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Permit - - 1 CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00371 *.114 DEVELOPMENT SERVICES DATE ISSUED: 6/18/03 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S101AD -02400 SITE ADDRESS: 12753 SW 68TH AVE. 3114 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 032 JURISDICTION: TIG 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: 3N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 354 BASEMENT: sf AREA SEP. RATED: STOR: 2 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 : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 50,000.00 Remarks: Tenant improvement, create new offices and unisex restroom. (Existing fixtures are being relocated.) Owner: Contractor: WESTERN EVANGELICAL SEMINARY ROBERT GRAY PARTNERS INC PO BOX 23939 PO BOX 1000 PORTLAND, OR 97281 SHERWOOD, OR 97140 Phone: Phone: MBL 793 -8520 Reg #: 693-4675 0Eb81N 65424 gggg FEES MET REQUfRSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 6/18/03 $470.80 Electrical Permit Required Fire Alarm Permit Requirec [TAX] 8% State Tax 6/18/03 $37.66 Plumbing Permit Required [BUPPLN] Pln Rv 6/18/03 $306.02 Framing Insp [FLS] FLS Pln Rv 6/18/03 $188.32 Gyp Board Insp Total Final Inspection $1,002.80 This permit is issued subject to the regulations 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 ' • -6699 or 1- 800 - 332 -2344. Issued _ -! , • 1. .�.:_ i��Lr� -� ` Pe rm ittee Ar k Signature: ` Call 639 -4175 by 7 p.m. for an inspection the next business day .e ' Building Application FOR OFFICE USE ONLY RPlan Date / necei By: veing d G Building Date/By: to / 0 Q .5 Permit No.: H C.! D�pU3 -OQ 3 of Tigard Approval City Other y g Permit No.: 13125 SW Hall Blvd. Plan Review Other - Tigard, Oregon 97223 Date/By: C - /d •03,D Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 - 1960 " '��`'' � q�o- 1 ' `.- Post - Review Land Use el I I Date/By: Case No. Internet: www.ci.tigard.or.us Contact ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 Name/Method: / ic, Supplemental Information TYPE OF WORK REQUIRED DATA: ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING x'41 Addition/alteration /replacement ❑ Other: CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate ❑ 1 & 2- Family dwelling K. 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 $ JOB SITE INFORMATION and LOCATION J No. of bedrooms: No. of baths: Job site address: 1 2.'7 S 3 S w 69 ,1. S..f Total number of floors New dwelling area (sq. ft.) Suite #: RIBP Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: por+ J(, _ J CPr. 3+r Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Z k v/ Y-2 ¢iu ....,0 4 ° Other structure area (sq. ft.) /0 60 /A^ REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: ' 1 Lot #: Tax map /parcel #: ZS / - 1 A 12 2.11 0 O Note: Permit fees* are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ---- goo 0 Valuation $ so, OLY>, OD T Existing building area (sq. ft.) New building area (sq. ft.) Number of stones si PROPERTY OWNER 1 ❑ TENANT Type of construction Name: 6. u, b ,G /� )› ' .1-+�' 1 1J Occupancy group(s): Existing: New: Address: 4 / u N 2 . S f - / -, l ' City /State /Zip: _t t s) . ') 7132 Phone: _s j 2 o / `l Fax: 5 O 3 _CPI z D o NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under ❑ APPLICANT. _ ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: C--zeorse ) ci-i .‘icSpl y jurisdiction where work is being performed. If the applicant is exempt Contact Name: Detn . S o ti v if -2� / from licensing, the following reason applies: Address: 41 L t • / dsa, S 1 City /State /Zip: Phone: I Fax: BUILDING PERMIT FEES* E -mail: Please refer to fee schedule. CONTRACTOR ,/ " - S Business Name: (2 6.4,--1- 6.4,--1- ( r ff Pe"- / ". Fees due upon application $ Address: Po boa 100 / City /State /Zip: ,S 1..t1' 4 DQ � 7 i vo Amount received $ Phone: S b 6 4 1 Z, 1 alt :.5 3 6 i2 4 Z' 2 Date received: CCB Lic. #: 6s < Z Y Authorized ' Notice: This permit application expires if a permit is not obtained within Signature: - _±,d - � Date: - 2 0,. PJ 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03 f — - A Plan Submittal Requirement Matrix - 1 1 1 Commercial & Multi- Family City of Tigard New, Additions or Alterations 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:\ Building \Forms\PlanSubMatrix.doc 04/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 2 'a 3" (937 INSPECTION DIVISION _ Business Line: (503) 639 - 4171 BUP Received Date Requested AM - fl M BUP Location 12-73 Suite MEC Contact Person Ph ( ) ' �SS�� PLM Contractor Ph ( ) SWR ` UILDINC Tenant/Owner 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 ( « l Q /� (U /3 � ,q "e y Drywall Nailing Fire Sprinkler 7 _ /� �� nl 7� `/ �v 77) t Fire Alarm C/A-e 77 7 c a )- /e Susp'd Ceiling Roof Other: • B PART FAIL ING CO 5 ,� � !'L Post & Beam Under Slab Rough -In 5 Water Service 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 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Date �/L / U Approach/Sidewalk Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 4 p /.3,10 tez7 `3 -00 37/ Received Date Requested //-- AM - PM BUP Location f - 7 £3 �p �n cam* MEC - 60 c —''f ( Contact Person Qijn d. Ph ( ) 7 1 h - d 7 O L PLM Contractor Ph ( ) SWR , Tenant/OwnerZ • ELC ELC Foundation Access: feL6—' Ftg Drain (�-Od- 1 ELR Crawl Drain Slab Inspection Note s: _ _ Q SIT Post & Beam Shear Anchors Ext Sheath/Shear __ .O�:r — Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fi = Alar - • • Other: FiI- ?rP >, PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole - Storm Drain Shower Pan Other: Final PASS PART FAIL Po Beam Rough -In Gas Line Smoke Dampers aP PART FAIL RICAL 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 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line .% ADA Date C A / !/O 3 Inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING -- Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION • . Business Line: (503) 639 -4171 • BUP 3 -.0 Received Date Requested — AM PM j UP 3 - 0/>37.1-- Location ) 2 153 6 VIA- c1 MEC Contact Person Ph ( ) { 74J l S PLM Contractor Ph ( ) SS ( i' SWR BUILDING Tenant/Owner DQ -0^f ' l�'z� `-c_ -/ J• ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: �► a SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire S • rinkler i ..+''"' r ' ts �- / /`- \ S % A Pf ik ov &- - • p • Ceiling Roof Other: 46 i1 le - ASS ART FAIL PL I MBING Post & Beam Under Slab Rough -In 9 - Water Service 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 ❑ Please call for reinspection RE: Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Data W5/ 3 Inspector /� Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL