Permit A DEVELOPMENT SERVICES CITYOFTIGARD
I BUILDING PERMIT
PERMIT #: BUP2003 -00567
A I DATE ISSUED: 9/18/03
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112DC -00100
SITE ADDRESS: 15605 SW 72ND AVE
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 5.380 sf N: S: E: W:
TYPE OF USE: COM SECOND: 4,759 sf PROJECT OPENINGS?
TYPE OF CONST: 5N TOTAL : 10,139 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 20,278 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 83 BASEMENT: sf AREA SEP. RATED:
STOR: 2 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: $ 99,600.00
Remarks: TI
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300
TIGARD, OR 97224
Phone:
Phone: 624 -7717
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 9/18/03 $744.30 Electrical Permit Required
[TAX] 8% State Tax 9/18/03 $59.54 Plumbing Permit Required
BUPPLN Pln Rv 9/18/03 $483.80 Framing Insp
[BUPPLN] Gyp Board Insp
[FLS] FLS Pln Rv 9/18/03 $297.72 Final Inspection
Total $1,585.36
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: _ �� _ - i
Pe rm ittee i
Signature: 1l //✓/ A7 IV �
i
Call 639 -4175 by 7 p.m. for an inspection the next busines ; -
•
A . T iildiigPermitApplicati®n = - = .
r Datereceivedi8 0 ...__. o • -
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Project/appl.no.: Expire date:
City ofTigand Phone: (503) 6394171 7:n
' Date issued B Receipt no.:
Fax: (503) 598 -1960
- . *-: ,' , - Case file no.: Payment type:
Land use. aPPmvall .) N e i. ^ 1&2 family: Simple Complex: �i4?,� 7�G y: ,mp mp , .
TYPE OF PERMIT
01 & 2 family dwelling or accessory 0 • mmercial/mdustrial 0 Multi- family 0 New construction 0 Demolition
O. Addition/alteration /replacement P. Tenant improvement 0 Fire sprinkledalazm 0 Other.
JOB SITE INFORMATION .
Job address: /$& , rr 7, 1 • T._ Bldg. no.: Suite no.:
Lot I Block: (Subdivision: Tax map/tax lot/account no.:
Project name: Vi/��= T1,/iX -W
Descri • tion d 1 n .f work on pre t, ' special conditions: / / /
• OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: PacTrust - ( Floodplain , septic capacity. solar, etc.)
Mailing address: 15350 SW Sequoia Pkwy. , #300 1 2. family dwelling: _
City: Port l and . I state: OR .IZ>P: 97224 Valuation of work $
503 Phone:562 4 63 00 01 Fax6 4 =-7.'/ 5 4E -mail: No. of bedrooms/baths ..
Owner's representative: De n n i s P a g n i Total number of floors
• Phone: Same Fax:- . u e E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: PacTrust • . . Covered porch area (sq. ft)
Mailing address:15350 SW S e u o i a Pkwy. , #300 Deck area (s q' �)
City: Portl and 1 state: O R I UP; 97224 Omer S0°rcture area (sq. ft.)
503 Phone:6 24- 6300 Fax6 24 - 7 7 5 E-mail: Commercial/industrial/multi
CONTRACTOR Valuation of work $ '0 ,..„(.„)....,
Existing bldg. area (sq. ft.) Ansee $r
Business name: H . L . Green
New bldg. area (sq. ft)
Address: 15 350 SW Se s uoi a Pkwy. , #300
City: Port and state: I R ZIP: 97224 ' Number of stones
503 i Phone624-7717 I Fax: I E -mail:
Type of construction PAr
CCB no.: 41328
Occupancy group(s): Existing: 4
New: .:
City/metro lic. no.: •
Notice: All contractors and subcontract:: are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Boaid under
Name: John R o m i sh provisions of ORS 701 and may be required to be licensed in the
Address: 1 5 3 5 0 SW Sequoia Pkwy . #300
jurisdiction where work is being performed. If the applicant is
City: Portl and l State: 0 R IZ1P:9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
503) Phone:624 -6300 Fax:624 -775 ' E mail: . ohnr@ , act . ust I ' . com
ENGINEER
Name: . Contact person: Fees due upon application $ '
Address: - Date received:
City: IState: (ZIP:. Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not as juria 5ctiom accept cre cards. please call juriscliction far more information.
attached checklist. All provisions of laws and ordinances goveming this 0 visa 0 MasterCard
work will be complied with, whether _ s • . . herein • not. Credit card number: ./ Ex
Authorized si : • , g�1111/%�'Ii /zi % 5.. 1//1g - Name of cardholder as shown on credit card p
.., :• �.. i . ..- "
$
Print name:
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 (6A0ACOM)
CITY OF TIGARD 24 -Hour .
BUILDING-- . _---- Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
C:103 C�
/�/ pos.- — O 7
Received ' �9 0 9; 0 9 Date Requested ///f 7/0 3 AM PM BUP
Location / 75 D �S 7 2`'` /L' Suite MEC
1 Contact Person �(3 )-� Ph ( ) 30 7 — C�� PLM
Contractor cSS �'�%(1-f Ph ( ) ! 2f) eV6 D 1 SWR
BUILDING Tenant/Owner r? e • f? u Pa-ln (< ELC
Footing ELC
Foundation A ccess:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
1 Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•._ •
'd'' PART FAIL
PL BING
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
Approach/Sidewalk Date /1/7/0 ✓ Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL