Permit r-
A CITY OF TIGARD
AI BUILDING PERMIT
PERMIT #: BUP2004 -00423
� DEVELOPMENT SERVICES DATE ISSUED: 9/3/2004
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 400
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 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: 2FR : 4,952 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 4,952 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 49 BASEMENT: sf AREA SEP. RATED:
STOR: 5 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: $ 80,000.00
Remarks: New T.I.
Owner: Contractor:
TIGARD TRIANGLE I LLC R & H CONSTRUCTION
4650 SW MACADAM AVE STE 220 1530 SW TAYLOR
PORTLAND, OR 97201 PORTLAND, OR 97219
Phone:
Phone: 503 - 228 -7177
Reg #: LIC 38304
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 9/3/2004 $634.90 Electrical Permit Required
TAX 8% State Surchari 9/3/2004 $50.79 Fire Alarm Permit Required
[TAX] ! Plumbing Permit Required
[BUPPLN] Pln Rv 9/3/2004 $412.69 Framing Insp
[FLS] FLS Pln Rv 9/3/2004 $253.96 Gyp Board Insp
Total $1,352.34
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: , _
Permittee /�
Signature: j , .. - A W .
7 ,1r 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Appli( V / � FOR OFFICE USE ONLY
City of Tigard Received n 3_ Y
Date/By: 7 Permit No.: 1„ pd t -ed y
13125 SW Hall Blvd., Tigard, OR 97223 V; r',,', r ,,r. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 tii. ' � '- 1 ) �� "no'�IplM ` ii�� Date/By: Other Permit:
Inspection Line: 503.639.4175 ■ L j- _I Date Ready/By: Jug ® See Attached Checklist for
Internet: www.ci.tigard.or.us �6Y1 f CL' I',1r A T -� Notified/Method: - S 1 k. ,T Supplemental Information
BUPLO9N9G DIVISION
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
❑ Addition/alteration/replacement I Other,' .. equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION` ; . . work indicated on this application.
❑ 1- and 2- family dwelling [Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
, JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: S O� 1 AO (0% ‘- a -ri oQ 1 New dwelling area: square feet
City/State/ZIP: Ti. U V 0�. � Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: P A T mk i a 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: 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.
TI. r�l t,l l..�Ot� OW ` - Cia_. (L ae EA IS - r - fA i Valuation: $ g 0 do
.1?-ubEi. Existing building'area: square feet
New building area: square feet
PROPERTY OWNER • . ❑ TENANT Number of stories: "°
Name: T , clay -Lt_ `_ r�� Type of construction: Li — f 2
Address: (j? - SU) l.Jl O ?a, ,t.Wq-A - Occupancy groups:
City/ State/ZIP: ( 0 Y &L...., Existing:
Phone: ( ) Fax: ( ) New:
3
❑ APPLICANT 0 CONTACT PERSON . .
NOTICE:' �; '�"
Business name: � 4..( 0 S.yI,I.Ci.; on All contractors and subcontractors are required to be
Contact name: \ n 11 uvA t ,l/1i licensed with the Oregon Construction Contractors Board
""'■ "` under ORS 701 and may be required to be licensed in the
Address: 1 6--c A ) -I- for jurisdiction in which work is being performed. If the
City/ State/ZIP: Po r.iiriincA a a'l t � applicant is exempt from licensing, the following reasons
apply:
Phone: ( )34 --'.,S-7 (7 7 Fax: : as ) as c f - 3(03$
E -mail: 21 VI t Ue,r1Y-Ct,e ® %eh CCYLSt. (,.( l
CONTRACTOR'
Business name: e t - - t o wsiir pr`{ d^ BUILDING PERM FEES*
Address: 57y6 Elk) �1� l
1 ` v' , 1 .
City/ State/ZIP:
,e6 144 � —"— q 7 �- Please refer to fee schedule.
'- )%. 7 / 7 7 ) a 1L L„340 Fees due e ce i application
Phone: (
u Fa x: v`f
cat lic.: 3�3 6 Amount received
Date received:
Authorized signature: Th permit application expires if a permit is not obtained
L within 180 days after it has been accepted as complete.
Print name: /l ��d.? Date: , /J/Y ! *Fee methodology set by Tri- County Building Industry
6 `�f Service Board.
i:l Building \Pennits\BUP- PermitApp,doc 12/03 440- 4613T(11 /02ICOM/WEB)
Building Division
'' H� * � i. Plan Submittal Requirement Matrix
` C ommercial & Multi- Family - New, Additions or Alterations
City of Tigard
Type of Submittal # of Plans
(Includes new, a dditions 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 n"
BUILDING Inspection Line: .iO3) 639 -4175 M 1 rl GS '
(5
INSPECTION DIVISION Business Line: - 3) 639 -4171 �(
Cr 070 - DO
Received Date Requested /6 _� 9 AM PM BUP
Location 1 a, 2- I 6 8'- PK , -c ) 4 Suite Ve MEC
Contact Person Ph ( ) 7 5 -, C 1- 1<0 . 0 PLM
Contractor Ph ( ) SWR
U Tenant/Owner A CS-c�?0 `TEA- , ELC
Foo
ELC
Foundation Access: c/�_ oo h q / 3 i ( 32
Ftg Drain G�/l 0.1��" ELR
Crawl Drain t,,, aoo q- bolo 4 t
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear A g , S ' " _" S $
Framing ,
, EG _ 06 , l ‘ ( ' ),4-
lnsulation °-- ..! ■ \ US
Drywall Nailing _ •
Firewall 0 L(Z zeaLl - no 2Gt l L- 1k O'
Fire Sprinkler L_ I
Fire Alarm 1' Eta_ y --2, t 4 _ D7j 3 C V 01' c_e_/ 0
Susp'd Ceiling
Roof n Ea, t2 ZQV 4 — Lid 3 1 C'7z. -- V of Ge 6...-A JO
Other:
- ART FAIL
4 • :ING
Pest & Beam ` 6N)- 1 V _ (9-1P---` ` c • c.
Under Slab 1
Rough -In It
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain / •
Shower Pan
Other: •
Final
PASS PART FAIL . .
MECHANICAL 01 '
Post & Beam ,..,
4.
Rough -In :,
Gas Line ,;,,``
Smoke Dampers ,
-0`
Final .,,
PASS PART FAIL
ELECTRICAL •
Service
Rough -In
,UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line ADA Date o/ 1 G 70 y Inspector \ A-- 2 Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL