Permit J:
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00014
,� DEVELOPMENT SERVICES DATE ISSUED: 1/8/03
4a
- II 13125 SW Hall Blvd.. Tinard, 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: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: F1 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: $ 500.00
Remarks: Tenant Improvement - drying room
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRE SYSTEMS WEST INC
15350 SW SEQUOIA PKWY #300 -WMI 600 SE MARITIME AVE #300
PORTLAND, OR 97224 VANCOUVER, WA 98661
Phone:
Phone: 360 - 693 -9906
Reg #: LIC 49732
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 1/8/03 $72.50 Sprinkler Final
[TAX] 8% State Tax 1/8/03 $5.80
Total $78.30
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: /444 , 1# /'
Perm ittee
/.
Signature: t6��% r
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application FOR OFFICE USE ONLY
f7 O Received / 1 !, I e Building ( �
7 Z� 3 / Date/By: 1J 3 Permit N o2�3 ''fl9 / /
City f Tigard J � v Planning Approval Other
Y g an Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960
A. t`i �9 i : Post- Review Land Use
Internet: www.ci.tigard.or.us e__a Date/By: Case No.
24 -hour Inspection Request: 503- 639 -4175
Contact Juris.: Su See Page for
P 4 Name /Method: Supplemental Information
r SO//R/ N o' C l-- N R V,
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi - Family
❑ Master Builder ❑ Other: Valuation 5
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
/705 r 4 5/4.1 j b1 Total number area Job site address:
y ���New dwelling area (sq. ft.)
Suite #: 1 Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: /vl i - 604z A,I/tNOF /9/14/ /1t Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: 1 Lot #:
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
b 57/ &x 7 /4i D/Zef/.v
/2-2041 Valuation $ 57 b
Existing building area (sq. ft.)
New building area (sq. ft.) 2 O
Number of stories
0 PROPERTY OWNER 1 - TENANT Type of construction V-Iv
Name: A/l , /NG - Occupancy group(s): Existing: • /l/
New: P-/
Address: f S 705 SW 7ZAvil" /ti/
City /State /Zip: pvytizAiJD ail— 17773
Phone:624 - /go `I I Fax: NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
151 • PPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
: usiness Name: A// lL / / VC . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: 6724c S0 T/Se-A-) from licensing, the following reason applies:
Address: / g EX1 it , -
City /State /Zip: lqe?h/�7z tf pyy . e5766c
Phone: 67, • 286 Z 1 Fax: lv , 1736
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule. 1 72 .
CONTRACTOR
Business Name: p /A *5/ ,t)-' ,5 C Fees due upon application $ 6-2-0
Address: GOO 5E rf7, A//6 . 5 /aSao
City /State /Zip: W rjvvp.- , w . x'866 / Amount received $
Phone:; 60 93 I Fax: ,1"03 7E6 — 7,zog Date received:
CCB Lic. #: 7 3 Z
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: %/i..., Date: / `8 ? ' a 7 180 days after it has been accepted as complete.
4
lOtt-E - A- ) 5 A-J *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03
,
/ /M/�q� / � Commercial Plan Submittal
.� III Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(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:\dsts \forms \COM- matrix.doc 9/24/01