Permit A4 CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00098
�� DEVELOPMENT SERVICES DATE ISSUED: 3/25/03
----- �" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14800 SW SEQUOIA PKWY PARCEL: 2S112AD -00900
SUBDIVISION: ZONING: I -P
BLOCK: LOT: 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: M 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: $ 5,000.00
. Remarks: Rack storage
Owner: Contractor:
HOME DEPOT USA INC FERGUSON CONSTRUCTION
370 CORPORATE DRIVE 7433 5TH AVE. S.
TUKWILA, WA 98188 SEATTLE, WA 98108
Phone: 1- 206 - 574 -3567
Phone: 206- 767 -3810
Reg #: LIC 91351
FEES REQUIRED INSPECTIONS
Description Date Amount Struc Steel Insp
[BUPPLN] Pln Rv 2/27/03 $59.35 Misc. Inspection
[FLS] FLS Pln Rv 2/27/03 $36.52 Final Inspection
[BUILD] Permit Fee 3/25/03 $91.30
[TAX] 8% State Tax 3/25/03 $7.30
Total $194.47
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: , , ,A__‘, _„e .
Perm ittee -\
Signature: - / - � -
C
Call 6394175 by 7 p.m. for an inspection the next business day
.,-' 66_
Buildig Permit Application FOR OFFICE USE ONLY
,r Received Building
Date/By: ai /0 3 Permit Nc - QOoyg
City of Ti�rand Planning Approval Other Vv
Y b Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review /� Other
Tigard, Oregon 97223 Date /By: 3-2 5 c L Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960
4 f - Post- Review Land Use
��, e_ Date/By: Case No._
Internet: www.ci.tigard.or.us Contact Juris.: ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: Supplemental Information
TYPE OF WORK
REQUIRED DATA:
W New construction ❑ Demolition 1 & 2 FAMILY DWELLING
Addition/alteration /replacement ❑ Other:
CATEGORY OF CO STRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling 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 Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: n
Job site address: /4 $Do sw ref 140 /JkWy Total number of floors
/ New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. Garage /carport area (sq. ft.)
Project Name: germ 444',0 444',0 T i rpe TO n// E /(ed 4 /t!ti Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
I 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
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
Zti r F , en is G k , ^ PI overhead and profit for the work indicated on this application.
4 AL � �� �� � �� Valuation $ -5 DDt
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
XPROPERTY OWNER I ❑ TENANT Type of construction
Name: Noma a Deco - 1,1S44-- 1 group(s): Newting:
Address: 3 ?O Cor�Oor #— V r Ai
City/State /Zip: TK k w-' /.` / �
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
APPLICANT CONTA PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
usiness Name: r �P ✓ !� IA s? C D)1 S I • jurisdiction where work is being performed. If the applicant is exempt
Contact Name: Cat-ii rG hoc k from licensing, the following reason applies:
Address: 7 ¢33 1 5" 'fee RaN 1- i
City/State /Zip: 5'.Qa. /e Of' 4$/0 g
Phone: 206 )6 ) 38/0 I Fax: zo6,6) )10_ .
E -mail: csch' c k it✓� C04, t.ro' al , da
BUILDING Please refer PERMIT FEES*
Ci Please refer to fee schedule.
CONTRACT OR
Business Name: � � Fees due upon application $
S Address 6 / , 0 �0
City /State ip: 00 (f) Amount received $
Phone: • Fax: [/ Date received:
CCB Lic. #:
Authorized j ®3 Notice: This permit application expires if a permit is not obtained within
Signature: l/ Date: 180 days after it has been accepted as complete.
C r� S 1 N G *Fee methodology set y Tri -County Building Industry Service Board.
(Please print name] A' - j
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 P L V I, C
c�5 4 ' 7 , �1
9
hi �� Commercial Plan Submittal
Requirement Matrix
City of Tigard
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.
is \dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Ho
BUILDING Inspec ine: (503) 639 -4175
INSPECTION DIVISION Busines e: • (503) 639 -4171 MST 2
BUP 3rOoa `�g
Received Date Reque d — AM PM BUP
Location '14 Suite MEC
Contact Person 7 Ph ( 06 ) o S5 3 3 PLM
Contractor Ph ( SWR
LDING Tenant/Owner ELC
Foundation ELC
Access: 1144/c .5 ToR p-b-
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT o 9 1 d d 0 37
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL r
G
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
SIT Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line �/
ADA / / f
Date / /) ) Inspector 77 Ext
Approach/Sidewalk
Other:
tam= , DO NOT REMOVE this Inspection record from the Job site.
el 1 ART FAIL