Permit 4 BUILDING PERMIT
CITY OF T PERMIT #: BUP2005 -00456
ei ek DEVELOPMENT SERVICES DATE ISSUED: 9/9/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -00400
SITE ADDRESS: 15912 SW 72ND AVE B17 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK 1 LOT: 017 JURISDICTION: TIG
Project Description: TI, walls
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: 56 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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 ') 0 . 60
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone: 503 - 624 -6300
Phone: 503 - 892 -0066
FEES Reg #: LIC 66070
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/9/2005 $634.90
[TAX] 8% State Surcharl 9/9/2005 $50.79
[BUPPLN] Pln Rv 9/9/2005 $412.69
[FLS] FLS Pln Rv 9/9/2005 $253.96
Total $1,352.34
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
req ' ou o$f•Ilow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 - 001 -0010 thro • h OAR 952 - 001 -0100. You may obtain a copy of these rules • • ect ion to OUNC by
ailing 503 - 246 -6699 • :' A 332 -2344.
Issued By: - "� / 41� Permittee Signature: ,.. ` _ .
W
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. •
..t.
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Received 0 7 e
Date/By: / ... I
Permit No.: ,
rbioo •0 ,
do
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 „.. 4, ' A
:i4F 4i i' , Date/By: Other Permit
. :
Inspection Line: 503.639.4175 Date Ready/By: lisk.... 0 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: .,'/ / 6 Supplemental information
,:' 71..,';'' 1 :':'' Y. iiiigiiiiip ' t_i' nwsi T min
CiAglif..:fte;:i;Errgitt.':4:Me--A11 ' .;.:,,•::..,.;: ..,::; ; :: ::.:'.., : ::::.:'. ,.,;,:: . . ;.:,.„ .: :i..,..,, ” " ' -
El New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
. t5,1,Allaition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the
■„TiktittiAgaa‘• NM, 6146eige6**:'‘gialiyakitk,74:41:k!;:,,o,r000ltigi,:m work indicated on this application .
i ji., ,,,:S.IN ,i:4:, , .tr,e41.......0,410TMat X IIC ,13,49,141{4-IVU,74,1A•41a17*,7,■{77rFjVr,t`P".'..'.',10,0;1!!.4.07, r.!'"A!ir.'!!*")11L'...■'h,piljr,,,631*1:!rAll
Valuation: $
0 1- and 2-family dwelling .2
El Accessory building 0 Multi-family
Number of bedrooms:
CI Master builder ID Other: Number of bathrooms:
'tilirlOrArl'.:4;',Ei.ii
tyetg .,,,imi.i. Li: rmeziocial5 4 1 1.41 g it i o.4 3 ...,, , , , ,N, ri., ,,,, ,, sii,... ,,, , , ,,,,,, ...,,, 0.1 1, Total number of floors
Job site address: a /5 - 9/ e , _<i " ,e/D New dwelling area: square feet
City/State/ZIP: 2,4 )9 -/ ‘772_ ‘ 7.2.g . ' 91 Garage/carport area: square feet
Suite/bldgJapt no.: I Project name: ' ,k, 4r- .ee e../ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Subdivision: 1 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
,, ..0,t: two W...Y1. 0 ^Mlitg'Adird:IckAIII2FArt..7....■?fft‘r.. , 2,44 ,1 02!?..2:EF4::.. ,,
ittftlif Ft7.11 i g x ,!..' H ;...! :lit,WAlilicaliaiiMitiOWFIritillVITV work indicated on this application.
1
Valuation: $ "A° Ai 0
',..-5
Existing building area: „z/ qtiare feet
.4'5/1 , J9- - 21-0: . 1 - /
New building area: :12e:9 square feet
-I! Number of stories
. ,IPt ' , 1 , jitz ,1 !+■•' . 77 4 1ty , ''
IA. ''''' ' /ftt,(0., :A • 1 ,'" : ' ., ;■ kg,,,,,, , , ,,,-,, .,.. , .Litia■ 5, -- 1,. : /
".it q "t ' • . ,poximo.itirr Kulhy. .3■41i .', , ..ge,.. ' t'!
Name: PacTrust Type of construction:
Address: .15350 SW Sequoia Pkwy., Suite 300 Occupancy groups: 3 ‘9.....
City/State/VP: Portland, OR 97224 Existing: _ , l_r -- a 0
Phone: (503 )624-6300 Fax: ( 503 ) 62 . New:
r MIN,:fgrAIR#45r - a aro .. • ,•"•„., ,,,, _ - ••,, • „ ,Ip e oie,ORNA ..,N11. viiM -.,-. ', ' .";40,,,,Its:'• it--::; .:. ?: • ,: , .
11'.:11.4i1111;1 11. '...° ' ' ;- '''''''• ''''- - 4' ''' . ' '' t . igigillii iNtaia;APOYARPSF.VVIAqi
Business name PacTrust All contractors and subcontractors are required to be
• licensed with the Oregon Construction Contractors Board
Contact name: 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/StaterZW:Portland. OR 97224 apply:
Phone: (503 ) 624-6300 Fax: : (503 ) 624-7755
E-mail:
mo ,,„,,, ,, .sp ' In, Ari,,t
trettalMilartnitOlfig .. a
Business name: Matthew Olson Construction 4Ei*
,,,,i4m::::;1:,;,:zit:111 •••• •
Address: 5320 SW Dover Lane Please refer to fee schedule
City/State/ZIP: Portland, OR 97225 Fees due upon application
Phone: ( 503 892-0066 • 03 892-0067 Amount received
CCI3 lic.: 66070 J Date received:
Authorized signature: — This permit application expires if a permit is not obtained
• Wi..--E-.42.--n / --1 7/,/..r ._S within 180 days after it has been accepted as complete.
I Print name: Da e: • Fee methodology set by Tri-County Building industry
Service Board.
ii: \ Buildins6Permits \ SUP-PerrnitAno.doc 12/03 440-46137(11/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005- 00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/9/2005
Phone: (503) 639 -4171 /raur �
A
Inspection Requests (24 Hrs.): (503) 639 -4175 ;111.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 56
SITE ADDRESS: 15912 SW 72ND AVE B17 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE:
PROJECT NAME: COOKIE LEE
DESCRIPTION: TI, walls
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503.624 -6300
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503892 -0066
Inspection Request Scheduled For: Date: 10/31/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 019829 -01 503 - 793.0552 N
Corrections /Comments /Instructions:
. 44r FAMIP; 4011,0
r.1
. 1 .... .,■.t lq:. twv
v t .
...•■•• A A O P A i r 441 P.-
!, I ,j
F P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C 'LL . FO INSPECTION ❑ ADDITI NAL EES ASSESSED
Al
Inspector: A �M Date: 1 3 1 °.----- Phone #: (503) 718-
CLF TIGARD
BUP2005.00456
BUILDING DIVISION PERMIT #: 9/9/2005
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 - 4171 ,, x11"Np� IL
Inspection Requests (24 Hrs.): (503) 639 -4175 _14- IL
10/24/2005 7:02AM 26
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
15912 SW 72ND AVE B17
SITE ADDRESS: OREGON BUSINESS PARK I 017 CLASS OF WORK:
SUBDIVISION: COOKIE LEE LOT #: TYPE OF USE:
PROJECT NAME: TI, walls
DESCRIPTION:
PACIFIC REALTY ASSOCIATES, 503 -624 -6300
OWNER: MATTHEW OLSON CONSTRUCTION PHONE #: 503-892 -0066
CONTRACTOR: PHONE #:
10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Co # Iig�ection JJesFription Sw ii r S � 105 Mevage
as spencie� ceilingg
Corrections /Comments/ Instructions:
f _ � 441.
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL NI CALL FOR IN PECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: A1hh( I Date: ( Phone #: (503) 718 -
CLTYQF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/9/2005
Phone: (503) 639 -4171 4,41i1 n
Inspection Requests (24 Hrs.): (503) 639 -4175 1 h
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 120
SITE ADDRESS: 15912 SW 72ND AVE B17 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE:
PROJECT NAME: COOKIE LEE
DESCRIPTION: TI, walls
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503- 892 -0066
Inspection Request Scheduled For: ' Date: 10/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 018890 -01 503-793-0552 N
Corrections /Comments / Instructions:
A / ,a 4ice Iti„ ,. , /' wirii, ,-• 64 A
,__
kil 47 T/1 , i1 5-5 t Gc y' —mss
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
X FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
(O Inspector: Date: #: (503) 718-
CITY OFTIGARD
BUILafIVG DIVISION PERMIT #:
BUP2005 -00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503).639 -4171 7,m�j„�i illel� 9/9/2045
Inspection Requests (24 Hrs.): (503) 639 -4175 -' " I
INSPECTION WORKSHEET FOR DATE: 9l27/200F TIME: 7 :05AM PAGE: 67
SITE ADDRESS: 15912 SW 72ND AVE B17
CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE:
PROJECT NAME: COOKIE LEE
DESCRIPTION: TI, walls
OWNER: PHONE #:
PACIFIC REALTY ASSOCIATES, 503 - 624 -6300
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #:
TH 503- 892.0066
Inspection Request Scheduled For: Date: 9/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 016708 -01 503-793-0552 N
Corrections /Comments/ Instructions:
1\--7/1
e p ,;_,/,
I
1 1 1----.------- i w•
•
r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F•R INSPECTION ❑ ADDITIfz7 AL FE ASSESSED
Inspector:
(R
Ins Date: � hone #: 503
P � ) 718 -
CLTY „OF TIGARD
BUILDING DIVISION A , PERMIT #: gUP2Q05 00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED. 9/9/2005
• Phone: (503) 639 -4171 4/ ,0 ill
Inspection Requests (24 Hrs.): (503) 639 -4175 L__..
INSPECTION WORKSHEET FOR DATE: gl2 ?005 TIME: 7:12AM PAGE: 88
SITE ADDRESS: CLASS OF WORK:
15912 SW 72ND AVE B17
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE:
PROJECT NAME: COOKIE LEE
DESCRIPTION: TI, walls
OWNER: PHONE #:
CONTRACTOR: PACIFIC REALTY ASSOCIATES PHONE #: 503-624-6300
MATTHEW OLSON CONSTRUCTION 503892 -0066
Inspection Request Scheduled For: Date: 9/26J20Q5 Pour Time:
Code # Inspection Description Confirm # Contact # Message I D W
275 Framing 016549-01 503-307 -2105 Y
Corrections /Comments /Instructions:
Pr of/u0 ' r . LA - ' , § , ,
IN R '7A90 - O v 2t. 1 ir 1 q/6/05" b-&• -- 1 . ( opo . tmcAreirse
f 1-I 20 0 0 0 4'4 7 p ° g/ G21 %E S )
MEG 219 0 - 0 d 6q ` ' P " Sl-AiLs - Act/6g_ -6 " 1' S
%fp E i,c 266 - 00 (.(2 Li
L TLy Z Zed 4 — o v I-1 , h 5 s - al,6-.A 4 ` ( '''s43.41,4
I ) At. .4),NM_ ./v,Api;-,S 2 -- (2 -` 11 ^ . '•- 15 v l e \A.A' S- + - 6-e 6 k-A-4-ci (" -(2.
Are- i w. — y22 4 ' I i 0 c ' q Pew .
N 5 nf Cktu-S
I
t "1"....e.-- 6 cef v--4,3 .
- ( ";�Gte I _ \ Z' c-9 1 Q • L
*--- Q - 0 --1/V\_. l'\ CYN,Q j._.--_0,_," 4.--ek._X kA...1 °a l ' \ • • / (32 -t .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
S - = ' iU ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/v /
kSt
Inspector: Date: 9 /�`(l 6 Phone #: (503) 718-