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Permit
IL o CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2007 -00575 COMMUNITY DEVELOPMENT DATE ISSUED: 11/6/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 101 AD -03200 SITE ADDRESS: 12909 SW 68TH PKWY).907 O ZONING: MUE SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG PROJECT: BENEFICIAL FINANCIAL Project Description: TI REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: 2,979 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: 2,979 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 30 BASEMENT: sf AREA SEP. RATED: STOR: 4 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: $ 72,000.00 Owner: Contractor: PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION 15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LANE PORTLAND, OR 97224 PORTLAND, OR 97225 Phone: Contact #: PRI 503 892 - 0066 FAX 503 - 892 -0067 Reg #: LIC 66070 FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 11/6/2007 $472.30 [TAX] 8% State Surcha 11/6/2007 $37.78 [BUPPLN] Pin Rv 11/6/2007 $307.00 [FLS] FLS PIn Rv 11/6/2007 $188.92 Total $1 . 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 a obtain a copy of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By:' / Permittee Signature: • � f — _ _ 4 v 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. Buiiding Permit Applicat ail . " iv ED ED OFFICE USE ONLY City n -' o /., :, , . 7:,, . 1 Date received: fr / D7 `' b n t S75 IP th 150 E. Main Street, 4 Floor, H ��ro� 97 3 / e l A 6 Permit no. v7 1 Phone: (503) 681 -6144, Inspections: (503)68 244 I �� fe� o: ;/�/ p 1( fech Permit no.: Fax: (503) 681 -6469 CITY OF WAND _ Internet Address: wwwAyinglpagivisioN Plumb Permit no: On -Site Permit no: TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION - work indicated on this application. Valuation ❑ I- and 2- family dwelling _-Q tnmercial /industrial Number. of bedrooms: ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: Number of bathrooms: Total number of floors: JOB SITE INFORMATION AND LOCATION I Job site address: Q 7� New dwelling area: square feet City/State/ZIP: Garage /carport area: square feet y i _ e, i �2c"�7 Covered porch area: square feet Suite /bldg. /apt. no.: Project nameB ,.� Deck area: square feet Cross street/directions to job site: / /I✓itLif&-AQI Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Permit fees* are based on the value of the work performed. Subdivision: I Lot no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the Tax map /parcel no.: work indicated on this application. DESCRIPTION OF WORK Valuation 7�QU4' .6 �1 .L.* ; 7 14i vJ►�f E xisting building area:' l et New building area: square feet Number of stories: PLAN NO.: REISSUE: ❑ Type of construction: /7-17 !PROPERTY OWNER I ❑ TENANT Occupancy groups: / 42?. Name: /�,•� o f 1— Existing: Xf , 7Q Address: /� D . SA.-' - �G9 IJO /II reiet...4'/ (^S--© New: G.� City /State /ZIP: XOR ? O NOTICE Phone: ( ) Fax: ( ) All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board ❑ APPLICANT ❑ CONTACT PERSON under ORS 701 and may be required to be licensed in the Business name: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons Contact name: �iP I'l t7 Ll .," f apply: Address: City /State /ZIP: Phone: ( ) Fax: : ( ) BUILDING PERMIT FEES* E- mail: Please refer to fee schedule CONTRACTOR Fees due upon application Business name: . /2 2 ,40, 77 - ) . /4 ,_,,, Q ,/ e y Amount received Address: Date received: City /State /ZIP: Phone: ( ) Fax: ( ) This permit application expires if a permit is not obtained within 180 days CCB lic.: after it has been accepted as complete Authorized signature: rtf - li''�/t * Fee methodology set by Tri- County Building Industry Service Board Print name: `,hri t c , f' ,, L , , Date:: ,/ /j l7 440 -4613T (04 /05 /COM /WEB) CITY OF TIGARD BUILDING DIVISION PERMIT #: B(JP2007- 00575 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/6/2007 Phone: (503) 639 -4171 Ao ,c "� Inspection Requests (24 Hrs.): (503) 639 -4175 % " ' I I� INSPECTION WORKSHEET FOR DATE: 1/18/2008 TIME: 7 :02AM PAGE: 4 /O l) SITE ADDRESS: 12909 SW 68TH PKWYAffr CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: E3ENEFICIAL LIFE INSURANCE DESCRIPTION: 11 OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: OLSON CONSTRUCTION, MATTHEW PHONE #: 503 - 892 -0066 Inspection Request Scheduled For: Date: 1/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 799 Final inspection 063541 -02 503-956-6290 N Corrections /Comments /Instructions: A P IN PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL II CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / Inspector: Date: 1 M 0 Phone #: (503) 718 - Z--"7 Y CITY OF TIGARD BUILDING DIVISION ' A PERMIT #: BUP2007- 00675 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/6/2001 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 "'I �.. INSPECTION WORKSHEET FOR DATE: 12/7/2007 TIME: 7:00AM PAGE: 8 /CO SITE ADDRESS: 12909 SW 69TH PKWY — CLASS OF WORK: SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE: PROJECT NAME: BENEFICIAL FINANCIAL DESCRIPTION: TI OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: OLSON CONSTRUCTION, MATTHEW PHONE #: 503 - 892 -0066 Inspection Request Scheduled For: Date: 12/7/2007 Pour Time: Code # Inspection Description Confirm # Contact # MesI - / 275 Framing 061076 -01 503-956 -6290 Corrections /Comments/ Instructions: — 1M C o "1 NJ rig •./o i -e, \ir:1Z iFr/ V 1./42-!___ 4J c -t- -' L' v"l fs , L^-1 6 IL r:2 xi_ 1../4 r ��L.- I PLU ✓h t . M>WC Bv CZc v el, ❑ PASS C!. - 'TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: CZ--A /07 Phone #: (503) 718- 214:4q CITY OF TIGARD -- BUILDING DIVISION • A PERMIT #: BUP2007 -00575 13125 SW Hall Blvd., Tigard, OR 97223 ` DATE ISSUED: 11/612007 Phone: (503) 639 - 4171 , 1 rl Inspection Requests (24 Hrs.): (503) 639 -4175 +� �'-'L INSPECTION WORKSHEET FOR DATE: 1216/2007 TIME: 7:06AM PAGE: 10 SITE ADDRESS: 12909 Sy!/ PKWY 19 CLASS OF WORK: SUBDIVISION: TIGARD TRIA � GLE CENTER LOT #: TYPE OF USE: PROJECT NAME: BENEFICIAL FINANCIAL DESCRIPTION: TI OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: OLSON CONSTRUCTION, MATTHEW PHONE #: 603 -892 -0066 Inspection Request Scheduled For: Date: 12/6/2007 Pour Time: Code # Inspection Description Confirm # Contact # Mes e L I{ `U 276 Framing 060978 -01 503956 -6290 Y Corrections /Comments /Instructions: , or V-c--39)/ ❑ PASS 1111 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS •FAD 7 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: it (0 N Phone #: (503) 718- C6W