Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00472
4 DEVELOPMENT SERVICES DATE ISSUED: 10/1/2004
1 3125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC -00201
SITE ADDRESS: 15865 SW 72ND AVE BLDG -C
SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P
BLOCK: LOT: 003 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: : 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: /? /. a0
Remarks: Relocate (4) sprinkler heads for TI.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone:
Phone: 620 -4020
Reg #: LIC 64174
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 10/1/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchan 10/1/2004 $5.00
Total $67.50
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
callin 503) 246- 99 or 1-800-332-2344.
Issue By: • IQ ::
Permittee --
Signature: V �
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building - Permit Application FoR OFFICE USE ONLY
City of Tigard Received
Da a l(41 D q Pem it No.: i �, ,0 ,' 72—
13125 SW Hall Blvd., Tigard, OR 97223 n
/a,,, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 htQ I `" Date/13y: Other Permit:
Inspection Line: 503.639.4175 'I 11 Date Ready /By: Juris: RI See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
T )(L° QF wORK . `T ! a . 4 :r. - wa a v , � -'•.. ;:-: . _
... n.� :. zsREQ>EIIRER DATA; Z :,
❑ New construction ( ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
4ddition/alteration/replacement 1 ❑ Other: equipment, materials, labor, overhead, and the profit for the
+-ti- S/ ' ar i
�`�' ;CATEGORYy CONSTRI CTION' 24.4.... ' ?' �` _ ='Y work indicated on this application.
❑ I- and 2- family dwelling I g mmerQ)industrial
Valuation: $
❑ Accessory building 1 ❑ Multi- family
Number of bedrooms:
❑ Master builder 1 ❑ Other: Number of bathrooms:
. . 0g p FoI A IjtA :. .;no 7 n ;. zh i Total number of floors:
Job site address: 45-8(05- c SW 7a � New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldgJapt. no.: I Project name: CYR (k ' i 1r 3 Covered porch area: . square feet
Cross street/directions to job site: "C-1 Deck area: square feet
y��{"??Other structure area: y C i square feet ''.. 1 ,. 1 .- anic,. tesA ssr r Cal '^ '+a� �`X' K '+ ^- r ' :
` •
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
_� _ 1 , �. : equipment, materials, labor, overhead, and the profit for the
., - -.•:'` : r.•. .K D1wS , _Q - �_.. ` c K ,.. - . ,. b ., 1' work indicated on this application.
l s.� is
O C Valuation: j
Existing building area: ` square feet
New building area: square feet •
4'. x i47 a �'„ �., r q iIS'' ',:U's' iut0.4r41 n. : . :µ .i -; "+ '',..1' -i+>
Y ' - _ .• _ ,8 u . Number of stories: f
Name: i/) // A , 1, S Type of construction:
{./ v
Address:
Q 7 Occupancy groups: •
City/State/ZIP f (j\ j 7 24.14 Existing:
Phone: ( ) Fax: ( )
F a _ New
rk L 1.: -U. - 1 • ' AiFL ^—, .. ,:.- { .. 4"r t s • M i t i(^,Ly ., ��4 .... , A , . l r a 7 * , ∎_ ?". yYti ''. . • ' 7. P , [" yr - ,` +`� f iii4 f . F
Business •name: 9=,:•'1,,C.-.--.
- r,_. �. ,.� ,...77 :�� -day �
���'� - L� i . 9"I r--Q V1( - All contractors and subcontractors are required to be
Contact name: {� C C licensed with the Oregon Construction Contractors Board
� el
under ORS 701 and may be required to be licensed in the .
Address: 141 5 31A) ` 1 N `7 Ate_. jurisdiction in which work is being performed. If the
City/State/ZIP: y`�1 �j r 61.7 applicant is exempt from licensing, the following reasons
apply:
Phone: (50) (P20.....40Z3 Fax:: (503) (P 20 — 1 oG�
E-mail: \rC_k_4 -e, Cte � (j.- `-iVe' j`_(fv 1
. "" , j•n,. s f T CO TRk ( lll . :: z r * : _ Y : mss',
Business name: 1-1-(L \he_
Address:
1 7 1 1 V , ;°1 ii J a sN -f t d
City /State/ZIP: � l acvN6 OP^ l 7 27- Y Please refer to fee schedule. S
/_ Fees due upon application (c • O
Phone: ( , ) (,, O — voc90 Fax: 503) W O — 1b5ce?
CCB lic.: t —7 f I Amount received •
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri-County Building Industry
Service Board.
i :\Bwlding PemutApp. 12/03 440-4613T(11 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2004 -00472
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/1/2004
Phone: (503) 639 -4171 /194 1 1il l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/3/2005 TIME: 7 :O6AM PAGE: 18
SITE ADDRESS: 15865 SW 72ND AVE BLDG -C CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: Q03 TYPE OF USE:
PROJECT NAME: CHEMWEST
DESCRIPTION: Relocate (4) sprinkler heads for TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: 620-4020
Inspection Request Scheduled For: Date: 8/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection - 012724 -01 503-307 -2105 Y
M A - 1 ' T 01SQv\ f An 10 C o✓ 6
Corrections /Comments /Instructions: - S nA;ca - To ,i iS Tin fO /ace
( ( t . GO 7v SGT L', a N►ce?i'ii g
r
0:
\IF w I; i i i
/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR I SPECTION ❑ ADDITI • NAL F ES ASSESSED
Inspector: ALI& Date: ,11.), I ir, 0 Phone #: (503) 718 -
!W