Permit I:
CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00270
-•�.1 4 ''IA , D EVELOPMENT SERVICES D ATE ISSUED: 6/11/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 100
SUBDIVISION: ZONING: I -P
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: 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: $ 4,344.00
Remarks: TI
Owner: Contractor:
AMB PROPERTY L P RAVEN CONSTRUCTION
BY TRAMELL CROW NW INC 4949 SW MEADOWS #175
4949 SW MEADOWS LAKE OSWEGO, OR 97035
Li NgrU WEG 59Y3T441a 3
Phone: 503 - 526 -1088
Reg #: LIC 63403
FEES REQUIRED INSPECTIONS
Description Date Amount Framing lnsp
[BUILD] Permit Fee 6/11/2004 $91.30 Final Inspection
[TAX] 8% State Surchari 6/11/2004 $7.30
[BUPPLN] Pln Rv 6/11/2004 $59.35
Total $157.95
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: A i` i . i . ,: Ifi
Permittee
Signature: -
Call 639 -4175 by 7 p.m. for an inspection the next business day
Aftwe Ass /. -/>- oit .
. Building Permit Application
Date received: 647MI Permit no.: re „a ,
b.,q� City of Tigard
• ^__ . Project/appl. no.: Ex • ire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: B A Receiptno.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory mmercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
Addition /alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm • ❑ Other:
. J OB SITE INFORMATION
Job address: � - �! Bldg. no.: Suite no.: De) L.
Lot: Block: Subdivision: A ingWfi : Tax map /tax lot/account no.: . G d;- i
Project name: 4 -
Description and location of work on premises/special conditions: eGC -7 4 ,q at of e_A- .r,'rrr !.i /ertdD.74.) 60a m
OWNER. _ • FOR SPECIAL INFORMATION, USE CHECKLIST
/ irr0 J :A LT' / Itt/5 (Flood plain, septic capacity, solar, etc.)
Mailing address: s , S - d, • • Zw . rm r # am1 r welling:
EIT--: MP.MB State: Qj1? ZIP: -" 7t Valuation of wor $
Phone , , » -. , i Fax: E -mail: No. of bedrooms/baths ... ...
Owner's representative: ,i- , - 4E-►. Yn ,_ Cpl • - Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.
• - • APPLICANT - • - - Garage /carport are. q. ft.)
MEC Y u.eto Covered por • . ea (sq. ft.)
M. h • .11 ' • 1'4 4 Sup m " ,. s 44/75 Deck . • . (sq. ft.)
• - . •.(4 ) .
City: ,_ air un to d o Statepre_ ZIP: 97435•
Phone: 03 -51 . - /o ff ax:4 _ S IQ 9 E-mail: Commercial /industrial/multi- family: ,,//
CONTRACTOR Valuation of work $ I.3 'y _
Existing bldg. area (sq. ft.)
Business name:
, »" - a ` 'ov -e—, New bldg. area (sq. ft.)
Address: -
City: State: ZIP: Number of stories
Phone: Fax: E -mail: Type of construction S^(
Occupancy group(s): Existing: a
CCB no.: , New: 3
City /metro lic. no.: • • . Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
/State: ZIP: exempt from licensing, the following reason applies:
Contact person: _ Plan no.:
Phone: • Fax: E -mail:
ENGINEER
Name: G ro • / !"n2r _ Contact person: — La — Fees due upon application $
Address: ■l/l ' of .,1G Date received:
City: State: ZIP: Amount received $
Phone: 2 _ 93--d, Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied with whether specified herein or not. Credit card number: EX
Expires
Authorized signature: -54 Date: to - // Name of cardholder as shown on credit card
•
Print name: 4-e A kr's s Cardholder signature $
J Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o- 46130roacow
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
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 plan sets for distribution purposes (for Contractor, City of
Tigard, Washington County, and Tualatin Valley Fire & Rescue).
Total ft of
TYPEOF SUBMIT „TAL Plans ' ' KEY:
`� . . �v Submlited
S = Site Work (must include
S (New, Add or Alt) 4 location of all accessible parking)
B (New, Add or Alt) 1* B = Building
F (New, Add or Alt) 3 ** F = Fire Protection System
M (New, Add or Alt) 2 M = Mechanical
P (New, Add or Alt) 2 P = Plumbing •
E (New, Add, or Alt) 2 E = Electrical •
New = New Building
Add = Addition
.Alt = Alteration to existing
building
•
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" requires that plans bear the original seal of an Oregon licensed fire
suppression engineer, or NICET level "3” technicians.
•
I : \dsts \forms \matrxcom.doc 10/27/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION • Business Line: (503) 639 -4171 MST �/
BUP(* - W70
Received a ( Date Requested AM PM BUP
Location / ���` �!`�" _�..isi� Suite VC MEC
Contact Person Ph ( ) 9-- ,4c3C PLM
Contractor Ph ( ) SWR
BUILDI Tenant/Owner ELC
ooting
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing 3'
Insulation
Drywall Nailing
Firewall !>
Fire Sprinkler
Fire Alarm _..
Susp'd Ceiling
Roof
• • -r:
•SS PART FAIL 1
P • = ING 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 1 11- , ' /
Rough -In ��� I
Low Votage ®�1���v1�.�i,,:
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 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site
PASS PART FAIL