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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
p n BUP
Date Requested �� D�t� 7 APA Pik BLD
Location 1 �5 s o &ZS ' " � �1.� v Suite MEC
Contact Person bQjL-�t� Ph (D_�_ _ �"� 7 PLM
Contractor _ Ph -�� SWR _
LDI G- Tenant/Owner __ ELC
UI
Retaining Wall ELR
Footing Access: FPS
Foundation -
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
SIT
Post&Beam
Ext Sheath/Shear I —__
Int Sheath/Shear
Framing —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler --
Fite Alarm
Susp'd Ceiling ---- ----- — --
Roof
Misc: L� ---- ---- -- - — -
A FART FAIL -- -- — ----------- --- - - - ��_ --
LUMBING
Post&Beam
Under Slab _
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough In
Gas tine
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough !n
UG/Slab --
�_ Low Voltage
f- Fire Alarm -
Fin,,l
PASS PART FAIL _
SITE
m Backfill/Grading
Sanitary Sewer
1.0 Storm Drain I J Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please call for reinspection RE: ---- _ ( ]UnaF!e to inspect-no access
Fire Supp!y Line
ADA
approach/Sidewalk Date Cq Inspector 1 CJ/L� Ext
lother - -
I"mal
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
,C I, Y OF TBUILDING IDERMIT
DEVELOPMENT SERVICES F-,ERMIT #. . . . . . . : DUF,9r3-r 552,
13125 SW Nall Blvd., Tigard,OR 97223(503)639.4171 DATE ISSUED: 12/J.6/98
PARCEL- x:5101 AD--00B00
SITE ADDRESS, . . : 12580 SW 68TH AVE
SUBDIVISION. . . . : PORTLAND HEIGHTS ZnNIN(;:
BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . . J;.iRIST)1CTION: TIG
-------------------------------
REISSUE: FLOOR AREAS-- -- - - - - EXTE=RIOR WALL CONSTRUCTION--
CL_ASS OF WORK. :DEM F I RST. . . . : 0 s f N: S: L : W:
TYPES OF USE. . . :SF SECOND. . . : 0 s f PROTECT OF'E.N INGS?-----------
TYFIE OF CONST. : '? . . . . 0 s f N: 9: E: 14:
OCCUPANCY GRP'. : R3 TOTAL.--•----: 0 s f ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 5f AREA SLF,. RflTED:
STOR. : 0 HT: 0 ft GARAGE— : 0 sf OCCU SEF,. RATED:
B SMT? : MEZ Z?: REDD SETBACKS--------- REQU I
FLOOR LOAD. . . . : 0 F.r f 11-FT: 0 ft RGHT: 171 ft FIR SF'Kl_: SMOK DET. . -
DWELLING
ET, . :DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR AL.RM: HNDICF' ACC:
BEDRMS: 0 DATH',:3: 0 IMF' SURFACE: 0 PRO CORR: F'ARK I NG: 0
VALUE. $ : 0
Remarks: Demolition permit to demolish 1500 sq ft SF dwelling 6 garage. All
debris to be removed, sewer to be capped or septic tank to be pumped, filled and
inspected.
Owner : __.__._.. _..___.._.._.____-----___-- FEES —__._._—_•____.____
L!URT DALBEY type amoI.Ant by date re(--pt
7125 SW HAMPTON F'RMT $ 25. 00 DEH 12:/16/98 98-311.574
PORTLAND OR 97223 :SF,CT $ 1. 25 DEB 12/1.6/58
98--3,1 1574
EROS $ 26. 00 LEB 12/16/98 98-311574
Phone #: 670--3100 ERPC $ 8. 45 DELA 12/16/98 98-3115174.
ERPC $ 8. 45 DEP 12/16/98 98-31157/f
Contractor:
GVS CONTRACTING
PO BOX 760
SHERWOOD OR 57140
►=hone #: 625-6832 $ 69. 15 TOTAL
Reg #. . . (100543
- REGIUIRED ACTIONS or INSPECTIONS- ----
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ere. Specialty Codes and all other ►►,,j �,7r- _
applicable laws. All work will be done in accordance with
approved plans. This permit will <,xpire if work is not started
within 1P9 d.ys of issuance, or if work is suspended for more e.)!'�
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 DAR 952-001-0010 through DAR 95?-00101981.
You many obtain a coi.j of these rules or direct questions to Ol1NC �
by calling (503)246-,387.
F,erm:ttee Signati_tre _ Issued B �
-1 +++++++++++++++++++•}+++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by '/:PCO p. m. for an inspection nepripri the next bi.tsiness day
1
CITY OF TIGAI;D r Commercial Building Permit Application Recd By ? c
13125 SW HALL BLVD. New Construction and Additions DateRec'd
TIGARD, OR 97223 nate.to P.E.
(003) 639-4171 ,� 1�%'1(� tz% <<//% — 1,C1 G �� Date to DST
Permit
Print or Type Related SWR#__
Incomplete or illegible applications will not be accepted Called_
Name of Development/Project
Job IJ -A�-A VA5 Nri'2 -- Existing Building New building
Address Street Address Suite
_ Building
61 �. Bldg# City/State lip Data 4U �-f
� Exisa or Property:Name
PropertyOwner Mailing Address suite Propg o Property:
— _M• —G
City/State lip Phone — _ _
b- No. Of Stories
l�iV�
Occupant Na�mee Sq. Ft. Of Project:
Name Occupancy Class(es)
Contractor C LIAI71-WyC'r/til'..,---
Prior to permit Mailing Address suite Type(S)Of Constructionissuance,a copy
of all licenses __ _
are required it City/State ip Phone Will this project have a Fire Suppression System?
expired in C..O T 4�LA0 _Yes (� NO E
database d Li Americans with Disabilities Act (ADA)
Oregon Const.Cont.Board Lfc.# Exp.Date
, //,-1) . 9� Valuation X 25% - $ Participation
Complete Accessibility Form _
Name
Project $
Architect tAV I !:5 A4A Valuation
Mailing Address Suite
-TI+ -- '�` Plans Required: See Matrix for number of sets to submit
City/State 7ip Phone on back
Engineer Name I
I hereby acknowledge that I have read this application,that the information
given is correct,that I am the owner or authorized agent of the owner,and
Mailing Address I Suite that pjao7ubmitted are in compliance with Oregon State Laws
70 Q — 1of O n g Date
City/State Zip Phone ' _���r
t� ntact Person Nar a on _
e
U, J
Indicate type of work New O Addition O Demolition
1- Accessory Structure O Foundation Only O Alteration O
J _ Repair 0 Other 0 _ FOR OFFICE USE ONLY
Jescrlptlun of work:
pmol-t T(CrN eF VAuh StrJ�l,� Map L# C /d l,�c�On
Notes: land Use:
�' ►+111� i OUB % Qr � '7
Parks: Estimated#of Employees TIF n
It the above figure Is not supplied at the time of application,the city will
calculate the fee based upon the number ofarkln s aces.
Note: Site Work Permit Application must precede or accompany Building el,t a L. 2 J,OD
Permit Application 7A,y /, Z E.NorleAl 24,OV
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RPRrtr
I ICOMNEW bOC (D3T) 5/98 EX'Fl�
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COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal, the application must contain the
signature of the supervising electrician before plan review will be conducted.
After plan review approval, Plans Examiner will contact the applicant to request
additional pian sets for listribution purposes. (Copy for Contractor, City,
Washington County, Tualatin `.'alley Fire & Rescue)
Total # of •
TYPE OF SUBMITTAL Plans _KEY:
_
Submitted_
S (Private) ~ 1 S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) 3 F = Fire Protection System
M (New or Add or Alt) _ 1 M = Mechanical
B & M (New or Add) i P = Plumbing
P (New, Add, or Alt) 2 E _ E=lectrical
B&,-M—& P (New or Add) 2 New = New Building
E (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E 3 Alt = Alternation to Existing
(New , Add) Building
*B or B & M (Alt) 1
*B & M & P (Alt) 3
*B & M & P & E(Alt) 3
v *B & M & P & E & 1=(Alt) 3
G7
NOTES.
-J
*Shaded areas designate ALT submittals only.
I WsWmaxtr.xI doc 07/06/98