvd., Tigard, OR 97223 Dan Review
V (/� ��� /(! / y
Phone: 503.639.4171 Fax: 503.598.1960 FEB 10 201; a / / - d'h,LL� \ D g V 1E`v , ‘/ Other Permit
Inspection Line: 503.639.4175 c_ I I Date ReadyBy: i ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method:p /� 0) Supplemental Information
CITY OFTIG
Btfl P IV1�i( h. REQUIRED DATA: 1- AND 2- FAMIL7?DWELLING - • •
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement 41/Other: l(' -. /„a equipment, materials, labor, overhead, and the profit for the
Y ��"� ' • • work indicated on this application.
• CATEGORY/ OF CONSTRUCTION pp
Valuation: $
❑ 1- and 2- family dwelling it Commercial/industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' JOB SITE INFORMATION AND LOCATION Total number of floors:
1.. . • -
Job site address: l . s 2.9 O c w 2 oeillia— /2rk' New dwelling area: square feet
City/ State/Z1P: - Q r er ,�,,/ 9 7 � Z GI Garage /carport area: square feet
Suite/bldg. /apt. no.: ``�� `"'`"''' Project name:: " 1 .0 ` C , ,1 ; Covered porch area: square feet
Cross street/directions to job site: el et ( Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK" work indicated on this application.
colss,, _ Y�A Yi Valuation: $ .K� d
Existing building area: square feet
New building area: square feet
PROPERTY OWNER ❑ TENANT Number of stories:
Name: p 4yl Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
g
Phone: ( ) Fax: ( ) New:
RI APPLICANT• ❑ CONTACT,PERSON NOTICE
Business name: 1 14 cd f4G f-f'�r / All contractors and subcontractors are required to be
Contact name: ��� . �r .�✓ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1 5 3 O S tiv f'� I � 6-YC,e� jurisdiction in which work is being performed. If the
City/ State/ZIP: edr-) t4. 0 k or- .� 1 7Z' 05
applicant is exempt from licensing, the following reasons
vv apply:
Phone: (97 /) .S ks 3 3442_,C Fax:: (6o3) Z Zy 363 y
E -mail:
•
. ' CONTRACTOR
Z
Business name: .. CONS....... .... . BU�LDING. .PE121�1TT.'FEES *' ' .
Address: r �'G� 1e r tf 'ee
J 3 S w y! S Please refer to fee schedule.
City/State/ZIP: Pe r+ I 0 g co 2 0s
/� / // Fees due upon application
Phone: ("!7I) 563- 3111-6 Fax: ( Sam 7.-2-ti _.3 b3 Fe
Amount received
CCB lic.: ' U 3 0
U Date received:
Authorized signature• i This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
T
Print name: .L_) 0 6 re-ivy Date: 2_//0/ * Fee methodology set by Tri- County Building Industry
Service Board.
i:\Building\Pemits\BUP- PermitApp.doc 12/03 440- 4613T(I1 /02/COM/WEB)
Building Division
all
A') Plan Submittal Requirement Matrix
-------- Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, additions and alterations) ' ' Required at
. Submittal • ..'
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
Fire Protection System 3 **
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.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005`00049
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2110/2005
Phone: (503) 639 -4171 :ow o fp.,1 #� 1���
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' __..
INSPECTION WORKSHEET FOR DATE: 5/20/2005 TIME: 7:11AM PAGE: 90
SITE ADDRESS: 15296 SW ROYALTY PKWY LEGACY CLASS OF WORK:
SUBDIVISION: PP1996 -010 LOT #: 002 TYPE OF USE:
PROJECT NAME: OSHU CLINIC
DESCRIPTION: Structural repair of exterior column.
OWNER: PARR - FRANKLIN LLC, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 5/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 007329-01 971 - 563-3426 N
Corrections /Comments /Instructions:
j ,
f"'
4
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR NSPECTION ❑ ADDITIO FEES SSESSED
Inspector: / Date b J ?o ne #: (503) 718 -