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Permit `` BUILDING PERMIT CITYOFTIGARD PERMIT #: BUP2004 -00176 44 DEVELOPMENT SERVICES DATE ISSUED: 4/20/2004 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AB -01201 SITE ADDRESS: 16505 SW 72ND AVE BLDG F 16505 -16535 SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L 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: 3N : 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 7,500.00 Remarks: New walls to create offices. Owner: Contractor: PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION 15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LANE PORTLAND, OR 97224 PORTLAND, OR 97225 Phone: Phone: 503 - 892 -0066 Reg #: MET g 0 g 0 � 0 7 0 Q 2036 FEES LIC REQ UIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 4/20/2004 $120.10 Electrical Permit Required TAX 8% State Surchari 4/20/2004 $9.61 Sprinkler gr Permit Required [TAX] ! Framing Insp [BUPPLN] Pln Rv 4/20/2004 $78.07 Gyp Board Insp [FLS] FLS Pin Rv 4/20/2004 $48.04 Final Inspection Total $255.82 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 -0' i I 0 thro . • OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by ca ' g (503) 246 -6699 o 1- 800 -332 1 1 4 , / LA4A.441 ssued By: £ r�r d Signature: i r-- v ►' ze Call 639 -4175 by 7 p.m. for an inspection the next business day ------\ J t Building Permit Application �� FGic OFFICE USE ONLY City of Tigard DateBed [� Permit No ��� ��� - - 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �� _`��+ Phone: 503.639.4171 Fax: 503.598.1960 / /'" G'IgFii �'l DateB : -so-O f Other Permit: Inspection Line: 503.639.4175 a _hi� _„ Date Ready/By: ® See Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK - 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 /EI,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 Commercial/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: 1 42. 9, i Z"'O /v New dwelling area: square feet City/ State/ZIP: eiL 5 2-2-4- Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 'L1 (Z_ Sy' )u S 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. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the . DESCRIPTION OF WORK' work indicated on this application. © cc I 5 Valuation: $ '1 j 0 O Existing building area: square feet New building area: square feet igf.P1t0i'ERTY OWNER ❑ TENANT Number of stories: • Name: " - T' Type of construction: — • Address: ' 535D 5v 5 ( 6 j)iC M/Y $ 7 0 so Occupancy groups: City/ State/ZIP: J@ 1,,o (9f2--- i 77.24 Existing: Phone: D ) Pic-I- 4,30 0 Fax: ( ) New: . - ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: 'FL, i,1 SYS T 14,15 All contractors and subcontractors are required to be Contact name: ewe= z_ licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City / State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( 9 0 -3)v,0-1 ' 3 i o Fax:: ( ) E -mail: • CONTRACTOR Business name: MP- w oLs c )'a 7 (L .4c_n on) _BUILDING PERMIT FEES* Address: 5'31. c Daft. l./ j , • _ Please refer to fee schedule. City/State/ZIP: p �i,Jt7 �Z c - c ) �Z - C J � ( 9 ) 89 z _aD o� Fees due upon application Phone: Fax: CCB lic.: O� J Amount received 0 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:, • b_ Or Date: - ^ al * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Perntiu\BUP- PermitApp.doc 12/03 440 - 46137(11 /02/COM/WEB) Building Division / /91 / 4 I1'1 P lan S ubmittal Requirement Matrix A Commercial & Multi- Family - New, Additions or Alterations City of Tigard Type of Submittal # of Plans (Includes new, additions and alterations.) Required at Submittal Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (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:\Bui lding\Forms \COM- PlanSubReq.doc 12/24/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Lire: (50S) 639 -4175 INSPECTION DIVISION Business Line:' (503) 639 -4171 MST e?, / ct i / BUI ADD l 7 Received Date Requested 3 1 7 �I 2 4i AM PM BUP Location 1 k.��6 70" �K) Suite /3 MEC Contact Person ?& Ph (.3__Z2) PLM u Contractor aA d l�" n -e/1) Ph ( ) SWR BUILDING Tenant/Owner c��2 ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Ina Sheath/Shear O,C Tb o ff , � Framing `�J' Insulation R00-�,,� S 13 3 0— ' F' it 1_ Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Ot er: .. PART FAIL • , BING Post & Beam I 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 fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE E Please call for reinspection RE: Unabl to inspect — no access Fire Supply Line ADA *AI Approach/Sidewalk Date Inspector &a Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL