Permit A .
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00010
A( DEVELOPMENT SERVICES DATE ISSUED: 1/13/04
13125 SW Hall Blvd., Tigard.,0R 97223 (503) 639 -4171 PARCEL: 2S101AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY50/
SUBDIVISION: TIGARD OFFICE BUILDING 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: $ 15,000.00
Remarks: Work being done in Suites 250 and 340 first and second floor). TI: New walls.
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:
Phone: 503 - 892 -0066
Reg #: MET 00002036
FEES LIC REQ�fRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 1/13/04 $187.30 Electrical Permit Required
[TAX] 8% State Surcharl 1/13/04 $14.98 P Permit Required
Plumbing Permit Required
[BUPPLN] Pln Rv 1/13/04 $121.75 Framing lnsp
[FLS] FLS Pln Rv 1/13/04 $74.92 Framing lnsp
Total Gyp Board Insp
otal $398.95
Gyp Board Insp
Final Inspection
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: ' - a./t.a___ c ,6 / .4
Signature: i, f _
Call 639 -4175 by 7 p.m. for an inspection the next business day
/ Mk !0
Building'ermit Application FOR OFFICE USE ONLY
City of Tigard Date/B
Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /44,4 Phone: 503.639.4171 Fax: 503.598.1960 i ' Date/B : Other Permit:
Inspection Line: 503.639.4175 14,.. e 1 Date Ready/By: Juris: ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
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
g Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling RI Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 121 09 So (4, 8 Pheil-tilitli New dwelling area: square feet
City/State/ZIP: p ,, 0 , 12 _ 'j 11.7: Garage/carport area: square feet
Suite/bldg. /apt. no.: lip/Sq. Project name: G I 4 J fj9ga ee- Covered porch area: square feet
Cross street/directions to job site: j..�- AyylP7�J Ay.JB 6/ 14 Deck area: square feet
6 Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
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
DESCRIPTION OF WORK work indicated on this application.
ref' — I M P P L=MI✓ - —
Valuation: - $ I 10 0 0.
N , w`S Existing building area: square feet
0,0 /" New building area: square feet
lgk PROPERTY OWNER ❑ TENANT Number of stories: 3
Name: pAc_ _ -'124 tc .. Type of construction: .. N
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
WAPPLICANT . 1 CONTACT PERSON NOTICE
Business name: fr rn�2 Ci DA (�7 j c.1 All contractors and subcontractors are required to be
Contact name: S licensed with the Oregon Construction Contractors Board
M�t'1T 6L under ORS 701 and may be required to be licensed in the
Address: 5 3 2_0 J y pJ J � - , i /L L/.-) . jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP:
pp-(LTt_A.,JD e4- all 2, J apply:
Phone: 6o ) 2 00 (,,,G, Fax: : f5b3) I- O0(1
E -mail: ,t.1 oLs 00J 0., 1■45 N e co■'1
CONTRACTOR
Business name:n/I C.X-S ol u £- z.) .tc n 0A / BUILDING PERMIT FEES*
Address: �'1 ri.A. iD i�,,J, Please refer to fee schedule.
City/State/ZIP: 9 1 2i 7
`T�[� e-12_. `� '6.-C-12, �t�1/ Fees due upon application
Phone: VP') 2 9Q (O �, , Fax: ( �`jo W (J 1
Amount received
CCB lic.: Cj(, 0 •
Date received: jc,...,LEDt2______
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /A r i `o D. O VSarj Date: 1 -1 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\BUP- PerrnitApp.doe 12/03 440- 4613T(11 /02/COM/WEB)
Building Division
Plan Submittal Requirement Matrix
Commercial & Multi - Family - New, Additions or Alterations
City of Tigard
Type of Submittal , # of Plans
(Includes new, additions and alterations.) Required at
Submittal
Demolition Permit 2
(site plan required showing location and square
footage of all buildings to be demolished)
Site Work 2
(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 \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION»iVISION Business Line: (503) 639 -4171 MST
BUP it-000 / 0
Received Date Requested °2 - AM PM BUP — GOO 2- 3
Location aZ d , . P e -� MEC
Contact Person Ph ( ) PLM
Contractor C i t h,t 77 Ph ( Cat ) 3" 7 0 - 1 0 3 SWR
BUILDING Tenant/Owner • Foi nl:4..14 • ELC
Footing �I J 2 2-1 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:
!" 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/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 Z 1/, /0
Approach/Sidewalk Date f 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: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
a� • d5 ° BUP
Received /'3 / 5 Date Requested �� / I � G' / " ` AM M BUP
Location /r 9 �O� Ste MEC
Contact Person / % ' -, i n ' Ph (,SI ex? 0 21:1 PPLM
Contractor � Ph ( ) SWR
BUILDING Tenant/Owner j't/Ll - �L.4 • ELC
Footing
Foundation ELC
Access: u 3 Z
Ftg Drain � Z /
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall ,� /0 2, f� =z._ po-sfp
Fire Sprinkler
�/ �
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
C
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
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
JUG/Slab
�ow Volta ecD
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART #D
Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA l /,�
Approach/Sidewalk Date / 7 Inspector C-te- CA Ext
Final DO NOT REMOVE this Inspection record fr m the jo te.
PASS PART FAIL