Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2002 -00061
:.,I�l DEVELOPMENT SERVICES DATE ISSUED: 2/21/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S103BC 03900
SITE ADDRESS: 12450 SW WALNUT ST
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: DEM FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 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:
Remarks: Demolition of a 2,100 sq ft residence and 1,000 sq ft accessory building. All debris to be removed. Septic system
to be properly abandoned and inspected.
Owner: Contractor:
WINDWOOD CONSTRUCTION INC WINDWOOD CONSTRUCTION, INC.
12655 SW NORTH DAKOTA 12655 SW NORTH DAKOTA
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503- 625 -6526 Phone: 780 -4375 M
Reg #: LAC 000501
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Final Inspection
PRMT CTR 2/21/02 $62.50 27200200000
5PCT CTR 2/21/02 $5.00 27200200000
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature:
Issued By: ..<1214}60
Call 639 -4175 by 7 p.m. for an inspection the next business day
11 "Building Permit Application
Date received: 1//0.2 Permit no. t?DDg do
:. �; .' City of Tigar / r
- Address.` 1 3125 SW Hal K� Illwww C CEAU '! D Project/appl. no.: Expire date:
City of Tigard
Phone: (503) 639 - 4171 Date issued: Byi„„y„il Receipt no.:
Fax: (503) 598 - 1960 r ; i I Case file no.: Payment type:
Land use approval: airy Uf iKAKI) 1 &2 family: Simple Complex:
_ . - . a.a A: : &. $
TYPE OF PERMIT
LI 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: /2 y 5 c . i Bldg. no.: Suite no.:
Lot: 'Block: Subdivision: 64 F ,eon / 4,9 /z *, 'Tax map /tax lot/account no.:
Project name: BA t Moro kczr .
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: ' /f3tA--•_eJL ,_, - - f VC (Floodplain, septic capacity, solar, etc.)
Mailing address: /2 e. -r -A p._ A/2/c 1 & 2 family dwelling:
City: 7 - x c,"' 'State:0 'ZIP: f 7 3 Valuation of work $
Phone: 6, C ' Fax: 'E -mail: No. of bedrooms/baths
Owner's representative: r . Mr./..--/-- - • Total number of floors
Phone: 6 6, Saco Faxes, /? E -mail: New dwelling area (sq. ft.)
Garage /carport area (sq. ft.)
Covered porch area (sq. ft.)
Name: , ���^
Mailing address: Deck area (sq. ft.)
City: 'State: 'ZIP: Other structure area (sq. ft.)
Phone: Fax. E - mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: 4i iw r New bldg. area (sq. ft.)
Address:
City: State: Number of stories
ZIP:
Phone: [Fax: 1E -mail:
Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: , provisions of ORS 701 and may be required to be licensed in the
Address:
jurisdiction where work is being performed. If the applicant is
City: I State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: A Contact person: Fees due upon application $
Address: `- Date received:
City: 'State: 'ZIP: Amount received $
Phone: 'Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with, whether specified herein or not. Credit card number: Expires
Authorized signature: Date: �d Oz N of cardholder as shown on credit card
�° -- , $
Print name: - • � � w , / -7 ( - - J Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6100/COM)
Commercial Plan Submittal
l- `t . 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.
i:\dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639 -4171 da__OPAd4 a Dnez j
Received Date Requested .3 - ( AM PM BUP
Location a` .mod Suite MEC
Contact Person P41 Ph ( ) 9 PLM
Con Ph (Pip ) 9 — 630 SWR
U ILDI N G Tenant/Owner ELC
0 o mg
Foundation Access: ELC
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 / A A S � Prl G✓c
Susp'd Ceiling
Roof O p...11LO
Other:
Fib
PART FAIL
P BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
•
Other: t
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 El Please call for rei pection RE: El Unable to inspect — no access
Fire Supply Line
ADA 1
A
- F n pproach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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