Permit ���':‘ BUILDING PERMIT
k o CITY OF TIGARD PERMIT #: BUP2003 -00094
� `��� ; � DEVELOPMENT.SERVICES DATE ISSUED: 2/26/03
- ' --- 13125 SW Hall Blvd.. Tigard, OR 97223 (5031 639 -4171
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110 PARCEL: 2S112AD -01000
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG .
REISSUE: � L � FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ABff FIRST: 2.907 sf N: S r E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 2,907 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 29 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: $ 18,000.00
Remarks: Demo, partitions, doors, adj. ceiling, casework and finish.
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 Mechanical Permit Require
[BUILD] Permit Fee 2/26/03 $216.10 Electrical Permit Required
TAX 8% State Tax 2/26/03 $17 28 Plumbing Permit Required
[TAX] Framing Insp
[BUPPLN] Pin Rv 2/26/03 $140.47 Gyp Board Insp
[FLS] FLS Pin Rv 2/26/03 $86.44 Final Inspection
Total $460.29
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: PA J ,t l €k) •
Pe rm ittee
Signature: ( 04,249,6..a r/
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application OFFICE USE ONLY
Date receivedal -a6 -0 Permit no . u7 �jp � - 000q /
..1j City of Tigard y
City of Tigard
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ProjecUappl. no.: Expire date:
Phone: (503) 639 -4171 Date issued: By: ar Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERM IT
❑ 1 & 2 family dwelling or accessory C mmercial /industrial ❑ Multi - family ❑ New construction ❑ Demolition
ddition /alteration/replacementnant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: . - - gip A 5 ,. 0 4 - (..., Bldg. no.: '" Suite no.: a
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: r. J
Description and location of work on premises /special conditions: il ' ,A.• 'a' u of i • •
rte is e - rn.e e - , - • - ...s"- e -
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
(Floodplain, septic capacity, solar, etc.)
Mailing address: 5 o S'w -Ca . a , j- 1 & 2 family dwelling:
izawiffi/ State: 0 ZIP: ' ,j - Valuation of work $
Phone: 5 62/--(e 0- MEM= Eleatt No. of bedrooms/baths
Owner's representative: Pe n n t P. Total number of floors
Phone: SAr..,,.,i_ Fax: f0.•.. -t INEMEIMMIM New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: _ Sa , — Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial /multi- family:
CONTRACTOR Valuation of work $ /9 000.
Existing bldg. area (sq. ft.) 3/
Business name: &r,Qg New bldg. area (sq. ft.) 3 783
Address: / 0 ,$W , - , -mo - 3oo
City: oc t fat, .0 ' State:0 0. ZI .. 1 7 2 , 1 _ Number of stories
Type of construction ✓' N
Phone:503 42 .7117 Fax: E -mail: Occupancy group(s): Existing: 6
CCB no.: 2, 13
New:
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: /I ` e¢-i al , KS0 provisions of ORS 701 and may be required to be licensed in the
Address: / s' '`p Sue .s . • 04_, 4P-300 jurisdiction where work is being performed. If the applicant is
SW ZIP: �7?.Z, exempt from licensing, the following reason applies:
Contact person: AMZEIMIE Plan no.:
Phone: y o3 tc{. 6 00
ENGINEER OFFICE USE ONLY . _
Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
1 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: / /
n Expires
Authorized signature: {} Date: 5/e` �/03 Name of cardholder as shown on credit card
Print name: TAG ti Is Ri.3vf 1 Cardholder signature $
i K Amount
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 /C0
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST q
. - • - BUP -Doo
Received Date Requ • ted ` S - 23 AM PM BUP
�
Location qt./5-
Suite - U MEC
Contact Person -40 Ph ( ) 35 - a s3 g PLM •
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam �D r' •f� - e "(G Q 'e
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
''T BING
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 1=1 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date S ) v') Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL