Permit c . CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00595
�I�,. DEVELOPMENT SERVICES DATE ISSUED: 3/10/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11355 SW TIGARD ST PARCEL: 1S134DC 00600
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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: U2 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: $ 165,000.00
Remarks: Install 60ft. tower.
Owner: Contractor:
SCHOMMER + SONS INC
6421 NE COLWOOD WAY '
PORTLAND, OR 97218
Phone:
Phone: 287 -4646
Reg #: LIC 4937
FEES REQUIRED INSPECTIONS
Description Date Amount Ersn Cntrl 681 -4444
[BUPPLN] Pln Rv 9/26/03 $648.57 Foot/Found Insp
[FLS] FLS Pln Rv 9/26/03 $399.12 Reinforced concrete final re
Lic.fabricated steel final rpt
[BUILD] Permit Fee 3/10/04 $997.80 Final Inspection
[TAX] 8% State Surchart 3/10/04 $79.82
(additional fees not listed here)
Total $2,480.91
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/
Pe rm ittee .
Signature: -��
4 - .„-' G �j� e:r 2/
Call 639 -4175 by 7 p.m. for an inspection the next business day
l3SS. Jw • T /6A21) ST
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Building Permit Application 1 ; v OF us O \ LY
E C E 1 D Date receive • f a(, ? ' Permit no�l O l r�O3 - O C7 5
'�I'i� . City of Tigard /
Project/appl. no.: Expire date:
City ofTrgard Address: 13125 SW Hall Bl prga d .01 0 1 1 7 3 223 n`,
Phone (503) 639 -4171 313
Date issued: By: Receipt no.•
Fax: (503) 598 -1960 Case file no.: Payment type:
y TY •FTIGA'D-
Land use approval: ,� „ e t , ��,�. -cot, Z 1 &2 family: Simple Complex: • ' ;. a. ' 1, ;' ,TYPE OF PERMIT • .
❑ 1 & 2 family dwelling or accessory )4Cotnmerctal /industrial ❑ Multi - family ❑ New construction ❑ Demolition
0 Addition /alteration/replacement ❑ Tenant improvement 0 Fire sprinkler /alarm 0 Other:
--;'.2:::;::"..(4:-.•',"•:,:-..':• '. -, ' ,.,JOB SITE INFORMATION,; •41 ':`,•••-! T -'• '
Job address: ' 55 '5..3 `(t l) Bldg. no.: Suite no.:
Lot: 1 3 Block: ISubdiv • n: I Tax map/tax lot /account no.: (X)(
Project name: cot, PAC R r `) \ 2r - (N L„,_N fek
Description and location of work on premises /special conditions: 103 QA C 64 VLC Glt`RA,l sr •-icr'
,k).): 4: \0 QSS�. S'sca S ut..4 • r,,ank. .
'•w f; � ,`, OWNER .'r : •FOR SPECIAL, INFORMATION, USE CHECKLIST
Name: L t , S '(Floodplain, septic capacity, solar, etc.) ,- :,: -I
Mailing address: ss T1 tom, - 1 & 2 family d *elling:
City: - 1, c , I State: ZIP: 91 Valuation of work $
Phone: I Fax: I E -mail: No. of bedrooms /baths
Owner's representative:. , c . p S,c0 Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
z _. _ , , , { ' z APPLICANT _y: , t' 'r• Garage /carport area (sq ft.)
- Name: Mt i Q ` . 0 C / • O ' , . . C -,C Covered porch area (sq. ft) -
g yS0 S - � \ . , 3c sit piJ`Z - r 1 D ec k area s t.
Mailing addres (sq. f )
City: pC.CkiIc4r,I3 State: a t ZIP: x-239 Other structure area (sq. ft.)
Phone: -i 3 -t-w , Fax: 13 -VQka E-mail:__ Commercial /industrial /multi - family:
' t .+" ,- ',CONTRACTOR ; .4 c Valuation of work $ tCoS OOb
Business name: f}Q in m iy j� a. ,5 0 fL f : ` ! � Existing bldg. area (sq. ft.)
Address. to 7 ,a / NE 0 0 ` uJ V / New bldg. area (sq. ft.) .. ZIP - � 7 - — Number of stories p
City � 'V'� I State: a � -
5 / 2 l � Type of construction WV
Phone: 2 8-7 - 414„ Vf e Fax: I E -mail: f ,
CCB no.: l y�7 Occupancy group(s): Existing: V�
New:
City /metro Itc. no.: Notice: All contractors and subcontractors are required to be
. „, , ARCHITECT/DESIGNER ' . licensed with the Oregon Construction Contractors Board under
Name: v (3 J - &) t , „ (C_ provisions of ORS 701 and may be required to be licensed in the
fi0
Address: co 3 C �� .(L, ..\zsLe, Ci jurisdiction where work is being performed If the applicant is
exempt from licensing, the following reason applies:
City 9a - �a State:(2. (ZIP: C11ZC�•
Contact person: ° ' - g r n ` Plan no :
Phone Fax: E -mail:
. •` t ' ): •• ENGINEER , • OFFICE :`;USE ONLY.'
.
Name. ' a Contact person Fees due upon application .... $
Address: 32_ \ � � L.�` pc,�sr_ \.��`"v.`p Date received:
City: ecr,k.e�GQ Stated?... ZIP: cl iZU'-I Amount received . $
Phone: 7 _ 9 s. e, Fax: E -mail. Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jwisdictrons accept credit cards• please call jurisdiction for more information
attached checklist. All provisions of laws and ordinances governing this ❑ visa ❑ MasterCard
work will be complied with, whether specified herein or not. Credit card number 1 /
�Iz1 03
Expires
Authonzed signature- �A � � \\......--..— Date: Name of cardholder as shown on credit card
Print name: Qlvi\� C( V. .Z. °` $
Cardho signature Amount
Notice: This permit application expires if a peen t is nnot witlun 180 days after it has been accepted as complete 440 -4613 (6100/COM)
. O ( \ 5- 3,1 . v/1
G� 3
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (50 75
INSPECTION DIVISION Business Line: (5i - MST
Co
f , 3 —O 5 t
Received Date Requested ( 14 -- AM PM BUP
Location 1 1 3 e- iI ii i.-&_., Suite MEC
Contact Person Ph ( J) (9- 5 PLM
Contractor Ph ( ) SWR
B Tenant/Owner t/ i % ` - C
Footing "L° (g --k 1(.k&,-t-<_ - ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: L ANI SIT
Post & Beam YY1 a'f
Shear Anchors U 11 t
lnt Sheath/Shear Sheath/Shear °
Int 12,,,,71,-tc °
Framing
Insulation i / 4t a- .. 0060 S 14— r 0 ` °7 -
Drywall Nailing
Firewall p A L ,g
� — 0 d 0 G D C P7 et c � U e
Fire Sprinkler Y+- - G a _ I 11 "( �+ )_
Fire Alarm '5 ([&) c/ L- (/�+ G4 — V 6144' C _ C_ -e “ c °1
Susp'd Ceiling tt ,, �Q /,• `l /- I \ r ,_.
Roof N U �" �^f v 1 �C �P C`� t ) �J�""" .
Other:
-_ 1' °14 1 (iH '7,66 4- O 6 2- '7 ( Crr 1 t--;"4 gFD
PART FAIL
" . BING
Post & Beam
Under Slab
Rough -In QC n •C � % 5 ' kl
Water Service �
Sanitary Sewer rIUi • ( �'\ l c( --� tj S
Rain Drains
Catch Basin / Manhole LA.S / .---- t — ' c.
Storm Drain
Shower Pan
J
Other: !r�Q _.,arN/L17.- 4
iin 1
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line , S----eiVI
Smoke Dampers -
r , - f
Final IL-. - i A • :'�_ - L
PASS PART FAIL
ELECTRICAL A' cc ` n 4 l ' —c—.1
Service a
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 ❑ Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line /V6
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL