Permit CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00362
[ COMMUNITY DEVELOPMENT DATE ISSUED: 7/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 113AB -01201
SITE ADDRESS: 16575 SW 72ND AVE BLDG F ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: TI - install storefront
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: 1 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: $ 10,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Contact #: PRI 503 892 - 0066
Phone: FAX 503 - 892 -0067
Reg #: LIC 66070
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/10/2007 $119.70
[TAX] 8% State Surcha 7/10/2007 $9.58
[BUPPLN] Pln Rv 7/10/2007 $77.81
[FLS] FLS Pin Rv 7/10/2007 $47.88
Total $254.97
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
issua• - -, or i • 's suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Or- .on Utility Notifica ''n Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
• these rules or direct • ion to OUNC by calling 503.246.6699 or 1.800.332.2344.
• sued By: 1
O' ot J . d . _ ; Permittee Signature: )C „.---,
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.
Building Permit Application lOR (iFFIC1 (sl.: O\LN
City of Tigard Received Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
, , ;
Phone: 503.639.4171 Fax: 503.598.1960 „Al- .. � i DateB . Other Permit:
Inspection Line: 503.639.4175 . C I �„ Date Ready/By. runs: El See Attached Cheeldist for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK , REQUIRED DATA: I- 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
Addition /alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
•
( - CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: $
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ O1}1er. Number of bathrooms:
JOB SITE INFORMATION AND LOCATION - . Total number of floors:
Job site address: / _' j 7 , Ail New dwelling area: square feet
City /State/ZIP: - 7,4 ji j d f 7f Gfo 6 .--- Garage /carport area: square feet
Suite/bldg /apt. no.: I Project name: / 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: 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
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK • work indicated on this application.
/� Yl�� 7�J
/ /e# / - 12.e.'re6,64+ Valuation: $ ��? DVC2
} Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER I ❑ TENANT Number of stories: /
Name: PacTrust Type of construction: /y/ 2r
Address: 15350 SW Sequoia Prkwy, Suite 300 Occupancy groups: 0 4:7
City / State/ZIP: Portland, OR 97224 Existing: ��5
Phone: (503 ) 624 -6300 Fax: (503 ) 624 -7755 New:
❑ APPLICANT ® CONTACT PERSON NOTICE '
^
Business name: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Dennis Pagni under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: apply:
Phone: ( ) I Fax: : ( )
E -mail:
CONTRACTOR
Business name: 0012a/..../ ,��ze...2 BUILDING PERMIT FEES* . •
•
Address:
Please refer to fee schedule.
City / State/ZIP: Fees due upon application
Phone: ( ) I Fax: ( )
CCB lic.: �lQ 010 Li II Amount received
�!' Date received:
. 1 * 1111 ; 0fr 7l Authorized signature: / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: '
4 Date:, • Fee methodology set by Tri -County Building industry
' T/r Z�� 7 / Service Board.
is\ Building \Pennits\BUP- 11- PennitApp.doc 12/03 4404613T(Il/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00362
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/10/2007 '
Phone: (503) 639 -4171 fr „Ari:tx
• Inspection Requests (24 Hrs.): (503) 639 -4175 LPG e7I L
INSPECTION WORKSHEET FOR DATE: 17/20/2007 TIME: 7 :01AM PAGE: 44
SITE ADDRESS: 16575 SW 72ND AVE F3LUG F CLASS OF WORK: .
SUBDIVISION: PACTRUS F BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: TI - install storefront
OWNER: PACIFIC FEALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503 -B92 -0066
Inspection Request Scheduled For: Date: 12120/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa.e
0 1 %;:l______
239 Final inspection 061915 -01 503 -956 -6290
Corrections /Comments/ Instructions: ,
/ �► mac_ !i ' a. \G( 6 0.00 4#-
■ F' ` — t PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
// CALL FOR INSPECTION ❑ ADDITIONA FEE ASSESSED
//
Inspector: Date: j Z o7 Phone #: (503) 718 CJ '