Permit •
is BUILDING PERMIT
CITY T PERMIT #: BUP2005 -00595
A DEVELOPMENT SERVICES DATE ISSUED: 11/8/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 460 ZONING: MUE
SUBDIVISION: TRIANGLE CORPORATE PARK LOT: 002 JURISDICTION: TIG
Project Description: TI
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 : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 147 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: $ 3,540.00
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
FEES Reg #: LIC 38304
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/8/2005 $81.70
[TAX] 8% State Surchan 11/8/2005 $6.54
[BUPPLN] Pln Rv 11/8/2005 $53.11
[FLS] FLS Pln Rv 11/8/2005 $32.68
Total $174.03
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 start- • ' 1 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
req • -s you to folio the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through 0.' °,952- 001 -0100. You may obtain a copy of these rules or : qu • • to OUNC by
c Iling 503 - 246 -6699 o ‘:' i 332 -2344
y: �� Lt ��
I ued B
Permittee Signature: 4 , , '‘
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 am required on the job site at the time of each inspection.
RECEIVED
Building Permit Anblicatilon rc)li orrici.: list: Om_)
City of Tigard NOV $ 2005 DaeB 0 No S TI' Permit No.: ! , • -� '
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGAR il /F9••� ,,'�' DateB
her Permit:
Inspection Line: 503.639.4175 t_Il I I' Date Ready/By: ® See Attached Checklist for
Internet: www.ci.tigard.or.us BUILDING DIVI 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
Addition /alteration/replacement 0 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 LOCA ION Total number of floors:
Job site address: /3 7 2 ) ! S5" & /Lk New dwelling area: square feet
City / State/ZIP: — 4 4' 1700 3 Garage /carport area: square feet
Suite/bldg. /apt. no.:.S 119 F Project name: j4_oeyk/ 4.4 Covered porch area: square feet
Cross street/directions to job site: -) Deck area: square feet
ljt Ali 2. / -7 /-& 1-11, i e.1 h / u/&i, Other structure area: square feet
r / A 04. le ',erLp, (! 7€ z // I REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees' are based on the value of the work performed.
Tax map/parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK " work indicated on this application.
A--6( Z /JO/IZ5 ,,,/, 6/;€". A/ tleS Valuation: $ 3 5- yo
Existing building area: 11 a13 square feet
New building area: square feet
PROPERTY OWNER l ❑ TENANT Number of stories: - ��`�
Name:
)211 (N e) p- c Type of construction: a F/2.
Address: Occupancy groups:
h. ife7
City / State/ZIP: Existing:
Phone:( ) Fax:( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: ,t 1--/ C� / 1 p) 47> u 0 r (d 0 All contractors and subcontractors are required to be
Contact name: `/M / 9 F .�p . , ' 'A /1AA n with the red to C Board
�''"' under r O 012S 701 and d may ay be a required to be e l lice icenssed ed in the
Address: i S 4(//ii,1
10 . /.� Tet N ( s •-1-- / u u jurisdiction in which work is being performed. If the
City /State/ZIP: 1)00)-- 0 a ` t applicant is exempt from licensing, the following reasons
,, apply:
Phone: (5-0 �7�ff i 7 I Fax:: ) 7 2 3 6 / 3 f
E -mail: ` PAA.- L ® 1 C 01.1 5-1- • c "vv..
CONTRA TOR
Business name:
BUILDING PERMIT FEES*
Address: A A pdv Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) I Fax: ( ) e 'Prilit-
Amount received
CCB tic.:
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: Date: * Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \PennintBUP- TI- PennitApp.doc 12/03 4404613T(11/02JCOMMEB)
•
Building Division
I ;' 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.
is\ Building \Permib\BUP- TI- PennitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
CITY OF MARP , - _
BUILDING DIVISIOfiI PERMIT #:I3 -D OS — D (2 595 —
13125 SW Hall Blvd., Tigard, OR 97223 DA TE ISSUED:
Phone: (503) 639 -4171
A �
Inspection Requests (24 Hrs.): (503) 639 -4175 R'I�
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 ajX21 670 (2 Ki/NR-i S #4 0 CLASS OF WORK:
SUBDIVISION: LOT #: Bt TYPE OF USE:
PROJECT NAME:
DESCRIPTION: j ¢
OWNER: m PHONE t ��G 72 TW r" 1
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 4 -- `T - 0 ceg Pour Time:
0 7ode # Inspection Description Confirm # Contact # Message
7C4°)/ PNPa 0 AVM; I-
Corrections/Comments/Instructions:
1 y
TN -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \4 Date: 0/ Phone #: (503) 718-