Permit r.
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00049
l DEVELOPMENT SERVICES DATE ISSUED: 3/3/04
a. 6 ' 1 ' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10865 SW WALNUT ST PARCEL: 2S103AA -00101
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS 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: El 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: $ 69,800.00
Remarks: Fire protection.Smoke and Manual, Audible and Visual
Owner: Contractor:
SCHOOL DISTRICT NO 23 J SHAW WEST
13137 SW PACIFIC HWY PO BOX 1427
TIGARD, OR 97223 TUALATIN, OR 97062
Phone:
Phone: 503 - 682 -3939
Reg #:
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[FLS] FLS Pln Rv 2/11/04 $232.08 Smoke detector insp
[BUILD] Permit Fee 3/3/04 $580.20 Final Inspection
[TAX] 8% State Surchari 3/3/04 $46.42
Total $858.70
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 -Os ! • • • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin; 03) 246 -669• • 1 -800 -3 4.
Iss ed By: / I i�yl C441.1
Perini
Signature: A ' / A
Call ; -4175 by 7 p.m. for an inspection the next business day
/Otis sk Vvgi.NVi
Fire Protection System S°
Fo w c. e+t
BiAlding Permit s FOR OFFICE USE ONLY
• •
CI of Tigard Received �/ '��+
`J `` �oo �- — / / ' 0I/ 'eSi Petmn Noe 0 F006? `� ,0(/J /
13125 SW Hall Blvd , Tigard, OR 97 1 1 Date
/By
Plan Review
Phone 503 639 4171 Fax 503 598 C 1kG I°) I Date /By.1"i 'Of /f 011ie' Pei mit
Inspection n Line. 503 639 4175 �`' O v1 — e! W Dale Ready /By. lulls 0 See Page 2 for
Internet www ci tigard or its GC ` ®` � p . Ok Notified /Method Supplemental Information
®v�� V
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
performed *
Permit fees are based on the value of the work N
❑ New construction ❑ Demolition p
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration /replacement ❑ Other equipment, materials, labor, overhead, and the profit for the T
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I - and 2- family dwelling Valuation $
® Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms •
❑ Master builder ❑ Other. Number of bathrooms
JOB SITE INFORMATION AND LOCATION Total number of floors
Job site address. 10865 SW Walnut New dwelling area: square feet
City /State /ZIP: Tigard, OR 97223 Garage /carport area • square feet
Suite /bldg. /apt no. Project name. Fowler Middle School Covered porch area: square feet
&-.'
Cross street/directions to job site: Walnut Street to Tiedeman Ave 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.
fax map/parcel no Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor. overhead, and the profit for
DESCRIPTION OF WORK work indicated on this application
Replace existing fire alarm system Valuation: S w '.--
Existing building area / square feet
New building area: squate feet
® PROPERTY OWNER ❑ TENANT Number of stories
Name: Tigard Tualatin School District Type of construction.
Address 6960 SW Sandburg St. Occupancy groups
City /State /ZIP. Tigard, OR 97223 Existing:
Phone. (503)431 -4000 Fax: (503)431 -4047 New
❑ APPLICANT ® CONTACT PERSON
NOTICE
Business name: Cornerstone Construction Management All contractors and subcontractors are required to be
Contact name John Abel licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address 5410 SW Macadam, Suite 250 jurisdiction in which work is being performed If the
City/State/ZIP: Portland, OR 97239 applicant is exempt from licensing, the following reasons
apply
Phone: (503) 295 -0108 Fax (503) 295 -1896
E -mail: johna@cornerstonemgi.com
cornerstonemgi.com
CONTRACTOR
Business name• Shaw West Co.
BUILDING PERMIT FEES*
Address PO Box 1427
Please refer lo fee schedule.
City /State /ZIP Tualatin, OR 97062
Fees due upon application
Phone: (503) 682 -3939 Fax (503) 682 -3723
CCB lie.: 63142 42- 2 -07 Amount received
Date received
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name Doug Ebanks Date 2/11/04 * Fee methodology set by Tr1- County Building Industry
Service Board
I \Budding \ Permits \FPS-Pei nntApp doc 12/03 440- 46131(11/02 /CON1 /WEB)
CITY OF TIGARD 24 -Hour ' 3 • I! / -
BUILDING Inspection Line: (503) 6 = 75 MST
INSPECTION DIVISION B ,.. (503) ; 3' r 7 --` �� ,3
i, j
1 ? .: u- .).-6-0S-
Received l • Da e queste • °' -- AM - MO - ' X49
Location / 0 49 SW k)i / !' , Suite MEC
Contact Person bkv-- Ph ( 5-0 3) 57 Q - S `l 3 3 PLM
Contractor �� Ph ( ) SWR
UILDI Tenant/Owner j .L_ ' ELC
o OZ- ELC
Foundation Access:
Ftg Drain / (� FF1 ELR
Crawl Drain Mr `-� L%
Slab Inspection Notes: n SIT
Post & Beam .• y r-
..i„p-r> €.LA.i...
Shear Anchors /
Ext Sheath/Shear 1 ' ��� 1
Int Sheath/Shear i (1y W D C �, ✓ ■ ci► —�.1 G `*�'
; 1 l
Framing J
Insulation
112,34 _ -s/°- ( i'7.L�� "�(� (co rywall Nailing -7 ` /�J -G=! 1 -1 J
Fi rewall . ,
Fi Alar kler - _
ire Alar
Susp • i I f' (Lf)
Roof n0, l U - ----. `1 fj.. , � . /
--) 1
�o� �.e `�'
1 PART FAIL
:ING t 24 173
Post & Beam t 2 �i �� - : - Z (�
Under Slab �1 - I
Rough -In 'F 4 u , ( 1 `p - - r I /
Water Service `T /
Sanitary Sewer
Rain Drains / •
Catch Basin/ Manhole r '' \�� ` \ V 1 (/
Storm Drain , � ��
Shower Pan I t ,.... ! 0 .: I Z C C lei
Other: X '
Final , .3Z
PASS PART FAIL
MECHANICAL k Z 43
Post & Beam ) 1 2._ L 3
Rough -In `
Gas Line X 1(/ i - / ` , '
f�
Smoke Dampers '1 "1
Final W 1 1 ---
PASS PART FAIL
ELECTRICAL
Service l
Rough -In - 4 ( 1 / 4 k?" \S ` 17 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 rei spection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA 1 0, b • VC (
Approach/Sidewalk Date Inspector, Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL