Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00407
4 DEVEL
_639 -4171 DATE ISSUED: 8/17/2005
.44 AT
PARCEL: 1S134BC-00300
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD ZONING: C -G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: Interior demo to prepare for future TI.
REISSUE: /� FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: py.Aff 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:
Owner: Contractor: •
VINNACOMBE CONSULTING WESTERN CONSTRUCTION SERVICES
12790 SE BLUFF RD 4612 NE MINNEHAHA ST
SANDY, OR 97055 PO BOX 5768
Phone: 503 - 826 -1726 VANCOUVER, WA 98668
Phone: 360- 699 -5317
FEES Reg #: LIC 63717
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/17/2005 $62.50
[TAX] 8% State Surchari 8/17/2005 $5.00
Total $67.50
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 startewithin 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
r Tres you to o = the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
52-001 -0010 throug' •AR • 2- 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 503 - 246 -6699 - -" 10-;32 -2344.
Is sued By: .. � � _�;! L Permittee Signature: h2. i .__-
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.
Building Permit Application FOR OFFICE l OO
City of Tigard Received
a e/B :: I 4 �M :N; ,,s - -• a
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ° "M.n�: I � 1k Date/By: Other Permit:
Inspection Line: 503.639.4175 - 'f „ Date Ready/By: El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: ( ( t Supplemental Information
TYPE OF WORK REQUIRED DATA: 1 -AND 2- FAMILY 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Clegtaltindustnal Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- NFORMATION AND LOCATION p Total number of floors:
lob site address: /N.80 so s" 01.3.6 fc `� 11 fl New dwelling area: square feet
City/ State/ZIP: ,1-1 b►pa fl Garage/carport area: square feet
Suite/bldg./apt. no.: I Project name: D1ZEsoD1s) 0/%4M, GKEOIT Covered porch area: square feet
Cross street/directions to job site: U Ai 101V Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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.
-t� tetD Valuation: $ 5 ) OOp
0 Existing building area: a •0 D7 square feet
New building area: square feet
❑ PROPERTY OWNER I FILTENANT Number of stones: I
Name: \J An1 prcolti.8E Sv1t,TiAl I ► Type of construction:
Address: 1 a„ 3 r.p 'Feb Occupancy groups:
City/State/ZIP: , rt el .u! Dg 9 0Ss- Existing: 'B
Phone: (a>3) 8' a( .- (-7 ?t0 Fax: (S03)7 -' $s New: B
[9' APPLICANT '' CONTACT PERSON NOTICE
Business name: (A as.T cow) ST 20 G'" 0 N Sep/ I G isi , All contractors and subcontractors are required to be
Contact name: ' yam / licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being yt�ia- � ,f" �IIJ►�1E S-t. j gl� ormed. If the
City/State/ZIP:kimi >uJ E1 OA. (, applicant is exempt from licensing, the following reasons
Phone: (360) (ociA .. 531'7 I Fax:: (3O (01t1 — be %d
E- mail:. /� 0v►atke:f',e(h[.Or1..S4 ClA.C. iOYt .CDwI.
CONTRACTOR /
Business name: W E� Tt^"7e ( Cl71JSr2.4 f -rt ntp Se V41 C IiN/C—
BUILDING PERMIT FEES *
Address: X10 k ■ E ilAtvi Itl5 s
�� Please refer 10 fee schedule
City / State/ZIP: 11 01+t J L a 14 (a
1 Fees due upon application
Phone: Qb0) 6 A . 4 -53 t - 7 I Fax: (3 ( • O) ( a 4 ti . `Lg\ g Amount received 6'1 5Z)
CCB tic.: ( - ) 7
Date received: � 74 S
Authorized signature: P eotAA/t. This permit applicatio6 expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: p pota , 4 A ` U >Ai j1 I Date: Sh 7 DDS' • Fee methodology set by Tri -County Building Industry
Service Board.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 2c _(iA
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 71:1- 4 � t
Inspection Requests (24 Hrs.): (503) 639 -4175 '! ^ 'I I..
INSPECTION WORKSHEET FOR DATE: ( z :� t TIME: PAGE:
SITE ADDRESS: VZZ80 St,3 SCt1dLGS CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
Q
DESCRIPTION: �l(9N (T� c.4..4) 01Z` t?�
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message .
Corrections /Comments /Instructions:
1 s:V
Amor
•
eAPASS 0 PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
0 FAIL II CA L FOR I PECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: ` Date: l6 z7 ( C#: (503) 718-