Permit .,., _ ,,e. ,, .
A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00361
DATE ISSUED: 6/16/03
� • DEVELOPMENT H BM SERVICES 639 -4171 • PARCEL: 2S112AD -01000
SITE ADDRESS: 14945 SW SEQUOIA PKWY 110
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: 3,783 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: 3,783 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 33 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 55,000.00
Remarks: Tenant improvement, create new offices
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 6/16/03 $498.15 Electrical Permit Required
TAX 8% State Tax 6/16/03 $39.85 F r Permit Required
[TAX] Framing Insp
[BUPPLN] Pln Rv 6/16/03 $323.80 Gyp Board Insp
[FLS] FLS Phi Rv 6/16/03 $199.26 Susp Ceilng Insp
Total Final Inspection
$1,061.06
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 starte w n�180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
req ' s you to folly the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 - 001 -0010 through AR 952- 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 o 1 -800 -3 • • 4.
1 4 r'
1 ' 4 '
Is ed By: f .6 r /�►rl� N /
-,� : LL
" Permi
Signature: 4, �� ��� -1 •
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
644.40.2av3 - ca 34 /
• , ; - ilVED - j r
•
- • BU 1dingPermit Application -- _ _
Datereceived: Permit no.:
. ,, City o f Ti and
- ° -� g Project/appl.no.: Expire date:
City agard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: ET. Receipt no.: .
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: 1&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 0 Tenant improvement 0 Fue sprinkledalarm 0 Other.
JOB SITE INFORMATION
Job address:/9 j ' _ d , may- .4 , 1 107ZMIIIIIIIIIIII Bldg. no.: Suite no.: •
Lot I Block Subdivision: Tax map/tax lot/account no.:
Project name: <`74" :el— / ,
Description and location of work on pre special conditions: s • • vcr�++.•/ ' /►'7 / _
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: PacTrust • ( Floodplain , septic capacitv.solar,etc.)
Mailing address: 15350 SW Sequoia Pkwy. , #300 1' & 2. family dwelling:
City: Portland . I State: OR IZIP: 97224 Valuation of work $
503 Phone: 624.63 00 OIFax62.4 5± E -mail: No. of bedrooms/baths
Owner's representative: D e n n i s P a g n i Total number of floors
• Phone: Same Fax: S . e E -mail: New dwelling area (sq. ft.)
A1'I'LICANT 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 Sequoia Pkwy ., #300 Deck area (s R-)
City: Portland State: 0 R I ZIP: 97224 Other structure area (sq. ft.)
503 Phone:6 24- 6 3 00 Fax6 2 4 - 7 7 5• E-mail: Commerclallindust ial/multi- family:
CONTRACTOR Valuation of work $ � zie d
Business name: H H. L . Green Existing bldg. area (sq. ft '
Address: 1 3 50 SW Sequoia Pkwy. , #300 New bldg. area (sq ft.) 37��
City: Portland. 'State: OR I ZIP: 97224 Number of stories
503 1 Phone6 2 4- 7 717 I Fax: I E-mail: Type of construction
CCB no.: 41328 Occupancy group(s): j Existing: . _ . .e . ,4;
New: _
City/metro tic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Boaid under
Name: J o h n R 0 m i s h provisions of ORS 701 and may be required to be licensed in the
Address 15 3 5 0 SW W Sequoia Pkwy. . #300 jurisdiction where work is being performed. If the applicant is
city: Portl and (state O R � ziP:9 7224
exempt from licensing, the following reason applies:
Contact person: Plan no.:
5031 Phone:624 -6300 Fax:624 -775 ' E -mail: 'ohnr@lactustil.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 NO all jurisdictions accept t>ccEt cards. please call jurisdiction for more information.
attached checklist. All provisio /o and ordinances 'governing this 0 vsa 0 MasterCard
work will be complied wii fc died herein or not. c..mut csini mm / /
-
Expires
signatu ; Date t��s N ame of cardholder as shown on credit card
Print name: / s
�i - ` cstaidder striatum Amami
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (61001COM)
-4
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) G39 - 4175
INSPECTION DIVISION Business Line: (503) 639.4171 MST
BUP 3 — c==t 3Co.
Received Date Requested 3 AM PM BUP 3 - 0 0 y3$
Location 1 t R t {S ...�.e- �--c� Suite I (0 AE 3 ° Q -1
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: 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
Uot & 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 / 9 /
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL