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Permit 4. _ , A CITY OF TIGARD , J DEVELOPMENT SERVICES BUILDING PERMIT PERMIT #: BUP2003 -00089 DATE ISSUED: 2/21/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AA -01000 SITE ADDRESS: 16550 SW 72ND AVE B -09 SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L BLOCK: LOT: OOC 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: 10 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 36,000.00 Remarks: CA j t p) 7.1 Owner: Contractor: PACIFIC REALTY ASSOCIATES H L GREEN 15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD PORTLAND, OR 97224 STE 300 • TIGARD, OR 97224 Phone: Phone: 624 -7717 Reg #: LIC 41328 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 2/21/03 $365.80 Electrical Permit Required TAX 8% State Tax 2/21/03 $29 26 Plumbing Permit Required [TAX] Framing Insp [BUPPLN] Pln Rv 2/21/03 $237.77 Gyp Board Insp [FLS] FLS Pln Rv 2/21/03 $146.32 Susp Ceiing Insp Total Final Inspection $779.15 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: ,�P, /lv� Pemnittee Signature: / / /�/y . A; 11 / / /,x/ / Call 639 -4175 by 7 p.m. for an inspection the next business day Building Permit Application .�, City of Tigard Datereceived:.2 -a1 - Permit ro'. j 17, 06F5 '' .• Project/appl.no.: Expire date: City ngard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: By:-i- 1 Receiptno.: • Fax: (503) 598 -1960 Case file no.: Payment . y type: Land use approval: 1&2 family: Simple Complex: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/mdustrial 0 Multi - family 0 New construction 0 Demolition 0 Addition /alteration/replacement .Tenant improvement 0 Fire sprinkler/alann 0 Other: JOB SITE INFORMATION • Job address: I _ I a Zd.W•�' Bldg. no.: Suite no.: Lot Block: Subdivision: Tax map/tax lot/acco : no.: Project name: , (/ it/A6 Sf J.57, ris Description and I... ..on of work o} .ptemises/special conditio t 1 - t/ / - . • ./.--/- OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: PacTrust ( Floodplain , septic capacit) . solar, etc.) Mailing address: 15350 SW Sequoia Pkwy. , #300 1 & 2. family dwelling: City: Portland Jstate: OR VIP: 97224 Valuation of work $ 503 I phone:'T624 =6300 1Fax6.24=- 775E-mai1: No. of bedrooms/baths _ Owner's representative: D en n i s P a g n i Total number of floors • Phone: Same Fax: S e E -mail: New dwelling area (sq. ft.) Garage/carport area (sq. ft.) Name: P a c T r u s t Covered porch area (sq. ft) Mailing address:15 3 50 SW Sequoia Pkwy ., #300 Deck area (s q" ft-) City: Portland State: OR j ZIP; 97224 Other structure area (sq. ft) 503 1 Phone 2 4 - 6 3 0 0 Fax6 2 4- 7 7 5' E -mail: Commercial/industrial/multi- family: // � CONTRACTOR Valuation of work $ �� Existing bldg. area (sq. ft.) 7 4� f Business name: H H. L. Green •� Address: 15 3 5 0 SW S e q u o i a Pkwy. , #300 New bldg. area (sq ft.) _„ City: Portland state: 0 R 1 ZIP: 97224 Number of stories . 503 1 Phone6 24-7717 1 Fax: 1E-mail: Type of constriction e CCB no.: 41328 Occupancy group(s): Existing y • New: .J' - City/metro lic. no.: Notice: All contractors and subcontractors are -, • • to be ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: John R o m i s h provisions of ORS 701 and may be required to be licensed in the Address 15 3 50 SW Sequoia Pkwy. 17300 jurisdiction where work is being performed. If the applicant is City: Portland !State: 0 R j 71P:97224 exempt from licensing, the following reason applies: Contact person: 'Plan no.: .503 phone:624 -6300 Fax :24 -775 E -mail: •ohnr@ actrust 1 . com Name: Contact person: Fees due upon application $ Address: . Date received: City: State: ZIP:. Amount received $ Phone: 1 Fax: 1E-mail: _ Please refer to fee schedule. I hereby certify I have read and examined this application and the ' Na all jurisdictions accept credit cards. please au jurisdiction for more iafoimation s attached checklist. All provisions of laws and ordinances governing this 0 visa 0 MasterCard work will be complied 'tit hether pecc . herein o • lot. t:,edit card number: Expires Authorized signature: Jrj;L // r ' Ap_ r / / //' % .n . " e 3 Name of cardholder as shown cm credit aid $ Print name: ,/. . i ..•-• J., car Cardholder pgnautc Amount , Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 WO COM) CITY OF TIGARD 24 -Hour BUILDING Inspection UM (5V) 639 -4175 INSPECTION DIVISION Business Link (503) 639 -4171 MST "' '/ BUP . – 1)DO ST Received Date Requested / 7 AM PM BUP Location / L 3 7e-) '11cj Suite_ y' MEC Contact Person .Gt Ph ( ) 3/ — gZ_3 / PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner z-e ELC Footing Foundation Access: ELC Ftg Drain � '" - � -� '± ` ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Insulation Drywall Nailing Fire wall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: F'.... ' PART FAIL BING 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 Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date c/ / D 3 Inspector Ext Other: f 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 4 1 — a AM PM • BUP Location 1 6 SS) 7d 4 Suite MEC Contact Person D s-( 74t' Ph ( ) U ' PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulatio all "' Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: fe PART FAIL 1 11 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 Please call for reinspection RE: Unable to inspect – no access Fire Supply Line 7 \� ADA Date 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 3- boo ' j Received Date Requested AM PM 'BUP Location ) t 5 5 O 7 • Suite 9 MEC Contact Person Ph ( ) 3 to- Sg3 1 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing 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 Roof Other: Final _ A S PART FAIL PL BING 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 El Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Date 6 7 /Z) 3 Inspector CRT)I? Ext Approach/Sidewalk 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 3' .9a0 gF Received g3 4 Z4 Date Requested 3a AM PM SUP Location /�D SLv 7Z' Suits44 g MEC Contact Person 1)14» 5 Gt ef Ph ( ) 91 sg PAM t Contractor Ph ( ) SWR 41212li Tenant/Owner lZD1/4 f ELC Footing 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 Susp'd Ceiling Roof Other: 1i ► (4 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 0 Please I for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA 3 0 / 0 3 47 Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL