Permit 5 `,
CITY PERMIT
7) `TY OF TIGARD PERMIT #: BUP2003 -00616
1ek DEVELOPMENT SERVICES DATE ISSUED: 3/2/04
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11450 SW WINTERLAKE DR PARCEL: 1S133DA 707200
SUBDIVISION: SUMMER LAKE PARK ZONING: R -4.5
BLOCK: LOT: OOA JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: 256 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 TOTAL AREA: 256 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 17 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: 14 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: $ 10,000.00
Remarks: 16' x 16' metal shelter.
Owner: Contractor:
TIGARD, CITY OF PRECISION COMMERCIAL CONTRACTORS IN
13125 SW HALL 5112 SE 49TH AVE
TIGARD, OR 97223 PORTLAND, OR 97206
Phone:
Phone: 503 - 630 -5447
Reg #: LIC 151513
• FEES REQUIRED INSPECTIONS
Description Date Amount Foot/Found lnsp
[BUILD] Permit Fee 2/17/04 $139.30 Struc Steel Insp
[TAX] 8% State Surchart 2/17/04 $11.14 Framing Insp
BUPPLN Pln Rv 2/17/04 $90.55 Re n rced Inp
[BUPPLN] Reinforced concrete final rE
[FLS] FLS Pln Rv 2/17/04 $55.72 Bolts in concrete final repot
Total $296.71 Structural welding final rept
Final Inspection
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 (50 . 46 -6• • • •r 1- 800 - 332 -2344.
c
Issue • By: �'_� c1IO 0 Il - l ! .
Pemiittee / I
Signature: I > 1 ..• , �d �D '� — �
Call 639 -4175 by 7 p.m. for an inspection the next business day
ii 4 re 5" w•. -ra<,R.a mkt
folst, dt t..4 gar I .eC
Building Permit Application FOR OFFICE USE ONLY
Received Building ^ , � ,
Date/By /0 � 1/ <G4 ""' Pe rmi t No. r2d7) 3'fi7) f ,/t,
''
Ci} of Tigard Planning Approval Other
�,7 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By:s.— /1-o q D Permit No :
Phone: 503- 639 -4171 Fax: 503 -598 -1960 /� sn• I " 'l Post - Review Land Use
. t.
Internet: www.citigard.or.us ";� 'I Date/By Case No. No
C ontact J ur i s . ® Se P age 2 for
24 - hour Inspection Request: 503 639 - 4175 Name/Method: Supplemental Information
y vas- 1: t_t. ;' ' '''''',:,4744,' . ..y .,,e . y =ry - ;.lx 1 . ,. w9:t ' 1 5} i- l'1.Q.. '-'4'-''
�" h 9f,T' d WORK , kit . �` - `�±i' ' e'' 1 R E Q D DA l ' - `Z I
* i ::�
[ New construction ❑ Demolition }" , • o f r. D L'I. p-" " =
❑ Addition/alteration/replacement ❑ Other:
t - ,.,1 *_ =.`, .CATFtORroF CONskritt(CPXQN„„x,; - , .I' -, * " 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 S
' k
= - . ' ' 'kJOB SITE IN oRIVIQTro and LOCATION ; ' 7. ' '- _ No of bedrooms: No of baths:
Job site address: / /NS0 S&,J eJ /it1?£ie,f /le£ DA- Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /A t. #: Garage/carport area (sq. ft.)
∎
Project Name: 5a ormr /4G¢ a., p �0-k ,5-e/1 Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
/NT�/L�PI� ,�, Other structure area (sq. ft.) v+-: Ya • • F
cSvr� , o► sr -/c - ea,- /c : iJ 9.b
e a.rS 5 �L'� , // � / 7 ` 4 p4 `~•�'�,M , ,,,y . 1v 3 •k': b�' ` yl. •.�'• •, '�n '�, •.9d': , ,
�.,0::0` .5 *
'' �5 414u
' PIRED`DA'.A„ , , xwr
Subdivision: Lot #:
y ;4_1. r K CON R �J i', -,1:} `I' F, IST. ..
Tax map /parcel #: 5 23 3 DA 07200 Note: Permit fees* are based on the total value of the work performed. Indicate
` z -. _'; DES,CRIPTIOIsrOMVOR C ';a, , M' -7 ? : ,• .44 the value (rounded to the nearest dollar) of all equipment, matenals, labor,
overhead and profit for the work indicated on this application.
fl o
U /%P X /d, r • Ae 714 _ 5 5 l e7 s:.,n4 n - / - Zg, P AS
L Valuation $ � oo � —
Existing building area (sq. ft.)
0,00e..., S4-46 oo Cj. i •- pc....9 - New building area (sq. ft.) ,ZS6
Number of stories
Z ; -_ f . 4 TEfit'AN�IT, ;'` - 1„:7, :. ;' Type of construction '///
Name: t'_/Ty a / - T /Gpy group(s): ��P Occuanc rou(s): Existin f} "3
New:
Address: /3/,,2 Sw /9 4-// /lid .
City /State /Zip: 7 Off.
Phone: 5 -2/8 ,2j 8 Fax: 5 ..7/9 2 S/O / NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
;,® -J I %NT _,' , ❑i! ONTAC'IIR - - ik p rovisions of ORS 701 and may be required to be licensed in the
Business Name: (7 y a / 7 /G A / /4o a /Z.c f jurisdiction where work is being performed. If the applicant is exempt
Contact Name: ,_sJ "/ /4 /•J from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: sa j -7/S a SY8 Fax: se) 3 - 2/ 8- a yo / . - * wo,;q . ,,b ;- -- ,,_ - .:,u. A .,. }-.
< C 7-/ : .
`�- 1 l •
�+� /'c �_ aeia :
, ; . �+,�y . • ;�Ele a� i :,,, g PEM3 rt. e fei"to, f bels�checu"le. ; � ` �, . • ,
: s. :. t? E -mail: + :' ',` , r,'CON+t'��Ar�FT�.O , ;' ,4 : - -.. !` �° ]Yst:;,,-, :._. . e ..:''w4. x-' . e A;,,`.. ^c:. . , _ , r .. , .-
Business Name: B& C j. pG q L (2o 1,}TQ4CI . t ' s'dSie upon application $
Address:
City /State /Zip: Amount received $
Phone: Fax: Date received:
CCB Lic. #:
Authorized / / �J Notice: This permit application expires if a permit is not obtained within
Signature:S / ' �� Date: 9 � r 4-.5 180 days after it has been accepted as complete.
_ - e, -,) ,7/ � - /A *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Pennit Forms\BldgPermitApp.doc 01/03 .
•
One- and Two - Family Dwelling
;,1:,y; Building Permit Application Checklist Reference no.:
Associated permits:
City ofTigard City of Tigard. = - ,
`J g - ❑ Electrical O Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TIIE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot
area; building coverage area; percentage of coverage; impervious area existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads; connection detail's, vent
size and location.
• 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor, •
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all•wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exteriorelevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. •
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered -
systems, see item 22, "Engineer's calculations." -
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted.
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.
27 "Drawn to scale" indicates standard architect or engineer scale. -
28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440-4614 (6100 /COM)
CITY OF TIGARD
Journal Entry Form JE # 202
G/L # 8 JE Date: 2/17/2004
Description: City of Tigard
• Summerlake Park - Dog Park Shelter
BUP2003 -00616
Month Ending: 2/29/2004 Reviewed By:
Entered By: pah Date Entered:
Debit( +) Additional
Ln# Account # Credit( -) Amount Information Trn#
1 225 - 0000 - 101000 - 296.71
2 225 - 6400 - 754004 + 296.71
3 245 - 0000 - 101000 + 285.57
4 245 - 0000 - 432000 - 139.30
5 245 - 0000 - 433000 - 90.55
6 245 - 0000 - 433020 - 55.72
7 100 - 0000 - 101000 - 11.14
8 100 - 0000 - 207020 + 11.14
9
10
11 + 593.42
12 - 593.42
13 = 0.00
14
15
16
17
18
19
20 _ �.
21
22
23
24
25 I: \FIN \Financial Operations\EXCELUOURNALS \03-04 FY\[2004- 02.xIs]08JE#202
26
27
28
29
30
A Fees Associated With ol Li &g4 Lit_ P6LA 12: 59:28PM
�.V. ��i�'i C ase #: BUP2003 -00616 •.� Q� �
,� �. � .trN'APi te. FEB 17 �,
City of Tigard
Fee Start End Revenue Created
Type Date Date Dept Description Account Number
By Date Amount Due
PRMT 1/1/90 12/31/05 [BUILD] Permit Fee 245- 0000 - 432000 BSB 2/11/04 139.30 139.30
5PCT 1/1/90 12/31 /05 [TAX] 8% State Surcharge 100- 0000 - 207020 BSB 2/11/04 11.14 11.14
PLCK 1/1/90 12/31/05 [BUPPLN] Pln Rv 245- 0000 - 433000 BSB 2/11/04 90.55 90.55
FIRE 1/1/90 12/31/05 [FLS] FLS Pln Rv 245- 0000 - 433020 BSB 2/11/04 55.72 55.72
Total: $296.71
0Z"/ 7
4 e- /
h�—
v 1 ,_)
4_6,4J._ i r, 3 -t - k.12. et_1064).c ' iaA....__,
. Ai j ......t
O N 4....._ . clueA 9.a 5" - bloc) - 754 V.
u) „LA --- ,;,L c5
/ 1
e ----\..._:Alip I
C ------$---io. ,
Al ...e.„...4.0 , A_ dg- t /Kg--
•
Page 1 of 1 CaseFees..rpt
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
•
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received If 5 Date Requested T — /- 79 AM PM BUP
Location // �[J G%4' 4 • Suite MEC
Contact Person �.1 6W 14. Ph ( ) 592 -if 2 4 /41 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner - . 4 4 4 .. L . - L' I • ! � ELC
Footing ;#*
Foundation ELC
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:
Fi ��
40 PART FAIL
•' - ING
Post & Beam
Under Slab
Rough -In
Water Service s
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
SITE El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line 77)-71"1 '
ADA y/' /Q ( f
Approach/Sidewalk Dat / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL