Permit _ CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00119
�.r,�� DEVELOPMENT SERVICES DATE ISSUED: 3/13/03
s 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
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: : 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: $ 9,200.00
Remarks: Add interior wall with door and relite, acoustic wall furring and airline drop.
Owner: Contractor:
PACIFIC REALTY ASSOCIAT HOWARD S WRIGHT CONSTRUCTION
15350 SW SEQUOIA PKWY #300 425 NW 10TH AVENUE #200
TIGARD, OR 97224 PORTLAND, OR 97209
Phone:
Phone: 220 -0895
Reg #: LIC 89229 0�22
FEES MET REQU INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 3/13/03 $139.30 Gyp Board Insp
[TAX] 8% State Tax 3/13/03 $11.14
Final Inspection
[BUPPLN] Pln Rv 3/13/03 $90.55
[FLS] FLS Pln Rv 3/13/03 $55.72
Total $296.71
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: /; ; � , d_�1� szL/
Pe rm ittee
Signature: - / ��� /c
C .-.--- --
II 639 -4175 by 7 p.m. for an inspection the next business day
Pr
Building Permit Application
Datereceived: '?j '' IS 'O Permit no.: l3 (�- `J /��
�.- �. iit City of Tigard
!>� Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: 1J lk 1 &2 family: Simple Complex:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration/replacement 5 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: SW 72nd Avenue S 70 - Bldg. no.: N A Suite no.: N A
Lot: 100 Block: Subdivision: Tax map /tax lot/account no.:
Project name: DC Golf Ball Lab - AJI ic. 601,1`
Description and location of work on premises/special conditions: Addition of new interior wa 11 wi th door and re1 i t e
Addition of acoustic wall furring and airline drop. Demolition of wall for new relite.
0wNER FOR SPECIAL INFOR19A17ON, USE CHECKLIST
Name: ' Ac..1 7-U (Floodplain, septic capacity, solar, etc.)
Mailing address: a w . -..r_ • * ' ci,J 1 & 2 family dwelling:
11311123ra ZIP• Z Valuation of work $
Phone: , _ . ._. ffiffrAtiggingr, No. of bedrooms/baths
Owner's representative: v . , tN s ft _ Total number of floors
Phone: _ _• . Fax: E -mail: New dwelling area (sq. ft.)
•
APPLICANT Garage/carport area (sq. ft.)
Covered porch area (sq. ft.)
Name: Nike Deck area (sq. ft.)
Mailing address: One Bowerman Drive
City: Beaverton State: OR ZIP: 97005 Other structure area (sq. ft.)
Phone: 1 .671.280• Fax: 503.641. 88611: N/A Commercial/industriaumalti- family:
CONTRACTOR Valuation of work $ 9 6
Business name: Howard S. Wri•ht Construction Existing bldg. area (sq. ft.) 121 ,035 sq_
Address: 425 NW 10th Avenue New bldg. area (sq. ft.) N/A
City: Portland OR 97204 Number of stones 1
State: ZIP:
503.220 . , = N A Type of construction V -N
Phone503.220.089
Fax' `' 1: Occupancy group(s): Existing: 8, F-1, S -1
CCB no.:89229 New: B, F -1 , S -1
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIrrLcunl :SIGNI• :It licensed with the Oregon Construction Contractors Board under
Name: Ralston Architects provisions of ORS 701 and may be required to be licensed in the
Address: 15256 NW Greenbrier Parkwa jurisdiction where work is being performed. If the applicant is
City: Beaverton State:OR ZIP: 97006 exempt from licensing, the following reason applies:
Contact person: Erich - • Plan no.: 1 1.1 ° /6.` .--
Phone: 503.531 .949 t ax: 503.617 .'iB -1 il: N/A x ii . i
INGINEI:R
Name: N A Contact person: Fees due upon application F $ - • ;--
Address: Date received:
City: State: ZIP: Amount received $ 3 9 LF ' 1 I
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 provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with whether specified herein or not. credit card number: ex ire
P
Authorized signature: Date: 3' /3 '!f 3 Name of cardholder as shown on credit card
• $
Print name 6:12-1C- S 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 (6I00/COM)
714
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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).
TYPE OF SUBMITTAL Total # of
(Includes New, Additions or Plans
Alterations). Submitted
•
Site Work (must include location of 4
all accessible parking)
•
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
*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 \dsts \forms \COM- matrix.doc 9/4/01
CITY OF TIGARD 24 -Hour y _
BUILI>RNG Inspection Line: (503) 75 MST
INSPECTION DIVISION Business Line: (503
BUP 3 -ero/I t g
Received Date Requested 3 °Z/ AM PM BUP
Location RS 7 6. 7 a' ' Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ) _ Q / SWR
'
BUILDING Tenant/Owner a�� Q ELC
Footing Q
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: � � � � 4.-v‘ �) SIT
Post & Beam
Shear Anchors WV t 631 5 "?2,
Ext Sheath/Shear /T V
Int Sheath/Shear
Framing
Insulation
r.
Firewa
Fire Sprinkler ta l '
Fire Alarm � `
Susp'd Ceiling
Roof
Other: •
Fin- •
PART FAIL
• g MBING
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 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
Approach/Sidewalk Date '�l Z v Inspector \' -
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour . i ii
- BI 1LI}QNG' ; Inspection -Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 T
BUP 3 -o6- iI q
Received Date Requested 3 - °Zo AM 9 PM . BUP
Location / 5 70 tit 7a Suite MEC ,_
Contact Person 49__e_...- Ph ( ) ,m, ' e Nis' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain - ELR
Crawl Drain
Slab Inspection Notes:
Post & Beam L ' .1 --- — V 4–f- e I SIT
Shear Anchors T 1
Ext Sheath/Shear
Int S al ath/Shear \ S) tt--c a Lc----
Insulation
Drywall Nailing 1 4
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling • Roof
Other: ( o � � � 6 ' 5 � 0 O \ � ?�-- .--
Final , C j -% .-- \ — AAA_ c-�— - k � .. __
PASS FAIL _
PLUMBING \/V C-2i► k �M ) ,
Post & Beam 4. C
Under Slab dC
Water Service
Rough -In 1 , h (/V`-� 5CAr-�tA.7S
) `— .
Sanitary Sewer c- ,.s_ck �-e t_e_
Rain Drains
Catch Basin / Manhole o
Storm Drain -
Shower Pan �P ' �/
Other: 1 e��' � tSL_/v2—e�� ' c--.4" ��
Final
PASS PART FAIL ■
MECHANICAL _ a . r f
Post & Beam Ili, � ° Y mulairtsef d
Rough -In Va.
Gas Line
Smoke Dampers
Final N. -4._I — 00 / 3
PASS PART FAIL y�l
ELECTRICAL ` ► CJL -�-r1∎ - t - ) k c ( 7 G -
Service k/h ,� l -15 Rough -In - (
UG/Slab ,
Low Voltage
Fire Alarm
Final El 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: El Unable to inspect - no access
Fire Supply Line • a
ADA
1
Approach/Sidewalk Date �� I nspector `' Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL