Permit 4 DATE CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00119
� DEVELOPMENT SERVICES
ISSUED: 4/2/02
- --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 160 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: 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: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 40 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:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 12,000.00
Remarks: Tenant improvement - construct a demising wall and creating (2) tenant spaces. Applicant must come in and get
additional tenant address prior to building final.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300
Phone: 503 - 620 -6197 TIkAoliD, (W3 4
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Gyp Board Insp
PRMT CTR 4/2/02 $158.50 27200200000 Susp Ceilng Insp
Final Inspection
5PCT CTR 4/2/02 $12.68 27200200000
PLCK CTR 4/2/02 $103.03 27200200000
FIRE CTR 4/2/02 $63.40 27200200000
Total $337.61
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344. /
A' Sig ' tue: Y 1��/ ✓�/71 L'J /. f7
Issu:d By: , _ l � �� • � l 4iA Y
Call • 9-4175 by 7 p.m. for an inspection the next business day .
, .
44 . Building Permit Application
•
�y ?' City of Tigard Datereceived: y A Permit no.:iy/.3. r.�,/ 7
City o�gard
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Prolxdappl•no.: Expire date:
Phone: (503) 639 -4171 Date issued: By:. I Receipt no.:
Fax: (503) 598 -1960 ' , t iO ��, ecl /0 Case file no.: Payment Y type:
Land use approval: 1&2 family: Simple Complex:
TYPE OF PERMIT .
0 1 & 2 family dwelling or accessory O Commercial/mdustrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement ' Tenant improvement 0 Fue sprinkler/alarm 0 Other.
JOB SITE INFORMATION '
Job address: j / .1'/ = • / /�41.�//,,` Bldg. no.: (p Suite no.: / -
Lot: Block: ubdivision: Tax map/tax lot/account no.:
Project name: /P/Wit/J: 91_, � /W.
Description and location of work n remiess/s ial canditio. • 4 i/ _.....40..L = i - i %,- /!'
W' 4�;e- �Y / - — ,� .eg�
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: PacTrust ( Floodplain , septic capacity, solar, ctc.)
Mailing address: 15350 SW Sequoia Pkwy., #300 1 & Z family dweWug:
City: Portland I State: OR IZIP: 97224 Valuation of work $
503 Phone: r;62446300 1Fax62.4= -775?. -mail: No. of bedrooms/baths
Owner's representative: D e nn i s P a g n i Total number of floors
• Phone: Same Fax: S a e E New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: Pa c T r u s t Covered porch area (sq. ft.)
Mailing address:15 3 50 SW Sequoia Pkwy . , #300 Deck area ( sq* R • )
City: Portland I State: OR I ZIP: 97224 Other structure area (sq. ft.)
503 Phone:6 2 4 - 6 3 0 0 Fax6 2 4 - 7 7 5' E-mail: CommerciaWwdastriaUmulti- family:
CONTRACTOR Valuation of work $ l� s� ------
Existing bldg. area (sq. ft.)
Business name: H . L . G reen New bldg. area (sq. ft.)
Address: 15350 SW Sequoia Pkwy., #300
City: Portland I Stale: O R I ZIP: 97224 Number of stories 7.7A:
503 y Phone6 2 4- 7 717 I Fax: I E -mail: Type of construction _ ha
CCB no.: 41328 Occupancy group(s): Existing: e
New:
City/metro tic. no.:
Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: John R om 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 I State: O R r zip:9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: Plan no.:
503) Phone:624 -6300 Fax{24 - 775' E-mail: ' ohnr@ r actrust 1 t . com
ENGINEER
Name: Contact person: Fees due upon application $
Address: - • : Date received:
City: (State: IZIP:. 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 cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances 'governing this 0 visa 0 MasterCard
work will be complied • , hethe s . red herein • not. Credit card number
Expires
Authorized signatu -T ',,f A v . ' , fi%��' . / --� " Name of cardholder as down oa credit card
Print name: V • A1,7 c/f S
s Cardholder signature Amrnmt
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM)
CITY OF TIG : RD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175
INSPECTION DI • ION Business Line: (503) 639 -4171 (MST
P * L ��d� � //k
1 '\ UU Z - // Received Date Requ ted r AM PM UP Q 7
//
Location � ; \ w Q 4, • 4, Suite /co d MEC
Contact Person S ` Ph ( ) 3/ g PLM
Contractor Ph ( ) SWR
ILDING Tenant/Owner ELC
Fo ting
ELC
undation Access:
Ftg Dr ELR
Crawl Drain
Slab Inspection Notes: SI
Post & Beam -.. -- 7 ,
Shear Anchors e /7'471/(4(6 . /ld 4 L----
Ext Sheath/Shear
Int Sheath/Shear , -�
rn b LL
Insula s ' N
Firewall /M g / / / 9 Fire Sprinkler
Fire Alarm C 0
Susp'd Ceiling
Roof
.J..
4 11:1-- - 5- - J PART FAIL N.
PLUMBING ,,,
Post & Beam
Under Slab \
Rough In �.
Water Service
Sanitary Sewer
(,,,,,z_ Z Uv Z OU/ / 9 Rain Drains J
)
Catch Basin / Manhole . 11 CO S ,4,-"- -5
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL r
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line � r
ADA Approach/Sidewalk Date q (a L I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL