Permit (7,0 4.. BUILDING PERMIT
C ITY OF T PERMIT #: BUP2004 -00457
. �1�A DEVELOPMENT SERVICES DATE ISSUED: 9/27/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 150
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: f.A9aq.b4
Remarks: (3) relocates (3) additions.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES • DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone:
Phone: 620 -4020
Reg #: LIC 64174
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 9/27/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchari 9/27/2004 $5.00
•
Total $67.50
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: Arc ,
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
' uii ing Permit Application . FOR OFFICE USE ONL1'
City of Ti Da 1 2 :27 0V 4 4.2poY S/5 I
V
13125 SW Hall Blvd., Tigard, OR 972R r Permit No.:
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /5 ,1
Date/By: Other Permit:
Inspection Line: 503.639.4175 a .'I . Date Ready /By: lur ® See Attached Checklist for
2
Internet: www.ci.tigard.or.us SEP ,S 20 i���
' Notified/Method: 1 Supplemental lnformadon
clie ty t( L? _
. -.. -. 11 -'' Oki-L . -7 :. . '. , i- REQu DATA4'A1 D Zr, a "
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
p4....kLidition/alterationtreplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. ;CATEGOR - t: '
` . _x work indicated on this application.
❑ I- and 2- family dwelling I ommerci industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
floors:
.: , , -,.. • ' `-= � JOB. S fNFORMATiO : " � ' .T ,
Job site address: Total number of New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt. no.: 25I ) I Project name: U C AJLa-i S Covered porch area: . square feet '
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
t ..,-.• n s: igfia y a' ..'r.
Subdivision: I Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
�
;.,.; •r.r�y, ;. _•�, < {.w equipment, materials, labor, overhead, and the profit for the
,s . .. j,.. _; `."�r,:M..* iiiif a ! Ir W itA!x �y .',' work indicated on this application.
'� S Valuation: $ 07(4a9
l �� x
.A - ]f1 Existing building area: square feet
�` 1 `� " , New building area: square feet .
Number of stories:
xlr�": `
y. i'ROPERTY'"QWNR
D` ' ° � Q" EIYgIVT � ,, `
Name: Type of construction:
Address: Occupancy groups: •
City/State/ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
z � yy�
3,i...v . -r•- �F : f ' Y � ? � ' �± ' ' J +.',� : - ..
i _ �''• .,� j 3'1 ` •• - ,.y � ,COAI9'ACY P y 7� ri - :. ,. �r 3 . -,''
Business name: 4 I /Z. All contractors and subcontractors are required to be
Contact name: r `� licensed with the Oregon Construction Contractors Board
/1-1 � � �, �(j�J , f � 4U7s.. under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZlP: applicant is exempt from licensing, the following reasons
apply:
Phone: 3 c j �� .10 Fax:: 3) / r � E-ge PP Y
E -mail: r�c� `^' c i'� "'_ _ L . . - . C�
Business name:, . , ti •.. r y
Address:
City /State/ZIP: Cyr, � � 4'�D Please refer to fee schedule.
,1 / Fees due upon application 07 , . ---- Phone: ,) �� —(_f ) Fax: j 3 (09..e0 tent
CIO L Amount received
CCB lic.: L{1
Date received: •
Authorized signature' • X / /ri This permit application expires if a permit is not obtained
J � _ �
� within methodology days after it has been as Industry
complete.
Print name: _ , I / Date e7 • Fe m oll b
ogy set by Tri County Building Industry
Service Board.
i:l Building ■Perm,u'BUP- PennrtApp.doc I :/03 4404613T( I I /OLCOM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Lin 503) 639 -4175
MST �
INSPECTION DIVISION • Bu Line 03) 639 -4171 BUP �� 7 / // _ 7'� 7
Received ' Date Requested % — Z g AM PM BUP A-- —
/
Location 1 , S `T 9 .-_ 0 Suite `SZ MEC
Contact Person R- Cam -- J Ph ( ) O yo ac 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 " "1.7i -
Roo
Air /AS
PASS PART FAIL \P_ = ING Mg&
Post & Beam ursmariffir Under Slab
Rough -In
Water Service -� ` 1- �
Sanitary Sewer divvy
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 fl Please call for reinspection RE: El Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL