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Permit , ;1 _ cril OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00326 41 DEVELOPMENT SERVICES DATE ISSUED: 6/27/03 - — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11410 SW 68TH PKWY PARCEL: 1S136DA-00101 SUBDIVISION: PERS SITE ZONING: MUE BLOCK: LOT: 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: 2N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 225,000.00 Remarks: TI- new office & expand server room Owner: Contractor: OREGON, STATE OF PUBLIC COLLINS MECHANICAL EMPLOYEES' RETIREMENT FUND PO BOX 900 11410 SW 68TH PKWY TIGARD, OR 97223 Phone: Phone: 503 - 723 -0139 Reg #: LIC 146993 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require -- [BUPPLN] Pln Rv 6/5/03 $800.67 Electrical Permit Required FLS FLS P ln Rv 6 /5/03 $492.72 Sprinkler Permit Required [FLS] Framing Insp [BUILD] Permit Fee 6/27/03 $1,231.80 Gyp Board Insp [TAX] 8% State Tax 6/27/03 $98.54 Final Inspection Total $2,623.73 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 By: Perm ittee Signature:/ 0 / 0- ---&‘; I CaII 639 -4175 by 7 p.m. for an inspection the next business day ir ll't/o sw . pkwy pate. o f /) 2 V-0 3 c G Building Perm , _ Received it Application FOR OFFICE USE ONLY Building Date/a 5-63 p Permit No.) ( ) + n aao3 - tX' 3d10 City of Tigard Planning Approval Other Date /B Permit No.: 13125 SW Hall Blvd. i7• v� w Other - Tigard, Oregon 97223 ` " G -L3 - 03�/SS� Permit No.: /C'' { \ P ost - Review Land Use Phone: 503 - 639 -4171 Fax: 503 - 598 -1960 h ;�l� ■ • . y: b " ?' 7 3 �, Case No. SU Internet: www.ci.tigard.or.us ©� �� �' U\ c. t J uris.: ®See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name ethod: Supplemental Information OETV OF TUAi D ' iJILDING DIVISION TYPE OF WORK DATA: r ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING ® 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 ® 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 r ❑ Master Builder ❑ Other: V 'cation $ JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: //4/0 SiJ 68 PiSeat T Total number of floors New dwelling area (sq. ft.) Suite #: 1 Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: OEkS /2 cct .7 w Rot Roothial Covered porch area (sq. ft.) `-_____ Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) /117411 es /? GIct o .r - 5 > �u bll c , Ertc p /o %&Es irrehl�f S ytf e " REQUIRED DATA: Heacif -urz rye+ -3' /5Id7- COMMERCIAL - USE CHECKLIST Subdivision: ✓ 1 Lot #: Tax map /parcel #: 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, I/A C � 99HQ J As oCI JV Q J d overhead and profit for the work indicated on this application. r"i �P�t✓e� Tefe c 644-t /'OD' -c5 Valuation $ 2'25 1 coo � Existing building area (sq. ft.) New building area (sq. ft.) Number of stories ❑ PROPERTY OWNER 1 ❑ TENANT Type of construction Name: Occupancy group(s): Existing: a New: A4 C4444.4. Address: City /State /Zip: Phone: Fax: NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under ❑ APPLICANT . g' CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: ©ljE4DN 1. c AD 1N. 54/CS jurisdiction where work is being performed. If the applicant is exempt Contact Name: 5eAtiN /JOW NNi from licensing, the following reason applies: Address: /ZZS {- tFieg y sr 5. es u to a City /State /Zip: 4014, 8/Z c173 Phone: $ o 3713 - nos' x 4 Fax: 5D 3.373.. 72 / D BUILDING PERMIT FEES* E -mail: be/4w . 7LJN5 6 SM.. cm u S Please refer to fee schedule. CONTRACTOR Business Name: i / //,is / b( I'fN/I/ 1( L- Fees due upon application $ Address: pp . To fox 106 City /State /Zip: OR Amount received $ Phone: O3 --p. 3 .o/3 5 1 Fax: Date received: CCB Lic. #: l ‘401 Authorized //J / Notice: This permit application expires if a permit is not obtained within Signature: " — d Date: 6 � � ( v3 180 days after it has been accepted as complete. r— i s g4pN W - NU) t4 S *Fee methodology set by Tri -County Building Indusj nt,8ervice Board. (Please print name) C I V I is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 J f 1 . C L)°( r L ✓ /. 41 A Plan Submittal Requirement Matrix - 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 applicantto request additional sets of plans for distribution purposes (forContractor, 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 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP 3 - oa 3 X(9 Received Date Requested `0 — / d AM _ PM BUP Location / 1 Lft 0 � Suite MEC 3 ` 00 29c • Contact Person ,Ph ( ) 3 / y- O 3 L3 PLM Contractor Ph ( ) "7 a - 3 a ( 3 7 SWR BUILDING Tenant/Owner 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 Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: �7 < I P `_% PART FAIL BING Post & Beam Under Slab Rough-In Se �( (' Water Service I Sanitary Sewer R r Rain Drains Catch Basin / Manhole Storm Drain c / Shower Pan Other: Final -- - _ . _ _ _ _ _ PASS —PART FAIL gCCHANIC - AN I Pos D, Rough -In Gas Line • e Dampers 1 PART FAIL E 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 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line ADA Date 42//0 / 0-3 Inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL