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Permit 4 .. . _ ,. BUILDING PERMIT . A CITY OF TIGARD P ERMIT #: BUP2004 -00442 1 DEVELOPMENT SERVICES DATE ISSUED: 9/16/2004 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00500 SITE ADDRESS: 16100 SW 72ND AVE B -18 SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L BLOCK: LOT: OOA 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: 5N sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 150 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: $ 8,000.00 Remarks: Demo and new walls. Owner: Contractor: PACIFIC REALTY ASSOCIATES C.A. GREEN 15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA PKWY. #300 PORTLAND, OR 97224 PORTALAND, OR 97224 Phone: Phone: 503 - 624 -7717 Reg #: LIC 156496 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 9/16/2004 $120.10 Electrical Permit Required TAX 8% State Surchar 9/16/2004 $g 84 Sprinkler Permit Required [TAX] ! Plumbing Permit Required [BUPPLN] Pin Rv ' 9/16/2004 $78.07 Framing Insp [FLS] FLS Pln Rv 9/16/2004 $44.20 Insulation Insp Gyp Board Insp Total $251.21 Susp Ceilng Insp Final Inspection 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: 4� :,L/�l/� Permittee Signature: /_ ;, ∎ /// ��. Call 639 -4175 by 7 p.m. for an inspection the next business day .. fl1111il �IllT>lg Perm A- plicatIon , ,a' .o ' , ""''°a FO RO FFICEUSEr©NLY ,t -.t. �' '' tom_ ' .r ., x, ' _ -_: --- - �4 City ®f Tigard EC����D Dateived ..C: 2 LL-� Rec /Bv / i� ' Permit No.: (l 7 13125 SW Hall Blvd.. Tigard, OR 9. _2_ Plan Rev , . ). 'T`'''Ill DaleiBV: i ®®( ( Vt�� Other Permit Phone: 503.639.4171 Fax: 503.395. i 460 200 Al ' Inspection Line: 503.639.4175 SEP 1 6 r:, / - Date Ready /By: kris. 0 See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: Supplemental In form ation �tWili SI°N REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all X Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ 1- and 2- family dwelling ommercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: /4/494 os / yz 4J New dwelling area: square feet City/State/ZIP: r�eV 41� OA' f7 ?, Garage/carport area: square feet Suite/bldg. /apt. no.: / I Projee name: /0, yl4` fs A��,�� / Covered porch area: square feet Cross street/directions to job site: . Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: 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 DESCRIPTION OF WORK work indicated on this application. X40, 9 ..,41' / � 4/0 ' J/ zi .1'/J ,em , 7 �� Valuation: $ 4 ��� ‘-----_) Existing building area: eMsquare feet / New building area: ! I , ` eWsquare feet CO PROPERTY OWNER . ❑ TENANT Number of stories: / Name: PacTrust Type of construction: yr Address: 15350 SW Sequoia Pkwy. , Suite 300 Occupancy groups: City/ State/ZIP: Portland, OR 97224 Existing: ,le/S.,,t Phone: ( 503 ) 624 - 6300 Fax: ( 503) 624 - 7755 New: l//S•0 APPLICANT ❑ CONTACT PERSON . N TICS Business name: Pac Trust All contractors and subcontractors are required to be 2 //y /� "7li��/ under ORS with the and may be required to Contractors licensed Board Contact name: J_ 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/State/ZIP: Portland, OR 97224 apply: Phone: (503) 624 - 6300 Fax:: ( 503) 624 - 7755 E -mail: CONTRACTOR Business name: C .A. Green Company BUILDING PERMIT FEES* Address: 15350 SW Sequoia Parkway, Suite 300 Please refer to fee schedule. City/ State/ZIP: Portland, OR 97224 Fees due upon application Phone: ( 503 ) 624 - 7717 Fax: (503) 968 - 1686 Amount received CCs lic.: 156496 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: V �} l D ate: fl . * Fee methodology set by Tri -County Building Industry '/ fl ,c Board. i.\ Building \Permits \BUP- PermitApp.doc I2/03 440.4613T(1I /02/COM/WEB) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / >> BUP ,Z N -do ditia Received UV`�� Date Requested /i'` / Z- AM PM BUP Location //a //,e 5ii) 7 Suite / MEC Contact Person r Ph(_) 93 TO dD�' S PLM Contractor Ph ( ) SWR 4 UI IN Tenant/Owner ,,,,,,ze ,,,,,! , ELC ' g ELC Foundation Access: Ftg Drain 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 1 Susp'd Ceiling I ` / Roof —' � J Other: 1 - — Ir • 4 i� PART FAIL ING 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 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please cal for reinsp ction R • 0 Unable to inspect — no access Fire Supply Line j ` �f A ADA Date ` ` v 4 Inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL //