Permit 4,-; CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00557
_rte II� DEVELOPMENT Blvd.. OPMENT o
SERVICES 1639 -4171 DATE ISSUED: 11/29/2004
SITE ADDRESS: 12398 SW SCHOLLS FERRY RD PARCEL: 1S1346C -00800
SUBDIVISION: PP1993 -058 ZONING: C -P
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: 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: bOo t 0
Remarks: Demolition of sheet rock to evaluate auto damage.
Owner: Contractor:
THOMPSON /DAVIDSON LEASE FXG CONSTRUCTION LLC
PROPERTY VENTURE, THE 1235 19TH ST NE
PO BOX 398 SALEM, OR 97301
PORTLAND, OR 97207
one:
Phone: 503 - 409 -3297
Reg #: LIC 141552
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 11/29/2004 $62.50
[BUPPLN] Pln Rv 11 /29/2004 $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 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 • -• ='9 or 1- 800 - 332 -2344.
Issu • . By: `� ti
Perm ittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
lv
f
Buildint Permit Application FOR OFFICE USE ONLY
Received '/
City of Tigard Date
B : / �`/ Pe rmitNo.:� j ` „ -
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Altr4 YI Date : Other Permit:
Inspection Line: 503.639.4175 _II B , Date Ready/By: El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: /10. Supplemental Information
: TYPE OF .WORK'. ',: . h REQUIRED DATA:,1 --AND 2-FAMILY DWELLING :..
❑ New construction lg 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
. , ,µ., _ , ! 1.•,: _ work indicated on this application.
, CATEGORY OF CONSTRUCTION._ : t r -
ID 1- and 2- family dwelling Commercial/industrial •
Valuation: $
❑ Accessory building ❑ Multi family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
''' = 'JOB SITE INFORMATION AND LOCATION . ` i- :=f' : "'„''-:': : 2' Total number of floors:
Job site address: /)3 g (5.L,/. . _mote, 1 Fay /2 *
7-76,0972, New dwelling area: square feet
City/ State/ZIP: / oh 97�97.70->3 Garage/carport area: square feet
Suite/bldg. /apt. no.: �Proj6ct name: 014 CA/v / / iNn y S Covered porch area: square feet
Cross street/directions to job site: 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.
?A 77 77 e"/ F ?- iz��A� Valuation: $
Existing building area: square feet
New building area: square feet
PROPERTY OWNER , TENANT Number of stories:
Name: e /,s" J i/ 09/v� /olL CAS I-eN29I I Type of construction:
Address: 1514 c< *M � j\�lz 'Dr . 4, (�' 0 / Occupancy groups:
City/State/ZIIPP:: //LA W e V t 3 C bS Gi O . O0 0 Existing:
Phone: (SO.Y bC�A , ( ( J Fax: (9 ) S3'i • 3 50 New:
X APPLICANT . - : - . .. or CONTACT PERSON , NOTICE
Business name: FX 6 Curt AS new- non/ £ % C_ 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: 423 S / 7 i'i- 31 '4, G jurisdiction in which work is being performed. If the
City/State/ZIP: S 7 4- 6 12 9 73) / applicant is exempt from licensing, the following reasons
apply:
Phone: (93) yv q - j,2 1 .,7 Fax:: ( )
E -mail:
_ :CONTRACTOR.
Business name:
• - BUILDING PERMIT FEES* •
.
Address:
Please refer to fee schedule.
City/ State/ZIP:
Fees due upon application tl &7r 5�
Phone: ( ) Fax: ( )
51 �D/3/D S
Authorized signature:, Amount received
CCB lic.: �
� ' Date received:
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: � , e- /' ". Date: //-0j...... Q Y * Fee methodology set by Tri -County Building Industry
V �� Service Board.
i:I Building \Permits\BUP- PermitApp.doc 12103 440- 46I3T(I1 /02/COM/WEB)
CITY OF TIGARD 24 -Hour
' BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
SUP cRDO dOSS
Received Date Request-d a AM PM BUP
Location - • '� =' / / 4 „ x ' I . e
Contact Person Ph ( l ) 4 / 6 9 - 3a 9 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner C 6„.„/„..) ELC
Footing ELC
Foundation Access: �
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
11124 PART FAIL
U = ING
ir
& Beam ' . �-
Under Slab _
�.
Rough -In .� fA,elP"
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
r
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fe- •f $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Plea := or r-inspec on RE: Unable to inspect — no access
Fire Supply Line �
ADA Inspector Ext
, /
Approach/Sidewalk Date _
Other:
Final D I NOT REMOVE this inspection record from the job site.
PASS PART FAIL