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Permit
CITY TI G D BUILDING PERMIT PERMIT #: BUP2005 -00226 '. DEVELOPMENT BIVIEN Tigard, S SERVICES OR 639 -4171 CES DATE ISSUED: 5/31/2005 SW PARCEL: 2S 112DD - 00200 SITE ADDRESS: 15618 SW 72ND AVE ZONING: I - SUBDIVISION: OREGON BUSINESS PARK III LOT: JURISDICTION: TIG Project Description: T.I. walls & ceiling. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 73 BASEMENT: sf AREA SEP. RATED: STOR: 1 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: $ 42,000.00 Owner: Contractor: PACIFIC REALTY ASSOCIATES ROBERT EVANS 15350 SW SEQUOIA PKWY #300 -WMI 1200 NE 48TH AVE. STE 1250 PORTLAND, OR 97224 HILLSBORO, OR 97124 Phone: Phone: 503 - 648 - 7805 Reg #: LIC 14426 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 5/31/2005 $410.80 [TAX] 8% State Surcha 5/31/2005 $32.86 [BUPPLN] Pln Rv 5/31/2005 $267.02 [FLS] FLS Pin Rv 5/31/2005 $164.32 Total $875.00 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 B ,.....---7-1 ,� Permittee Signature: By. .C, 2 .t'/ tit Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. �uilding Permit Ap "OV ED F OR OFFICE USE ONLY Received �7 � City of Tigard C� ; , 2005 Date/By: ✓ I Gj��' Pemit �°� � a` ti1� 'oZ� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie r Phone: 503.639.4171 Fax: 503.598.1960 //dmc h1,i,N Date/By: .' ) Z2 j Y vs ) Other Permit: Inspection Line: 503.639.4175 OSTY( OF TIGARD ; 41 4 1.-'111. 1 Date Ready/By: Juris: ® See Attached Checklist for Internet: www.ci.tigard.or.us BUILDING DIVISIO Notified/Method: ��( Supplemental Information .'e: 'ia; i w '°2 � r `ti.�':.:i?tu.M '�ida'�a: .� x M r � I Jai r a r 5p. A j 41 S! 1 el. . n as r i� s a µ g' fii cY > `^ r r s r , " �, a h Iiit D IJATiA 1' AND 2 FAMILY D • fst, :t,0� . +4, ik t Ir.!,q ?.. r g o , T]T E OE 4« O ? � r> a i %; ; $ - r.FC�.,m1e..� sts.: i*1��. iiu _r §t.�,t.. N !� ?r tvic . _. _ U. ,� Yfi - _ r•.h..,��e tm« .r„K...�x , r2,,r ,r - r.. .. J, •��.' , .n... . re .. ,. _:.0 ., n ,,p a3.. ��, . v •. Y ,. e Permit fees* are based on the value of the work performed. El New construction Demolition Indicate the value (rounded to the nearest dollar) of all ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the 1- ,s �, sh t g't<° ,ti: r ,_ ,,, 6 n ,Z MG = , VV F �� J ,j�y 1 work indicated on this application. 01 r " °l ' q h ., c i. ©RY t , F�, t µ fi O � � �?7. #.n ti- r::S -ct r �...:i�laa- 2f »,' 4 .�if1 X, I ,� .r, ...l.. -� .�,.� x. -.�.., ar;* �I.tir awz��w ..� .a. Valuation: $ ❑ 1- and 2 -family dwellingmmercial/industrial Number of bedrooms: Multi -famil ❑ Accessory building ❑ Multi-family ❑ Master builder ❑ Other: Number of bathrooms: 9�1� T Fra r h � ,� T.,, 4h�, ,x4c, � _� — '''"'x, "' "' ' T ,7 Total number of floors ■ o e 1 1! -,, �' �Q B 1 1, v .. ..Il �1 FF0 ' ! �, A 4- ON it(t f :4 ;r <,.: t,:„4' n •: Job site address: i' g 5.0 - 7, Yti PtM/i� New dwelling area: square feet City/State/ZIP: o L X QpI � 2-7 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Tech y1 O corvi in (:, e Covered porch area: square feet Cross street/directions to job site: ¶j U -p i ,.}p S jff y Deck area: square feet Rd el s� ' 72- Vt / a �` 1M I . ( Other structure area: square feet ( n i k7 1 Xr .k s 't ,,,, s t Y z" E n �rt .REQ D�DAT. COMMERG'IALf U E C$ECKLIST ,r!�......r d .... I,rcf 4s.r. � t .�.. d.h.. p . -. k"?. ,!'. Subdivision: Lot no.: Permit fees* are based on the value of the work performed. , Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the �� _ ri t ��� ' �" t '�`Wx t. d• " art ' i' ` #r work indicated on this application. �. x'i . 'S 4ic r),'N i', kt ni c ,--t IQ .rc+,,�;s ,o-*.", '': iE'� �. ;' . 1 ,'.,S :ra ,4 1'.. ' /� /' Valuation: $ � ` Co. o 00 fak- /t -1 boi r D©d r a l s' ga l L to / f 1 t-2k1 ki P, f Existing building area: square feet I. lvt a ^{l ! '/ [ 1 cur[. -or-P _ / / • ' New building area: i ,L ! l rl2 /� I, to_ g S &, l F square feet ll ,?„ x! ..Fxs x w -F « a m- ,5. t ` ' ' 4 t t , r rttf s` '� ' to Number of s S S a L ! rt 4 4' : �`ER�O ERTY/rd R iX t ! n�&, . r..a,.ra,awx#ro.,a. , , -d.._k b f tories: ( E �/l �.. r r ,.6 r te. .''� cr ..� -IIrraz ,�i t � wt_r, 4. �, r il. ,�.. o,u , Name: PacTrust Type of construction: . 5 Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups: City/State/ZIP: Portland, OR 97224 Existing: 13 /,7 .2----- Phone: (503 ) 624 6300 Fax (503 ) 624 -7755 New: 5 a- Q� Lb _ 3 .„ f.J Y �p itti - 'N h y ;� is F 4 I IF i3 . 4� .g . .,- ?.w.' ' ,� . i i v 3, Jr , i i .. , tf 7 1 - . - t „ p� "� '°' " F s® PLIC t. T.) u � r i .i`r it f 0 C' .,1W'T.�C P. 3x ; l' "q; d t e k t ' u i OTICE • 0„.,.....„„„,,,,,,,;...„.....,,,,,„:„...,„,„:„.., . .. r_., ,aWt�.. W �,ia.i ,.,a w.xi_...r.�. _ ,.., ��r i6s,.k . .: r d � . .r P #?��''N...e �t�, w.„£ ro, sf �... .i „o.,.. i:.. 4 , Business name: PacTrus t All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: 15350 SW Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State/ZIP: Portland, OR 97224 apply: Phone: ( 503) 624 -6300 Fax: : (503 ) 624 -7755 E -mail: 4'4r a s. ""r} r , h �r M " V A rx x.:.s i t ,*' "ag`. 4e .:�, D r '- a - P � rm15 R'L y ,t < 77 ORIr ze,4 l mt : ;,� ,1 iaN� •Ak .4lyi , r,k L� -} s�"��� ,"'t�.,.��.xtb 51:��L �n..lr �...� �'K�.. 4 '.��s.m >��;ss�.�r !�d`.r r6 e, b a F`, „ Business name: Robert Evans Co., Inc. '' 7,1,,,,i.:.,!.,11, 4 y r °I "� ` BI71TDIlI PERM1T FEES * . Address: 1200 NE 48th Ave., Suite 1250 Please refer to fee schedule. City/State/ZIP: Hillsboro, OR 97124 Fees due upon application Phone: ( 503) 648 -7805 Fax: ( 503) 648 -5883 Amount received CCB lie.: 14426 Date received: Authorized signature: This permit application expires if a permit is not obtained / n, within 180 days after it has been accepted as complete. Print name: /f4 , �1 ro „I Date: 5/z 7 7 * Fee methodology set by Tri- County Building Industry [ Service Board. i:\ Building \Permits\BUP- Permitkpp.doc 12/03 440- 4613T(11/02/COM/WEB)