Permit r
C ITY OF TIGARD � � BUILDING PERMIT
PERMIT #: BUP2005 -00035
�� DEVELOPMENT SERVICES DATE ISSUED: 2/2/2005
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S101AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 450
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: 89 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: $ 8,200.00
Remarks: New T.I.
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
Reg #: LIC 66070
FEES REQUIRED INSPECTIONS -
Description Date Amount Framing
[BUILD] Permit Fee 2/2/2005 $129.70 Final inspection
[TAX] 8% State Surcharl 2/2/2005 $10.38
[BUPPLN] Pln Rv 2/2/2005 $84.31
[FLS] FLS Pln Rv 2/2/2005 $51.88
Total $276.27
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: . /s-
Permittee
Signature: _ _ _
Call 639 -4175 by 7 p.m. for an inspection the next business day
. • „ib
... .
Buildkg Permit Applicatiw_ FOR OFFICE USE ONLY
City of C
SW Hall gar Blvd
Received 9 ....e ,,
13125 ., Tigard, OR 97 3C) " 4 V) ,* Plan Review Vi ej l?4-. ( Other Permit:
Phone: 503.639.4171 Fax: 503. • : ',.. 1 V ctt • . .,'• Date/By:
Inspection Line: 503.639.4175 `. , - ''' '
Date Ready/By: n Juris: El See Attached Checklist for
Internet: www.citigard.or.us '...._ ....
K N\ ‘ Notified/Method: Supplemental Information
C .<, '9
1 11'44)ii'1;1■1'.alt ::,...o.N!..! .izu tiATA.vAND 2-FAMILY DWELLING
0 Ny....construction I emolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
kddition/alteration/replacement 4 R7 0 Other: equipment, materials, labor, overhead, and the profit for the
0:4:144.00.a111§,91.41drit6tigiraire8kmiiiiiiii.W.'MAM014.04,141.20:k.:1,; work indicated on this application.
0 1- and 2-family dwelling d36Mmercial/industrial Valuation: $
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
hir,,tikookisotawitrisiema,4,,,Iww.,T10240 ,,,,..rocikegy.g..4111,041,,91:441,g,,i;u1:.si,,u1 Total number of floors:
[Y'-!,..0,44. igh;-t.,,,.. 1 4..,,,MqMar,krtose01 , 100; 0 e
Job site address: /gf. 0 q 5 6eitt, p", b L. "..y # f5r, New dwelling area: square feet
City/State/71P: p f p t O Oit q7 2-
1 Garage/carport area: square feet
Suite/bIdgJapt. no.: I Project name: Covered porch area: square feet
Cross greet/directions to job site: Deck area: square feet
Other structure area: square feet
.44-e ,
Subdivision: I 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
iliyrlagR*StnlgtttVrgftp4"'PUAV,raitie..,arritra,;r.IR,itr:,.i.rt;rISI work indicated on this application.
, , ,, 4 I'M ""g!,,,,'ITAIWPf---411.:-Y,X, ttip , . ,■,e , „ ;$ 140, 6+1,„i ,t i.,
Valuation: $ r
00. 00
I hie roe yowl t , dial ((Kt (44e s (414L a
-
( Existing building area: 4' 0117 square feet
tt ,»' • M woe- e,t / frptzrit_044, c lig'
k 04- . S PerktA t .. CO : l ,... A le" New building area: kile square feet
'.f,:•,.,/tp, 1."--! .44 441erns., :i....' rgepirt:444 •
Number of stories: e. 5 r
, . , ..,, imam., ,' 113114 . "+, C 1 ,,r,i, .,•Vir.A. .410E4 .P.114 MICI '', 1 Ii1R4:4,, h '''7.4141.
Name: PacTrust Type of construction: fl / . /..1.4 1
(1
rY" ."
Addre 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing: $
Phone: (503 )624-6300 Fax: (503 ) 624- New: 0
i - 11 4?- , ;•2 5 1 1 7 41 4 Mtfc . ,''.-.'-'', 1 7 . 1, 111_ , i .., . ,.. - . ,, , ,.,,, .. . , .- , l' t I; ,..Y.3i4Y :11 ' ' 4- r.iii , 4` , 1 , .. ,. .4 . ' . 4 r .: ...' • •
Business flan= PacTrust All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: 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. lithe
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:
p5v.a.wkio.tiover . , 47 " ,,,. ra-0 KlaMei, ■,_ ,a:rt , . • _,. A: ' ..,,
Business name: Matthew Olson Construction 140 . • -
son di.4,•:40:11,;:!z:,t116,.,:r;•.c....,tviv.,:;,,,,...,.. .
Address: 5320 SW Dover Lane .Please refer to fee schedule.
City/State/ZIP: Portland, OR 97225
Fees due upon application
Phone: ( 503 892-0066 Fax: ( 503 892-0067 _
Arnount received
CB lie.: 66070 .en/ c/ - .2_.) --
0
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print name: I1A 4. t • .
e .. i ie'r Aen.SDA.1 Date: p_/// 0 5
_ . Fee methodology set by Tri-County Building Industry
Service Board.
i: \13ui1diaseantitsASUP-PerruitAuadoe 12/03 440-4613T(11/02/COMAVEB)
CITY OF TIGARD
BUILDING DIVISION- PERMIT #: BUP2005-00035
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3123/2005 TIME: 7:08AM PAGE: 56
SITE ADDRESS: 12909 SW 68TH PKWY 450 CLASS OF WORK:
SUBDIVISION: TIGARD OFFICE BUILDING LOT #: TYPE OF USE:
PROJECT NAME: TRINITY UNIVERSAL INSURANCE
DESCRIPTION: New T.I.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503-892-0066
Inspection Request Scheduled For: Date: 3/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 002577 -01 503- 307 -2105 N
Corrections/Comments/Instructions:
�R jv/oo G OR &COJox.)5 II AO&
FINve)1
0�- % o 0 0.cu i pr
7_66 5 (4-
6 0-
►: SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6/Z Date: 3 `2-3 !$ Phone #: (503) 718- 2-3 51