Permit Ak- ',CITY OF TIGARD BUILDING PERMIT
- PERMIT #: BUP2003 -00687
- ��; DEVELOPMENT / Tigard. SERVICES 1 639 -4171 DATE ISSUED: 12/12/03
SITE ADDRESS: 06650 SW REDWOOD LN 150 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TI
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: 2 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 15 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: $ 49,000.00
Remarks: Tenant improvement, medical office.
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 12/12/03 $463.30 Electrical Permit Required
[TAX] 8% State Surchari 12/12/03 $37.06 Sprinkler Permit Required
Plumbing Permit Required
[BUPPLN] Pln Rv 12/12/03 $301.15 Framing Insp
[FLS] FLS Pln Rv 12/12/03 $185.32 Gyp Board Insp
Susp Ceilng Insp
Total
$986.83 Final Inspection
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.
/1' I
Perms -- / 40' Signature: pA / ,ay . Ak////�/VAL,..._
Call 639 -4175 .y 7 p.m. for an inspection the next business day
Alb . y Building Per -I -b_ , -Cyr f` on �
Datereceived: /2 3 Pea,*no.: 1 01 1 p 'f ,
1 , i!li_ City of Tigard
Project/appi.no.: Expire date:
o Address: 13125 SW Hall Blvd, Tigard, OR 97223
Bard Phone: (503) 639 -4171 -,, 31 S ', a �. 1 ; , ,, Date issued: By:. I Receipt no.:
Fax (503) 598 -1960 *''� �N �1v\S\ Case file no.: Payment
L2 P Z � �� �/ Y type: Land use approval: � 1&2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
Cl . Addition/alteration /replacement )Tenant improvement 0 Fire sprinkler/alarm 0 Other:
JOB SITE INFORMATION •
Job address: l.2 c. SX//CX.0 ' .4 Bldg. no.: / Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.:
Project name: 17 ` W2VAIN��re���Z.
G ..
Description and location of work on premises/special conditi ns: � • ♦ - � i -w J.G 41; = -
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: PacTrust ( Floodplain ,septiccapacity.solar,etc.) .
Mailing address: 15350 SW Sequoia Pkwy., #300 1 2 family, dwening:
city: Portland • state: OR PP: 97224 Valuation of work $
503 I Phone:' 024 63.00 OJFax6L4=- /.15$ -mail: No. of bedrooms/baths .
Owner's representative: Dennis P a q n i Total number of floors
• Phone: Same Fax: S a e E-mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Pa 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 ( sq. h.
City: Portland 1 State: OR I ZIP: 97224 Other structure area (sq. ft.)
503 Phone:6 24 - 6 3 0 0 Fax6 2 4 -775 ' E-mail: Commercial/Industrial/multi-family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.) � 7 7 . r
Business name: H.L. Green
Address: T5 3 5 0 SW Sequoia Pkwy., #300 New bldg. area (sq. ft
City: Portland State: O R I ZIP:
97224 7 2 2 4 / Number of stories
503 ) Phone6 2 4— 7 717 I Fax: I E-mail: Type of construction
_ CCB no.: 41328 Occupancy group(s): Existing
City/metro lic. no.:
New:
h Notice: All contractors and subcontractors are required to be
ARCHITECT /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 . #300 jurisdiction where work is being performed. If the applicant is
City: Portland `State: OR IZIP:9 7224 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
503) Phone:624 -6300 Fax:624 -775 ' E -mail: ' ohnr@lact.ustil.com
ENGINEER
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 jurist6etioas accept credit cards. please call jutist&ction for mote infotmatioa.
attached checklist. All provisions of laws and ordinances':oveming this °visa 0 MasterCard
work will be complied wit whe j • .i'`' 8 here' , o r . ot. _ /� Credit card number: / /
Authorized signatu� A /� /i 1� / �� -V 1 /// �' ' �/ Name of c ardholder as shown on credit card s
Print name: : .rte.. .III / .;
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 410.4613 (6100/CON)
CITY OVTIGARD 24 -Hour
BUILDIN^ Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
drriP3 6e)(03
Received /f ' / #- 2 Date Requeste �l 9/</ AM PM BUP •
Location
l cec o Suite l ce) MEC
Contact Person O�r Ph ( ) 2
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC •
Footing
Foundation Access: ELC
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
O•
PART FAIL
PL
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 /c7
Approach/Sidewalk Date 2 7 a/ Inspector ��� Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL