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Permit
CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00359 � i�n DEVELOPMENT SERVICES DATE ISSUED: 7/28/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101AD -03200 SITE ADDRESS: 12909 SW 68TH PKWY 450 ZONING: MUE SUBDIVISION: TIGARD OFFICE BUILDING LOT: JURISDICTION: TIG Project Description: T.I. walls for office space. 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: 5N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? 'OCCUPANCY LOAD: 117 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: 4 ,t. 6/ 100, 00 Owner: Contractor: PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION 15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN PORTLAND, OR 97224 PORTLAND, OR 97225 Phone: Phone: 503 - 892 -0066 FEES Reg #: LIC 66070 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 7/28/2005 $290.80 [TAX] 8% State Surcharp 7/28/2005 $23.26 [BUPPLN] Pln Rv 7/28/2005 $189.02 [FLS] FLS Pln Rv 7/28/2005 $116.32 Total $619.40 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. Tho - ules are se orth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rule •r direct qu - : ons to oUNC by calling 503 - 246 -6699 or 1-800- 332 -2344. / Issued By: T iU £1, Permittee Signatur •.,` _ _ _ 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. s _ , Buildin Permit A lication ED Received OFFICE USE ONLY City of Tigard DDEA m :. � _! 2- Pe'Na /4 13.5 131SW Hall Blvd., Tigard, OR P Review Phone: 503.639.4171 Fax: 503.598.1960 ; a '1005 U"t; . I�� DauJB : Other Permit Inspection Line: 503.639.4175 L a �!i- Date Ready/13y: Uill ® See Attached Checklist for Internet: www.ci.tigard.or.us - O Notified/Method: ed/Method: Supplemental lnformadon Go" �, to . x,' n � 4r° r i � :uw6wxu: & :, �, ., �i^IN r sa.` ' -I•x, @1• tm.�e k• g �::r�._ ti. .1 ,, .4 7 c :•:, :' • IP(G ,; 4 a x'j] ; .J `. i� `,, �g ,: 4 , 4 ' __. . ::, D ?i FD 2:I , DWELI .. '•qq�� .qr' � $y j ..�� �' .X ` y � ,� �,n" O rt � ,; .. � •'_ � 1 ',L. , ...,•-• ; . .. 4 ' � .;,,.: urP•.J'8;1�:�?•i!r�F�r•ti �. �.�21�3�r2��t °F '. .y� r #= .s�-,ou�'�!� JNt l'.P� `. VS i+Yl: �•�- °:•:.' y4y ,..,, •,�, . �: .:. .. ' ,.: ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the i + ia�k` 2 's 1 ` a 4 ` e \' tiv : ,, 81 i k e � a c?r , .. work indicated on this application. ❑ 1- and 2-family dwelling ercial/industrial �' Valuation: $ ❑ Accessory building r ❑ Multi- family Number of bedrooms: ❑ Master builder - 71W- Number of bathrooms: n ❑ Other. �.;, #' J 4'• 'i '' pp ,, Y 7 P! a' a a vis • 'd , h i, ; . © f ' El 1 j �t r + e a ' r 5 Total n s� .: Y 7. pg 2 J 0 ,, a -t a a ,- M° �.v aa ra , A4 wx T number of floors. Job site address: Age O q Stj p New dwelling area: square feet City /State/ZIP: Portia ,1 0 , 02 ! -7v73 Garage/carport area: square feet Suite/bldgJapt no.- is J . Project name: 4 h I , J _ Covered porch area square feet Cross street/directions to job site: 1 /4Tr4/S:e— P —r�.ut S'.t,4J Co — Deck area: square feet ��, _ _ c.4-) _ ...! Other structure area: square feet / .aJ 1. ?. ✓R ,,i •=•:Y.,•rs' d -.. ,,,,, Y ,, , CI.T. Subdivision: ! Lot no.: Permit fees* are based on the value of the work performed. Tax map/parcel Indicate the value (rounded to the nearest dollar) of all o.: v 1 rr " u a equipment, materials, labor, overhead, and the profit for the ;, 1 r a work on this a . 11. _��V 4 a 4 1 . - IGI�� .c Ii�Lti d 9 14 -. '�0! '�� JI l ny.�� r - :: gi .ar. ', k indicated hi application. ::' u�LL'^'.. L�i�: 1: e1��L�`'. �.:. �G.=, 1',] �..:: 4�It�� �. �Z& 2. �. � .m1 �! dIa- LJJ'"ty"A �:_4' L.�I•}.r kr /� f� / I t Valuation: $ 24 Doo Yom' ` news/ eRA/W r e_l Li rc .a .2 - 4.ket -eiv P PVl ci�t . � r t t, In 12.e, c, �va5► Ex isting building area: d '3 square feet 21/ 4.1.t L New building area: /� ) ,f- v � ( p f 5 square feet IY ':1 '[ y; _ ; , -q 40 ,:t, '� � x �' w � t ` i t• .� ,;,x•r 5,; ,' M .il tM1; ll � . it-- -j uY L 1 � r r 1 • r] { d L, . ! . 5! ,� ✓ .I h' � ll } ' . ' 7 ' 5 3q— ' �'. o- ? i L u . Number of stories: ,E �rW . .®:._ ati, ..L..s.:�•..s,;ms::t.h.�,r' `r.. .••'��i• '�. w,as:i a ^T"""r $� °' °.Sy;: Name: PacTrust Type of construction: . it . A /( ` Address: .15350 SW Sequoia Pkwy. , Suite 300 Occupancy groups: City/ State/ZIP: Portland, OR 97224 . Existing: •1: Phone' (503 )624 - 6300 Fax ( 503 ) 624- New: a, l4/1.12---- � �? '�� �,,�i � ,mac � � . F ��"s,4. PY"•F� tti` a', � iL ' 'D f t W` . r -d � „� i . 1 . : '••, - w 11 ; 1� 5 5 1 E t .,�, a : v¢ 1 ,- a t !' ° tr: i.: Lr a 1 '.�.� � ;. +�^1a 1.: , 1 r+ ,: p Jy '.I�` � a i I : G �. �9 H,- t���� �YLt�ww�r.- �'i� - - �se�+'e_L .�n.r� •m r C' 1 .,,�- .�I .. � �� "?i: �'� tye.. ,.�.. ..ai!`.Ir,.L_ rw�r.��iwn....::�: �,1.i ri".I . An �7� w•R:C.s rf: �rl Business name; PacTrust All contractors and subcontractors are required to be • Contact name licensed with the Oregon Construction Contrac tors Board under ORS 701 and maybe 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 Phone: (503.) 624 -6300 I Fax: : (503) 624 -7755 E-mail: 1, 4 r�Gl�,a ` 7 7 x - ilir } Ail ' 1 far 9 r M'! ( l C � 7.1e rJ a 1' µ15 4',,A41 ,Veq G ,tii M 11=1.v ..' uC .vrt' -'r ..i.i l ' `,F.r! . .- `,1 ritli,., ..r 404.1,} -1 r1s t ro 5 , ,0 1 Business name. Matthew Olson Construction-.- f J :t6 � i,! Address: 5320 SW Dover Lane Please refer to fee schedule. City/ State/ZIP: Portland, OR 97225 [ / � � 1 Fees due upon application O . Phone: ( 50g1 892 -0066 Fax: ( 503 892 -0067 Amount received CO3 lic.: 66070 • 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 name: ALA bA ✓¢'r, HA, tis ,.. I Date: 7//) S * Fee methodology set by Tri•County Building industry Service Board. c CITA"- OF TIGARD • BUILDING DIVISION PERMIT #: 13UP2005 00359 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/28/2005 Phone: (503) 639-4171 I C I Inspection Requests (24 Hrs.): (503) 639 -4175 .......� `- INSPECTION WORKSHEET FOR DATE: 9/28/2005 TIME: 7:OBAM PAGE: 79 SITE ADDRESS: CLASS OF WORK: SUBDIVISION: 12909 SW 68TH PKWY 450 LOT #: TYPE OF USE: PROJECT NAME: TIGARD TRIANGLE CENTER DESCRIPTION: TRINITY UNIVERSAL INSURANCE T.I. walls for office space. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE # : 503.892 -0066 Inspection Request Scheduled For: Date: 9/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 016793 -01 5037930552 N Corrections /Comments/ Instructions: ( ,_ i gar -- I 1f/ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL , 1! CALL FOR INSPECTION ❑ ADDITIO L FEES ASSESSED ' E' A f st Inspector: 4. Date: i hone #: (503) 718-