Permit P BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2003 -00617
Mk DEVELOPMENT SERVICES DATE ISSUED: 11/3/03
„i 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 11308 SW 68TH PKWY PARCEL: 1S136DA 00100
SUBDIVISION: ZONING: MUE
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 79 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: $ 3,912.00
Remarks: Fire Alarm Protection System.
Owner: Contractor:
BENSON CAPITAL OREGON ELECTIC CONSTRUCTION
1708 3RD AVENUE 1010 SE 11TH
NEW YORK, NY 10017 PORTLAND, OR 97214
Phone:
Phone: 503 - 234 -9900
Reg #: LIC 203
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 10/16/03 $81.70 Final Inspection
rm
[TAX] 8% State Tax 10/16/03 $6.54
[BUPPLN] Pln Rv 10/16/03 $32.68
Total $120.92
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 -0' :: : • •h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
c. ng (503) 246 -669 • i r 1- 800 - 332 -234 •
I. sued By: . �0j1 i ; 1 /,, �� /��
Signature: 4 I I %;�; 1�
Call 639 -4175 by 7 p.m. for an inspection the next business day
r(,' J 1-.
/1 WOTGCI or( , / ./5 d eplcoVEp /b -z9 -63 PS,
r
Building Permit Application
Date received: /n /G 63 Permit no.: 3U FolDa3 -DO G/'7
! -
�.,�t•= °� City of Tigard R ECEIVED
^ - -. Project/appl.no.: Expire date:
City CiojTigard Address: 13125 SW Hall Blvd, Ti OR 972 2 3
Phone: (503) 639 -4171 tO C 1 ; 6 2003 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: CITY OF TIGARD 1 &2 family: Simple Complex:
BUILDING DIVISIUNV
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory g Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement Tenant improvement 0 Fire sprinkler /alarm 0 Other.
JOB SITE INFORMATION
Job address: // .— C 1.7•771 ' l/0', `/ Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.:
Project name: 7/ 1 7 �% / C.1;1/) Z (3C7 I " - - / L
Descr and 1 e ation of work on premises/special conditions: /}1-- :/.. 7) f/ S/ / /� ' G/
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling.
City: !State: ZIP: Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
• Phone: Fax: E -mail: New dwelling area (sq. ft.)
`< APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: 'State: 1 ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercialrindustriallmulti- family: o�
CONTRACTOR Valuation of work $ j / /, CO
Existing bldg. area (sq. ft.) •
Business name: 0012 i- � Gee -,, - Ai u- New bldg. area (sq. ft.)
Address: /(J /(�� // /?J J�,� Number of stories
City: /;1f) 72.41 iii , 1 Stateat [ ZIP: 7 / y Type of construction
Phone: sc� 2 ,-S-2s(11 Fax: 73,, E -mail: Occupancy group(s): Existing:
CCB no.: p New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
= ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: gyp: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER -
Name: Contact person: Fees due upon application $ / 70 • c 7i
Address: Date received: 'l �j
City: State: ZIP:. Amount received $ ) 2 v . 7
Phone: 'Fax: 1E-mail: Please refer to fee schedule.
I h e r e b y certify I hav • d and examined this application and the Nor l jurisdictions accept credit cards, please call jurisdiction for more information'
attached checklis Al ii r visions of laws and ordinances goveming this visa 0 MasterCard
work will be co pli i
pt
� / /
✓ • e s. red herein or not. / Ledit carer number:
Expires
Authorized sign. 1._ .. Lr Date: f (/ 3 Name of cardholder as shown on credit card
Print name: `[11 � i� C $
Cardholder signature Amount .,
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-0613 (60WCOM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISI • Business Line: (503) 639 -4 71 MST
4 ,.
Received I/ Z Date Requested / ' - A - 7, , ! , 4' I►A'L ® 3 — &t 7
Location H 3�) _ 9 f') pi Suite MEC
Contact Person / 1 L C' tq 1 k Ph ( Q3) 6 9 'ettDrP 5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner PA,(rcr? e ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation = �NA C, APtAo v c7 F & /?/9lc, A-001i
Drywall Nailing
Firewall
r
dire A ar
Susp'd Ceiling
Roof
Other;.
Fi
PART FAIL
• ' BING
Post & Beam
Under Slab
Rough -In
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/SI•b
' ina 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 p n A � /8
ADA / L 6'6/ � Sec I/1� ,aL 4c-o,� zip
/
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL