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Permit b - J9-4 - ,,--..„.:„( -6 e..,---- C TY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00199 A DEVELOPMENT SERVICES DATE ISSUED: 5/4/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101AD -03200 SITE ADDRESS: 12909 SW 68TH PKWY 400 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: 2 -1 HR : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 80 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: $ 35,000.00 Remarks: TI, new rated corridor & 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 REQUp IRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 5/4/2004 $358.30 Electrical Permit Required [TAX] 8% State Surchari 5/4/2004 $28.66 F Permit Required Framing Insp [BUPPLN] Pln Rv 5/4/2004 $232.90 Gyp Board Insp [FLS] FLS Pln Rv 5/4/2004 $143.32 Susp Ceilng Insp Total Final Inspection $763.18 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 952-001-001! r• • ■ • OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling (50. 246 -6699 • 1- 800 - 33244. Issued B : �� �! —� .. ' • 6 Permittee C. Signature: r Call 639 75 by 7 p.m. for an inspection the next business day t3 Building Permit ' d� t A F ORO FIGEUSEOt1 .,... - „'.,`•.:-.:, Received I Pemtn No. / ® City of �'igal'd D Date /B/ 5 �/ / — /•I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review / r 4 ® Ot her Peptic Fhone: 503.639.1171 Fax: 503.E u . � ' ' ' : Date /Bv: ..1--- y Inspection Line: 503.639.4175 - Ir" 4 200 t',7 4/ .. _ -, Date Ready /By: Juris: 0 See Attached Checklist fur Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: ! ", Supplemental Information BUILDING DIVISION TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING Permit fees* are based on the value of the work performed ❑ New construction ❑ Demolition Indicate the value (rounded to the nearest dollar) of all X i.ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. • ❑ 1- and 2- family dwelling fCommercial/industrial Valuation: $ ❑ Accessory building ❑Multi-family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION LOCATION Total number of floors: Job site address: / ' Sly/ 4e �✓ � _ New dwelling area: square feet City/State/ZIP: �7�1c13 41e A1 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name : i ffe g Covered porch area: square feet Cross street/directions to job site: . Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees* are based on the value of the work perfornied. 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. /// /� ' / / ' /Pi �" ■ i _ Valuation: $ �, I�►' fa � /, *A ��/ ' 'N/" / Existing building area: ' quare feet �; jj//yy New building area: /' square feet . Ia PROPERTY OWNER . . . ❑ TENANT . . Number of stories: / Name: PacTrust Type of construction: -- hitA Address: 15350 SW Sequoia Pkwy. , Suite 300 Occupancy groups: City/State/ZIP: Portland, OR 97224 Existing: ice! Phone: ( 503 624 -6300 Fax: ( 503) 624 -7755 New: .. ' :U. AP" PLICANT . . • • _ . . . - , ❑ CONTACT PERSON ' ..... • NOTICE Business name: PacTrust All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 15350 SW Sequoia Pkwy. , Suite 300 jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/ State/ZIP: Portland, OR 97224 apply: Phone: ( 503) 624 -6300 Fax:: ( 503) 624 -7755 E -mail: . C ONTRACTOR — Business name: C. Green Company 4) BUILDING PERMIT FEES* Address: 15350 SW Sequoia Parkway, Suite 300 Please refer to fee schedule. City/State /ZIP: Portland, OR 97224 Fees due upon application Phone: (503) 624 -7717 Fax: ( 503 968 -1686 Amount received CCB lic.: 156496 Date received: Authorized signature: • This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print nam Date: �j ��j / /7� * Fee methodology set by Tri -County Building Industry v v Service Board. 4a0- 46t3T(I I /0? /COM/WEB) 1:\Buildin rtnits \BUP- PermitApp.doc 12/03 CITY OF TIGAR'D 24 -Hour BUILDING . = Inspection Line, (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP 9 ©CIt 7 Received Date sted bk AM P BUP C � Location l ?RO T Suite LAP MEC • Contact Person rt Ph (3) !Dv ° PLM Contractor Ph ( ) SWR = UILDING Tenant/Owner ELC Foundation ELC Ftg Drain Access: MST \�-' 3 t t co ELR Crawl Drain l i 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 41113iillo' , PASS, PART FAIL _ 1, PLU ; ING - os : 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 ��� � N = Low Voltage AMTMIANIir2111M1Fill rm !' 1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL LI Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL