Permit A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00650
il DEVELOPMENT SERVICES DATE ISSUED: 12/1/03
„ I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06900 SW SANDBURG ST PARCEL: 2S101 DD -00702
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: S2 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: $ 5,360.00
Remarks: High rack storage.16 feet.
Owner: Contractor:
J + K PROPERTIES CORP BTF INSTALLATIONS
6900 SW SANDBURG RD 16702 S ANETTE DR
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone:
Phone: 503 - 519 -3043
Reg #: LIC 137212
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 11/12/03 $100.90
[TAX] 8% State Surchari 11/12/03 $8.07
[BUPPLN] Pln Rv 11/12/03 $65.59
[FLS] FLS Pln Rv 11/12/03 $40.36
Total $214.92
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.
require . • • • . •w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -501 -0010 throug OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
call'. g (503) 246 -6699 o 1- 800 - 332 - 2344. •
Issued - : 1 ' �� (S�d� ��-9 �('
Permittee 1
Signature: ;C ��/ �,,,`_, 4 —
Call 639 -4175 by 7 p.m. for an inspection the next business day
G TOO .5 SAMPIWZ6-
wesli Pee"
' Building Permit Application Received FOR OFFICE USE ONLY
Building ie.
RECEN I D Date/By: / /// L- /off 56 Permit No.41.ukPaC'U. 6 Sv
City of Tigard Planning Approval Other
y g Date/By: Permit No.:
13125 SW Hall Blvd. � j 1 Plan Review Other
Tigard, Oregon 97223 NM 1 Date/By: / 1 - LC — 0.) Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 4.1°14!"511`; I Post -R view Land Use
Internet: ww CITY OF _�' l l Date/By Contact F 1t M • Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 631kPIN Name/Method: /0f0 ;(7)., ,D Supplemental Information
TYPE OF WORK REQUIRED DATA:
El New construction ❑ Demolition 1 & 2 FAMILY DWELLING
El Addition /alteration/replacement [R Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
El 1 & 2- Family dwelling IN 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: 4 9 DD S w Sa N u A lm A i Total number of floors
Suite #: Bld /A t. #: ✓ New dwelling area (sq. ft.)
g P Garage /carport area (sq. ft.)
Project Name: p/g 5 7 ra ' r € 2Cr- Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
o fie 7,24 REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
ESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
11 11t1" � j �� overhead and profit for the work indicated on this application. l
✓ Valuation $ 5 qp
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
[k PROPERTY OWNER 1 ❑ TENANT Type of construction
Name: We S kr e) Y/ t -P 7 /' Occupancy group(s): Existing:
Address: l,, 1 p . yv 4u k) bt,r- AV New:
City /State /Zip: 17 A. �7rz 9 3
0 O / p NOTICE: All contractors and subcontractors are required to be
Phone: r } t/ p 7R 2- Fax: 6
P APPLICANT 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: N jurisdiction where work is being performed. If the applicant is exempt
Contact Name: err 4. n Fe re j de- from licensing, the following reason applies:
Address: 7 3 73 S ( 7 T l v N ✓k; e E* p
City /State /Zip: FDr - I u r, p e /2 . °l 7 /.1$
Phone: 3 S . 1 4 30 N 3 I Fax: cp.; 6.5 1,4 do
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
CONTRACTOR
0 ��
Business Name: n � r > 1Ij pr5� � Fees due upon application $
Address: 110 7 0 7\ 3 )4ne ,e 0r-
City /State /Zip: br pn , 0g 9 7d yS Amount received $
Phone IN f 4 - 4 y 3 I Fax d /4 3 -7/ 76 Date received:
CCB Lic. #: /3 7 a ../ 6 6104
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: I ! rZ „.. Date: // 180 days after it has been accepted as complete.
S r ec ✓1 r L *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) l 00
i:\Dsts\Permit Forms\B1dgPermitApp.doc 01/03 n, _ (O5•6/
eus go.3497A;*
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Plan Submittal Requirement Matrix
• 4'
�•� 1 Commercial & Multi- Family
City of Tigard New, Additions or Alterations
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(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 \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
B 3 00 (5675
Received ' 'Il Date Requested / Zl S7 03 AM PM _ BUP • ,
Location (09 D D S a oLeruA — Suite MEC
Contact Person 6.{IC.1 An , Ph (_...) .-S 7-,34/3 3.3 PLM
Contractor Ph ( , ) SWR
13 Tenant/Owner / A � _is _ ' '-- / - ELC
s
Foundation ELC
Access:
Ftg Drain S`.2ec ELR ra
Crawl Drain /71/6-1/4 /,_
Slab Inspection Notes: // SIT
Post & Beam C / 0--4_, d 'f-2
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall i A C /C 5'17),t.516--e'
Fire Sprinkler
Fire Alarm
Susp'd Ceiling '
Roof --
Other: ∎C�< �i1
';■' '' PART FAIL ,
P MBING
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 E Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA /a -s 7-0-)n--1 `' U 7-0-)n--1 Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL