Permit CITY OF T I GA R D BUILDING PERMIT
PERMIT #:. BUP2004-00527
e
k DEVELOPMENT SERVICES DATE ISSUED: 12/14/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112AA -00900
SITE ADDRESS: 14160 SW 72ND AVE 125
SUBDIVISION: NELSON BUSINESS CENTER ZONING: I -H
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: 3N sf N: S: E: W:
OCCUPANCY GRP: S1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 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: $ 2,740.00
Remarks: Rack storage
Owner: Contractor:
SPIEKER PROPERTIES LP TENANT PER APPROVAL FROM OWNER
4380 SW MACADAM AVE STE 100
PORTLAND, OR 97201
Phone:
Phone:
Reg #: LIC 00013125
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 11/4/2004 $72.10
[TAX] 8% State Surcharl 11/4/2004 $5.77
[FLS] FLS Pln Rv 11/4/2004 $28.84
[BUPPLN] Pln Rv 11/4/2004 $46.86
Total $153.57
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
952-001-0e II ro•: OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin• 503) 246 -6699 o 1- 800 - 332 -.
Issu - • By: �: 104444211.i
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
4/ .✓ .3 T j / `, `, '
Building Permit Applic G i', � �h FOR OFFICE USE ONLY
) /,JT 04 ,z cvt- "
City Of Tlg�rd / � Date/13 B �M/I 7 Permit No.:i�, /� /=
13125 SW Hall Blvd., Tigard, OR 97223 t ° L c 2 ii l
g u �� � � Plan Review r
Phone: 503.639.4171 Fax: 503.598.1960 " 4 ... ' I Date/B : , / Other Permit:
Inspection Line: 503.639.4175 Crilf O _U l :y - 11 "'m I Date Ready : : ® See Attached Checklist for
Internet: www.ci.tigard.or.us i jUitA N AMINO¶ Notified/Method: r M Supplemental Information
• TYPE OF WORK • • • - ' REQUIRED DATA 1 - 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 'Other: ka , k i f.., &) equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION, work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling j33 Commercial/industrial
El Accessory building 1:1 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
. JOB SITE ' �I I/ NFORMATION AND LOCATION ' Total number of floors:
Job site address: fh46c 1— u(l 7 ' /'-(/ h 0 5 w 72d .11A New dwelling area: square feet
City/State/ZIP: s v r - ho ' .( f ;:( 0 ,4 Q . q 7 2 2_3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: j ie r AA i 11,Apr. y , / Covered porch area: square feet
Cross street/directions to job site: g'e S U✓ e—te S Deck area: square feet
701/7d Q it) don j Other structure area: square feet
REQUIRED DATA: COMMERCIAL- USE
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
n DESCRIPTION OF WORK / work indicated on this application. , /
0 15 a,/S 6 - Cl }ll/@ pa G' / Valuation: $ ;Z 7 7t.vd
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER . • XTENA.NT ` ' ' Number of stories:
Name: ( 61,-A- re.rj 1 Agaiaia, Type of construction:
Address: Occupancy groups:
City / State/ZIP: Existing:
Phone: 55 )65" — (//9... Fax: ( ) New:
DU APPLICANT . - • , ' ❑4CONTACT PERSON ' NOTICE,
Business name: A/0 r /r` / CI -- All contractors and subcontractors are required to be
'' Q licensed with the Oregon Construction Contractors Board
Contact name:
ati( I IA t )- re 1 t. k- under ORS 701 and may be required to be licensed in the
Address: 7 3 73 s.f / f j ; I &var/k, e_ X p jurisdiction in which work is being performed. If the
City/ State/ZIP: f 1 I ®� , a-] Z applicant is exempt from licensing, the following reasons
�U3) c"p 1 — g o tf (5.-v) 6 3 3 1 q b, e„
apply.
Phone: Fax:
E -mail:
. . . - CONTRACTOR •
` // '
Business name: ) i. /1 fe) I g('lo ps/ c r 7 GL e- al ro° 5 . . BUILDING' PERM IT FEES*
Address: / y(
)5' ,e®S e p.,,f)I0 d SI. QO e )L Z - Please refer to fee schedule.
City/ State/ZIP: / a 4 e OS A'er" 0 A 7 00 5 S
p /� Fees due upon application
Phone: ( 9) ) 1 M I 1 Fax: (5 65) 6 ql � 2_
y Amount received
CCB lic.:
Date received:
Authorized signature: 4:__ urn} CThis permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: E � a n Fe r, 1^ L Date: //gi y • Fee methodology set by Tri- County Building Industry
J Service Board.
i:\ Building \Permits\BUP- PemutApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
Building Division
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.
i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03
CITY OF TIGARD 24 -Hour
,-BUDDING Inspection Line: (503) 639 -4175 MST
INSPECTIbN DIVISION Business Line: (503) 639 -4171
Received Date Requested / —� AM PM BUP
Location (j / () 7 oZ 1 Suite ° MEC
Contact Person Ph ( ) 57 7 - 3 O ( ( - 3 PLM
Contracto -•- Ph ( ) SWR
UILDI Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Stab Inspection Notes: SIT
Post & Beam 3 0 / ' Y y •
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
; . •
144.
.ART FAIL
G
Post & Beam
Under Slab ` A .
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 Please II for einspection RE: Unable to inspect — no access
Fire Supply Line 1 tJ ���
ADA
Approach/Sidewalk Date Inspector ` Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL