Permit IN a CITY OF TIGARD BUILDING PERMIT
P E RMIT #: BUP2007 -00081
COMMUNITY DEVELOPMENT DATE ISSUED: 2/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AD
SITE ADDRESS: 16650 SW 72ND AVE B12 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG
Project Description: JOHNSTON SUPPLY. Demo demising walls & small office.
REISSUE: TALI''' FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OEM L 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: 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: $ 1,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone: Contact #: PRI 503- 892 -0066
FAX 503 - 892 -0067
FEES Reg #: LIC 66070
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/9/2007 $62.50
[TAX] 8% State Surcha 2/9/2007 $5.00
Total $67.50
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: , :
)C',j Permittee Signature: ,s' .P ;e QI ■,
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 Appliegitite_ , „,._,,/ k:„Alk FOR OFFICE USE ONLY
City of Tigard Received
D jf ate/B • - - / eIrL , rIBERINZ , t
II ” 13125 SW Hall Blvd., Tigard, OR 972*E3 0 9 2007 . _
Plan Review
- Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 A. i i Uk■ i WIIIK
TIGARD Date Ready/By: Juris: 0 See Attached Checklist for
Internet: www.tigard kr1.1 Notified/Method: Supplemental Information
luripm
TYPE: OF WORK --; - . . :,. ,:; ,-,' .:.: .' ,.- , .:,7 ----,.-_ ..: ':. . • REQUIRED DATA: 1 AND 2 FAMILY DWELLING _
El Ne onstruction emolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF 6iNsinu&1ON' ' -, ''--, : '-'-'' work indicated on this application.
„ . .
Valuation: $
0 1- and 2-family dwelling gi Conunerciallindustrial
0 Accessory building 0 Multi-family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION7ANDOCATION - r '- - • - • ' - .• .' Total number of floors:
Job site address: . / t 4 e d .... 60•0 . 9 4, 9 -01-/D A4
, .e........-- New dwelling area: square feet
City/State/ZIP: . Z, t r— <,../.] ap...._ 9 .7 „0 .= 41 Garage/carport area: square feet
Suite/bldg./apt. no.: I Project name,;_,... -- -i Covered porch area: square feet
Cross street/directions to job site: -C-C fi/ Deck area: square feet
Other structure area: square feet
.. .
;REQUIRED DATA COMMERCIALtDSE:CRECRLIST
Subdivision: I 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.
- • Valuation: $
,...e-e ,Pe' /7) i_s -e p4-—.S— Existing building area:
... . r' _ 6) /1-) .---Co2.2....- . ---, --L• : ". ----- . New building area: square feet
ED114icipOty:4* e , : ::--1 --;-,, .=:; - : --;,-.:: Number of stories:
.■
Name: PacTrust Type of construction:
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing: ,3 ,-.2 0 ,0
Phone: (503)624-6300 Fax: (503)624-7755
New:
APP LICANT '.'' . :.-- ' -1 ' eOi,:4ei PERSON ' - - . , --4 - --„ , - - - , • _: .. •-: " - ... - --
,-,- - - ' - - ,, , NOTICE :: •?•.'' ! . , .
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City/State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624-6300 Fax: : (503) 624-7755
E-mail: dennisp@pactrust.com
-. . .
CONTRAOR :. CT : , .•' ' - , -: 7 '
. • . . -
. _.. .
Business name: "2•7471 ef i",..1 :-: :c ',, .:.: BUILDING PERMIT FEES* ; ,r• : 34 ,,-,,-, , ..:
. ,
Address . - - - alettle refer to feischedule) , ',.- ."
:
Structural plan review fee (or deposit): it C2 o•
City/State/ZIP:
FLS plan review fee (if applicable):
Phone: ( ) Fax: ( )
Total fees due upon application:
CCB fie.:
Amount received: ( -- 7 , 56
Authorized signature:
. ....... ;: „ 10 .e........... 7... „--..._. This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: iftD e#Y11. / (1`. eve67,. Date: ,... • Fee methodology set by Tri-County Building Industry
Service Board.
1: \Buildineermits \BUP-PermitApp doc 03/21/06 440-46 13T(1 1/02/COM/WEB)
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007-00081
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/9/2007
Phone: (503) 639 -4171 4111
Inspection Requests (24 Hrs.): (503) 639 -4175 P:_..
INSPECTION WORKSHEET FOR DATE: 3/19/2007 TIME: 7:OOAM PAGE: 24
SITE ADDRESS: 16650 SW 72ND AVE 612 CLASS OF WORK:
• SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: JOHNSTONE SUPPLY
DESCRIPTION: JOHNSTON SUPPLY. Demo demising walls & small office.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503 - 892-0066
Inspection Request Scheduled For: Date: 3/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 045026 -01 503-307 -2105 N
Corrections /Comments / Instructions:
d1
PASS IrA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ 'AIL IC CA FOR INSPECTION ❑ ADDITIO ' L FEES ASSESSED
Inspecto Date: v 0 Phone #: (503) 718 -2 /y