Permit , ,
, ,
.1' ,, BUILDING PERMIT
CITY O F T I GA R D PERMIT #: BUP2004 -00524
1��; DEVELOPMENT SERVICES DATE ISSUED: 11/4/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -00200
SITE ADDRESS: 15618 SW 72ND AVE
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B 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: $ 42,000.00
Remarks: Renovation of existing space, H.C. upgrades.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ROBERT EVANS
15350 SW SEQUOIA PKWY #300 -WMI 1200 NE 48TH AVE. STE 1250
PORTLAND, OR 97224 HILLSBORO, OR 97124 •
Phone:
Phone: 503 - 648 -7805
Reg #: LIC 14426
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 11/4/2004 $410.80 Electrical Permit Required
[TAX] 8% State Surcharl 11/4/2004 $32.86 P Permit Required
Plumbing Permit Required
[BUPPLN] PIn Rv 11/4/2004 $267.02 Framing Insp
[FLS] FLS Pln Rv 11/4/2004 $164.32 Gyp Board Insp
Total $$75.00 Susp Ceilng Insp
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: /1 LT..? C. f�'
Permittee
Signature: LQ ..e , p \i m: ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
/ I
' ,
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Dot ` y /j - y y / Permit No. a,,,?2w -05:22V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 //^ +' a .. ti D iy 3 Other Permit:
Inspection Line: 503.639.4175 � � Date Ready y: Jury: � ®See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: 'L Supplemental Information
TYPE OF WORK - REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction 0 Demolition
Permit fees* are based on the value of the work perforated.
Indicate the value (rounded to the nearest dollar) of all
P Addition/alteration/replacement ❑ Other: equipment, materials, apl als, labor, overhead, and the profit for the
-CATEGORY 01? CONSTRUCTION. work indicated o this application.
i
:
❑ 1- and 2- family dwelling ,Commercial/industrial
❑ Accessory building
❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: • JOB SITE INFORMATION . AND LOCATION Total number of floors:
5�,� se 7
Job site address: / 27/0 A lj,� New dwelling area: square feet
City/ State/ZIP: 77/01p/W2, D� T ?j 4' Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: it2e.e � //€ y Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
• REQUIRED DATArCOMMERCIAL -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.
Valuation: $ w�
/ 1;4 /O.V �� /5 /�46 -c / '
Existing building area: square feet
New building area: square feet
'4"
[ii pkoogof OWNER - 0 TENANT
Number of stories:
Name: PacTrust Type of construction: 14-
Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups:
City/ State/ZIP: Portland, OR 97224 Existing: j el S�,?._
Phone: (503 ) 624 -6300 Fax: (503 ) 624 -7755 New: 4 /' _. 7.
® 'APPLICANT '" ❑ CONTACT PERSON':. NOTICE •
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: ,2:50.4,4/As- /12�pJ/' licensed with the Oregon Construction Contractors Board
6 under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: Portland, OR 97224 apply:
Phone: ( 503) 624 -6300 1 Fax:: (503) 624 -7755
E -mail:
. CONTRACTOR
Business name: Robert Evans Co., Inc. '. ' , BUILDING PERMIT FEES*
Address: 1200 NE 48th Ave., Suite 1250 Please refer to fee schedule.
City/State/ZIP: Hillsboro, OR 97124 Fees due upon application
Phone: ( 503) 648 -7805 Fax: ( 503) 648 -5883
Amount received
CCB lic.: 14426
• Date received
Authorized signature: / T his permit a pplication expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: \ � y /% �l7 f D ate: `/ -� •Fee methodology set by Tri-County Building Industry
`// Service Board.
is\ Building \Permits\BUP- PermitAPP.doc 12/03 440- 4613T(11 /02/COM/WEB)
A
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP Roo
Received Date Requested / 5 AM PM S u '-
Location / sCeo i la (414' Suite MEC
Contact Person � Ph ( ) c � �-3 - 7/ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fireyvaq
Fire Alarm
Susp'd Ceiling gir,
Roof
Other:
0" PART FAIL
= ING
• - Beam w.
Under Slab
Rough -In
0.1
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 $ r = . u' ed be ore next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL -
SITE Please II for rein ection RE: —�; El Unable to inspect — no access
Fire Supply Line ��
Approach/Sidewalk P
ADA D ate t G i✓ ✓ Ins Iii Ext
Other:
Final DO NOT REMOVE this Inspe Ion record from the job alts.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested l — / AM, PM BUP
Location l 5 1 0 7 ( 9 j Suite MEC
Contact Person Ph ( ) A %' 7 4- S PLM 06 £/ s3/
Contractor Ph ( ) SWR
BUILDING Tenant/Owner A.,C ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: 1,. SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
r
Insulation '
Drywall Nailing
Firewall /11
��
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In •
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
I2 ART FAIL
' CHANICAL
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 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line „ .
ADA �I ! Y /
Approach/Sidewalk Date G
' Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL