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Permit CITY OF T I G A R D BUILDING PERMIT PERMIT #: BUP2004 -00062 - � ��i�i DEVELOPMENT SERVICES DATE ISSUED: 2/20/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD 00700 SITE ADDRESS: 15780 SW UPPER BOONES FERRY RD BLDG D SUBDIVISION: ZONING: IP BLOCK: LOT: 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 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 9 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: $ 15,000.00 Remarks: TI, new walls for new tenant. Owner: Contractor: PACIFIC REALTY ASSOCIATES C.A. GREEN 15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA PKWY. #300 PORTLAND, OR 97224 PORTALAND, OR 97224 Phone: Phone: 503 - 624 -7717 Reg #: LIC 156496 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Pert Fee 2/20/04 $187.30 Electrical Permit Required nn [TAX] 8% State Surchari 2/20/04 $14.98 Plumbing Permit Required Framing ming Insp [BUPPLN] Pln Rv 2/20/04 $121.75 Insulation Insp [FLS] FLS Pln Rv 2/20/04 $74.92 Gyp Board Insp Total Final Inspection $398.95 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 952-001-01 I • • . • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by callin. 03) 246 -669• •r 1- 800 -332- 4. Is. ued By: _. jer0 Perm' - • , // / Signature: �� /./ :, r -� j � / / /�,�� Call 639 -4175 by 7 p.m. for an inspection the - .t bus' • ess day / • VCD " 2 -20-0 ,.S . Building Permit Applicataon _ _ Date received: / /d Permit no.: p � City of 'Tigard City ogigard Address: 13125 SW Hall Bl� Q1 Pro�ecdappl.no.: date: Phone: (503) 639 -4171 Date issued: Bt I Receipt no.: . Fax: (503) 598 -1960 r r o 2, u .104 Case file no.: I Payment type: t co Land use approval: LAY O l LGAR O � 1&2 family: Simple Complex: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 New construction 0 Demolition 0 Addit ion /alteration/replacement Tenant improvement 0 Fue sprinkler/alarm 0 Other: JOB SITE INFORMATION • Job address: ..-Mi / i" 1 • 'A. iii' -4/i _ Bldg. no.: _ jb Suite no.: O Lot: Block: Subdivi • on. Tax map/tax lot/account no.: Op Project name: 4 A. y-7 �l�JZ=�f. -� Descri • tion • r d location of work on . remises/special conditions: / / /�i /.. 2` /& BQ .7� T OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name P a cT r u s t (Floodplain, septic capacity, solar, ere.) Mailing address: 15350 SW Sequoia Pkwy. , #300 1' & Z family dwelling. City: Portland . I state: O R IZiP: 97224 Valuation of work $ 503 I Phone:'.:* 6 24 :63 GO 11Fax6..24-7.`/.S: E-mail: No. of bedrooms/baths Owner's representative: Dennis P a q n i Total number of floors , • Phone: Same • Fax: Same 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 5 0 SW Sequoia Pkwy ., #300 Deck area (sq• ft.) City: Portland state: OR I ZIP: 97224 Other structure area (sq. ft.) . 503 Phone:6 24- 6300 Fax6 24 - 7 75 ' E-maiL Commercial/industrial/multi-family: CONTRACTOR Valuation of work $ /-6;s4 . � • .\„/ Existing bldg. area (sq. ft) /. /.2d Business name:,::, /,!! A.j A. . 4 : !;• "'A —� Address: • ; : : �. : ., ; . ,..: - // � 5r�l %%� T� %r i i i , i r� r i ' • (mil ) / _ City: Portland : 1 7 A 7 : 2 29 • • tones Type of construction 50 3) Phon . ;- E -mail: / i Occupancy group(s): Existing: ,'/>_� V l CCB ne -: ;;', p5 '� �' -, i New: . : City/metro lic. no.: 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 OILS 701 and may be required to be licensed in the Address: l5 3 5 0 SW Sequoia Pkwy. #300 jurisdiction where work is being performed. If the applicant is City: Portland [State: OR f zIP:9 7 2 2 4 exempt from licensing, the following reason applies: Contact person: I Plan no.: 503) Phone:624 -6300 Fax{24 -775 E-mail: •ohnr@ actrust 1 . com Name: Contact person: Fees due upon application $ Address: • : Date received: City: IState: 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 coda 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 with, whether c' red herein o t• �t card number: p / Authorized signatu ' r i ./ -1� k , .: / v — Name of cardholder as shown oo credit card Print name: ':, a iI ♦ //. 46. .." Cardholder signature s Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.4613 (603/COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST c 0- 00 l0 Received e Aue Date Requested 3 /3 0/0 AM PM BUP Location A -Suite MEC Contact Person ›a Ph ( 2 6 - g 6 0 / PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain /:ar, X 71` /it /�' Crawl Drain Slab Inspection Notes: SIT Post & Beam 2v /2 1 A Shear Anchors Ext Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Cei i Fool O. PART FAIL MBING 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 ,► /�� O ' , ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST Received- 7' Date Requested 3l O 5/ AM PM BUP Location • • :lid uite ergo 4 7 - 00 /0/ Contact Person - ' .0 eeatiLr-4-- Ph ( V/ ) s3 20 cP6 / PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: • Ftg Drain ELR Crawl Drain Slab Inspection Notes: / � _ SIT Post & Beam e r-C �/,!_(l —( SD '- Zt.vl� Shear Anchors /" Ext Sheath/Shear (7 Int Sheath/Shear Framing / - o t s /, Drywall on l 1 17 • ��,/A �- 1 ( � & 1,0-,Y l �l tZ€ — U�� Drywall Nailing �",l ` w / � g Firewall �v / {�- Fire Sprinkler J % C �C' l Roof .4-7 ■ u / r J /O // -2 O/9-a' Final ille PASS PART 110 • PLUMBING '� �J/ r� Post & Beam 3 2 1� , ,r1, Ll V U o /ata 1-19-w , ^ S , ,( ,. _ Under Slab �l/ "� �/ v I'fi�fl� Water Service L3 1L „ , 1 n Water Se V i ‘ I VI A--th �/��///��\ h !� f � ( (1[ -�Y Sanitary Sewer VV Rain Drains �) _ ,�° Catch Basin / Manhole (�I L— Lg i 0 p L — a /� O 7�7 Low Ir Storm Drain Shower Pan 1- 6 -i vk A Z24 Other: Final PASS PART FAIL I c � I e �`e l Iw Q ge MECHANICAL _ �. . iI G _d LA I u't r `J Y �J Post & Beam Rough -In Gas Line l ampers 40 PART FAIL RICAL 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 ADAoach/Sidewa Date Inspector ��q. 1 Ext pp lk Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL