Permit ' ,' dITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00126
� � DEVELOPMENT SERVICES DATE ISSUED: 3/20/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 261 / 0 0
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 : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 0 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: # 700-00
Remarks: First Floor: Divide (1) room into (2) rooms. (Server and storage room)
Owner: Contractor:
TIGARD TRIANGLE I LLC R + H CONSTRUCTION
4650 SW MACADAM AVE STE 220 1530 SW TAYLOR
PORTLAND, OR 97201 PORTLAND, OR 97205
Phone:
Phone: 228 -7177
Reg #: MET 00001106
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[TAX] 8% State Tax 3/20/03 $5.00 Framing Insp
[BUPPLN] Pln Rv 3/20/03 $40.63 Gyp Board Insp
Final Inspection
[FLS] FLS Pln Rv 3/20/03 $25.00
[BUILD] Permit Fee 3/20/03 $62.50
Total $133.13
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. leiliz/ti Issued By:
Pennittee �
Signature: /Q (
Call .39 -4175 by p.m. for an inspection the next business day
• • •1
Building Permit Application t >1' IC1; UST? ( >NLY
t J I City of Tigard Date received' _� _� Permit no.: /0-3 —Q'7/ b Project/appl. no.: Expire date:
• City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: ► 10 Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE: OF PERMIT
0 1 & 2 family dwelling or accessory 0 CommerciaUindustrial 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration /replacement enant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: 1 3 21,..% S W - ,, -J-L Bldg. no.: Suite no.: ' - • 1
Lot: Block: Subdivision: Tax map /tax lot/account no.: 5101 p , r • 1
Project name: _ . _ Jr- ► u , i ✓ r • Bp w =I'
Description and location of work on premises /special conditions: 4-Cc— NM lit) O
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
_r r. D6't4 - r r_ SA ( Flood pla in, scpticcapacity, solar, etc.)
Mailing ad • ress: v • ,, f . 5 , I 1 & 2 family dwelling:
IEN p12Y(, _ _ r Valuation of work $
Phone: ZZ - , P • ' , n E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: ePCN ' (�/11, Covered porch area (sq. ft.)
Mailing address: 5 _ L. i frini Deck area (sq. ft.)
EErp al ZIP: 1 5- Other structure area (sq. ft.)
Phone ,�, . cr. b • lh�� o ' ' Commercial /industri f am il y: _ w
CONI RA(: FOR Valuation of work $ :S-
Business name: Existing bldg. area (sq. ft.)
B
• ! a•� - New bldg. area (sq. ft.)
Address: ., r 2
_ Number of stories
! PW ��7 ®, �TA ��� r Type of construction
A Phone: r - r�S . fati E - mail:
no.: d eiL•IIIMIIIIIMIIIII
Occupancy group(s): Existing:
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIf1E(°i' /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: . 4.2,_ j 1y provisions of ORS 701 and may be required to be licensed in the
Address: d • if S r► , . (LO 41IMEIMI jurisdiction where work is being performed. If the applicant is
ZIP: Z %' exempt from licensing, the following reason applies:
Contact person: `g j h . , z , /0 Plan no.:
Phone: 22L{ 1sip Fax: Zn,• /Z, E -mail:
ENGINEER OFFICE USE ONLY
IMEMIM IIIII Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: • Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisio of s and ordinances governing this Cl Visa ❑ MasterCard
work will be complied with er ecified herein or not. credit card number: / /
3 r 9 ` E
Authorized signature: r "Date: / Name of cardholder as shown on credit card
$
Print name: �r C.L 'Z W Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business (503) 639 -4171 MST
�51-a' BUP 3- od / oZt!p
Received Date Requested `� / ' — 7° AM f' @�P T
Location f 3? 1 �o � - pK Suite _a;4gE Vp14Wg 15 2---
Contact Person ( ) $1 - IS 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC • Access:
Ftg Drain ELR
Crawl Drain
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
Other:
ma
ASS PART FAIL
PLUMBING
Post & 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
UG/Slab
Low Voltage
Fire Alarm
Final ❑ 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: ❑ Unable to inspect — no access
Fire Supply Line
ADA / c( /0 3 Inspector Ext
Approach/Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART . FAIL