Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2003 -00373
i DEVELOPMENT SERVICES DATE ISSUED: 6/18/03
- 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 150 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 1.921 sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 1,921 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 19 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: $ 5,500.00
Remarks: TI
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L. GREEN, HL CO. INC.
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 Framing Insp
[BUILD] Permit Fee • 6/18/03 $100.90 Gyp Board Insp
[TAX] 8% State Tax 6/18/03 $8.07 Final Inspection
[BUPPLN] Pln Rv 6/18/03 $65.59
•
[FLS] FLS Pln Rv 6/18/03 $40.36
Total $214.92
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: 61g/A--"'
Pe mt ittee
Signature: • 4 // %r
rr .
Call 639 -4175 by 7 p.m. for an inspection the next business day
, • ,
A . Ba�dingPermitAppflicataon. ====
. Datereceived: 6- --03 Permno.:�i1 -0
i!� , City of Tigard it a 3 7 3
_1 Project/appl. no.: Expire date:
City ogard Address: 13125 SW Hall Blvd, Tigard, OR 97223 '
Phone: (503) 639 -4171 1 a b Date issued: 6 -) a -03 By:. I Receipt no.: ,
Fax: (503) 598 -1960 ��'t J Case file no.: Payment type: •
Land use approval: �� l&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 sprinkledalatmm 0 Other. •
JOB SITE INFORMATION .
Job address: i .. ,/ ^%l���� j Bldg. no.: f Suite no.: •
Lot Block: Subdivision: Tax map/tax lot/account no.:
Project name: ' /0 I/ ,�/ f / J
Des
ie location pr conditions: ,
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST -
Name: PacTrust ( Tloodplain , septic capacity. solar, etc.)
Mailing address: 15350 SW Sequoia Pkwy. , #300 1 & 2-family dwelling.
City: Portland . estate: OR ZIP: 97224 Valuation of work $
503 I Phone: ECr`24 63(QO OIFax624 - 7.' 1.5'.$E - mail: No. of bedrooms/baths
Owner's representative: De n n i s P a g n i Total number of floors
• Phone: Same Fax: S a e E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.) •
Name: P d C T r U S t Covered porch area (sq. ft.)
Mailing address:15 3 5 0 SW S e u o i a Pkwy. , #300 Deck area (9 • ft-)
City: Portland ' State: OR I ZIP: 97224 Other structure area (sq. ft.)
503 Phone Fax E -mail Commercial/mdusi ial/multi- family:
•62 -6300 524 -775' �-- / --�., del
CONTRACTOR Valuation of work $ � J �aO2
Existing bldg. area (sq. ft.)
Business name: H.L. Green New bldg. area (sq. ft.)
Address: 15350 SW Sequoia Pkwy., #300 �•
City: Portland. I state: O R I ZIP:
97224 7 2 2 4
Number of stories
503 Phones 2 4– 7 717 Fax: E -mail: Type of construc 741:11z7 CCB no.: 41328 Occupancy group(s): Existing
City/metro lic. no.: New:
Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: John R 0 m i S h provisions of ORS 701 and maybe required to be licensed in the
Address: 1 53 5 0 SW Sequoia Pkwy . 300
jurisdiction where work is being performed. If the applicant is
City: Portland I State: 0 R 1w:97224 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
503 ) Phone: 624 -6300 Fax:624 -775 E -mail: ' ohnr@ actrustl .com
Name: Contact person: Fees due upon application $ •
Address: Date received:
City: 'State: ZIP:. Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit muds, please call jurisdiction for more information
attached checklist. All provisions of laws and ordinances goveming this ❑ Visa 0 MasterCard
work will be complied i he • . s ,; . ed he ' ..' not. Credit rand number: / Expires
Authorized signatu a I, ✓// 1i - � . ./."'" v —/ Name of cardholder as shown on credit and
Print name: /.�i�� /i/ .. $
Catdhdder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6iO3+COM)
g 1 1 Li f z .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Businees Line: (503) 639 -4171
BUP s — CO 37,
Received Date Re uested - '7 AM PM BUP •
Location l �? (P ,D -C� -� Suite mo MEC
• Contact Person , � Ph ( ) _ 3`t' Te3 ( 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
• !' ! ING
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 Date 61.21 /0'3 Inspector Ext
Approach/Sidewalk _
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL