Permit A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00048
,�, DEVELOPMENT SERVICES DATE ISSUED: 2/14/02
_ 13125 SW Hall Blvd., Tistard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -00200
SITE ADDRESS: 15862 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: : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 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:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 20,000.00
Remarks: New ADA access to existing building.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300 q z� 2
Phone: Tl rnone'. qZ4 7 7'1 7 4
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Appr /sdwlk Insp
PRMT CTR 2/14/02 $244.90 27200200000 Final Inspection
5PCT CTR 2/14/02 $18.82 27200200000
PLCK CTR 2/14/02 $152.95 27200200000
FIRE CTR 2/14/02 $94.12 27200200000
Total $510.79
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Perm ittee
Si! • . ure: ' ' 4 t . A _.i. // 1 g -'
- sued By: st�l'. / ► y �U �'�`�`c - ( �
Call 6 • , . 175 by 7 p.m. for an inspection the next business day
BuiTdingPermitApplicalioa
• Datereceived: ;{ '' 0 Petmitno.: (��p�po't-4o g s
1,i; .v . City of Tigard .
.
cityo 8arid Add SW Hall Blvd, Tigard, OR 97223 Ftojecdappl.ao.: Expiredater
Phone: (503) 639-4171 - Date issued: By:. I Receipt no.
Fax: (503) 598 -1960 Case file no.: Payment type: • • - -
Land use approval: 1&2 family: Simple Complex: •TYPE OF PERMIT - _
U 1 & 2 family dwelling or accessory 0 Commercial/ industrial 0 Multi- family 0 New constzuc Lion 0 Demoli .o .
O. Addition/alteration/replacement. a .Tenant improvement 0 Fite sprinkler/alarm 0.Other. ." // - i.,/,....#".41 4.7/
JOl3 SITE INFORMATION -
Job address �% i _ I „n Bldg. no.:. ,All Suite no.:. IT ∎!2;f;:
Lot Blocic Subdivision: i` %vV : i L� g; .. tax lot/account no.:
Project name: I P' A
Descri • tion and location o work on premises/special conditions: .. ..r�t�' i/,ttrf�i��
OWNER FOR SPECIAL INFORiMATION, USE CHECKLIST
Name: PacTrust. • • ( Floodplain , septic capacity. solar, etc.) .
Mailing address: 15350 SW Se • u o i a Pkwy., :300 t &Zfamily dwelling:
City: o r t an. . State: 0 R ZIP: 97224 Valuation of work
(503 Phone: 6.2446300 ,_ iT. r3� �a;'_„ . No. of bedrooms/ baths ......................_....__.. $ •
Owner's representative:. D e n n i s P a• n i Total number of floors .. �� -
.. �... i
Phone: Same . u.. E -mail: New dwelling area (sq. R) _. ...
APPLICANT Garage/carport area (sq. ft.)
Name: P a c T r u s t. . • . Covered porch area (sq. ft.) .»...
Ming address:1 5350 SW S e r u o i a Pkw ., #300 Deck area (Sq• ft-) •••....•.....
City: Portland state: O R ZIP: 97224 Omer structure area (sq. ft.) »• ..- µ-- -•
(5 03 Phone:6 24- 63 00 Fax6 2 4- 7 75 ' E-mail: Commeicial/linda riaUmuld- family: 0-
CONT RACTOR Valuation of work...—. ............................... $ / ■� /./ -°
Business name: H.L. 6 r e e n Existing bldg. area (sq. ft.)
Address: 153 50 SW S e r u o i a Pkw ., #300 New bldg. area (sq. ft) ...
City: Port and State: t R ZIP: 97224 Numberof stories .....
(50 3 1 Phone 24-7717 Fax: E-mail: Type of construction
CCB no.: 41.328 . Occupancy group(s): Existing:
City/metro lit. no.: New:
Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Co
;,�. �, ? _ � � Construction Contractors Board under
r • ` 1 e ; :. • , >, :,o . , _ ' . . y .. provisions of ORS 701 and may be required to be licensed in the
Address: 15 3 5 0 SW Se r u ` 7 � . IC'''' - -
- - ' - t i jurisdiction where work is being performed. If the applicant is
City: Portland State: OR ZIP•:9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: Plan no.:
( 50 3 1 Phone: ' - .301 Fax:624_775' mail: - ohnr @ usti r .com
ENGINEER
Name: 4.../i1,20 '.. li;o "Ill pew: Fees due upon application ..... $
Address: , ` ✓ Date received:
®'• �� �� � /' State: ✓A� ZIP:. J Amount received $
Phone: 2. , j M E -mail: Please refer to fee schedule.
I hereby certify I . ve read and examined this application and the ' Not ad jmisdictioru accept credit cads, please call juriscection for more information'
auached checklist. All provisions of laws and ordinates governing this Cl visa 0 Maste:(ard
work will be complied wi w • ther s • -.Ted herein or .. • t cram cart! numbe / /
Authorized signature: /We /7 , ;// �; ''/ �, -) Name or cardboldcr.'down on credit cad Expires
$
Print name: l> /� i cadbotder signanne Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (&001COM)
•
A ,, Over-The-Counter (OTC) Building Permit
p , \ Building Check List
AI
City of Tigard
Description of Project: A1 6-7,J ,4f A-t,i S 4-o ex ,-s f_.',. S 1- 4/
av' . .:
GENERAL INFORMATION
Class of Work:* iQ, (..I- Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* n First floor: N: S:
Type of Construction: Second floor: E: l W:
Occupancy Group: 73 Third floor: Openings Protected Y/N ?:
Occupancy Load: Total sq ft.: N: S:
_ Stories: Note: Combine total floor area for _ E: E:
Height: all floors above third floor and Roof Construction:
Floor Load: add to the third floor s . ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinlder: Handicap access: )[x�
Smoke detector: Protected corridors:
Fire alarm: Parking spaces ( #):
Notes:
INSPECTIONS 1 FEES DUE
Footing/foundation Firewall $ ,25 Permit Fee
Post/beam structural Smoke detector $ / S, R Z State Surcharge
Shear wall Misc. inspection $ / 5 •'S Plan Review Fee
Masonry y� Approach/sidewalk $ 914 , 1 Z FLS Plan Review Fee
Framing $ Additional Permit Fee
Insulation Sprinlder rough -in $ Additional Plan Review Fee
Gyp board Fire alarm $ Investigation Fee
Suspended ceiling Sprinlder final $ Misc. Fee
Final inspection $ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Sl b , 79 Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs,
awnings or canopies); REP = repair.
i:\dsts\forms \OTC- BUP.doc 01/03/02
CITY OF TIGARD 24 -Hour ; 1
BUILDING Inspection Line: (503) 639 -4175 tree.
INSPECTION DIVISION Business Line: (503) 639 -4171 MST /`,�
BUP 2�o occcft�
Received Da: Requested ` -;.8) AM PM BUP •
,. q c ✓ / •
Location f ��J � / �� " Suite MEC
• Contact Person / b 2 D Ph ( ) 3/o 8 8 PLM
Contract Ph ( ) SWR
•
UILDI Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear f �� -
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fin ; \
PAS RT FAIL r ;
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
\)/e
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 fl 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: 111 Unable to inspect — no access
Fire Supply Line
Date /c- I cf Z Inspector Ext
ot, e ,. Yti "7W
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING , Inspection Line: (503) 639 -4175
INSPECTION DIVISION - Business Line: (503) 639 -4171 _` MST p�
: OUP .9 006 q
Received • Date Requested .3 - 5 AM PM BUP
Location /,S 'YQ ? 7 Suite MEC
Contact Person Hoz-AA-et,d, Ph ( ) d9 6 S PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
- •o n.►
ELC
o Drain Access: 6//
Ftg Drain CS C - 77/ ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling •
Roof
Other:
F'•:
• J•ART FAIL
' =ING
Post & Beam - _ - -- - --
Under Slab
Rough -In '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 $ 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
ADA /
Approach/Sidewalk Date 3 5 Inspector / � ' / Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
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 � AM PM ; BUP
Location 1 Z ? °� l�'�'� Suite MEC
Contact Person / Ph ( ) Zoo C - ? 5Z PLM
Contractor Ph ( ) SWR
I'IILDI Tenant/Owner ELC
g ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes:5 �� /Y/ --Q SIT
Post & Beam `
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof jl
Other:
Fi -
� e PART FAIL
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 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Date //Vf'' 2 , — Ctor l Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
1