Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2002 -00001
" � l DE VELOPMENT SERVICES DATE ISSUED: 1/3/02
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16160 SW UPPER BOONES FERRYRD PARCEL: 2S113AB -00600
SUBDIVISION: BA/SI IO CREEK ACRE TRACTS ZONING: I -L
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: 0.00 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: Y SMOK DET:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 32,956.00
Remarks: Commerical tenant improvement, construct walls in existing space, add restroom & shower.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300 p �2
Phone: Tl l one'. Fz4 7
Reg #: uC 41328
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PRMT CTR 1/3/02 $343.30 27200200000 Electrical Permit Required
Sprinkler Permit Required
5PCT CTR 1/3/02 $27.46 27200200000 Fire Alarm Permit Requirec
PLCK CTR 1/3/02 $223.15 27200200000 Framing Insp
FIRE CTR 1/3/02 $137.32 27200200000 Gyp Board Insp
Final Inspection
Total $731.23
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 JAR 952 -00 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -66: •7 r 1- 800 -3. , -234
Pe mi ittee _ , - My
Si! • - ure: ifi ..„......
Is- ed By: •_ (fiv i I i
Call 6 -4175 by 7 p.m. for an inspection the next business day
57C G36a--
_ A . Building Permit Application
City of Tigard Date received: / ,3 ,e) P... Permit �
Permit no :� /
' ''� �� Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:. 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/industrial 0 Multi - family 0 New construction 0 Demolition
A Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler/alarm 0 Other.
JOB SITE INFORMATION
Job address: / 6 / 60 $ , ' 64bN£3 p- /L t f 0 . Bldg. no.: 6 Suite no.:
Lot 'Block: L . ' vision: 'Tax map/tax lot/account no.: •
Project name: e)(ELM/S /N G,
Description and location of work on premises/special conditions: CON 3V cT w A ' S .v ex&sr .ulo S P4
10. .► - . me W E?C 1 iCA L. _ C 1' v I
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: PacTrust • . (Floodplain, septic capacity,solar, etc.)
Mailing address: 15360 SW- Sequoia Pkwy. , #300 1 & 2 family dwelling:
City: Portland (state: OR IZIP: 97224 Valuation of work $
Phone: 624 -6300 (Fax: 624 - 77551E -mail: No. of bedrooms/baths
Owner's representative: Dennis Pa g n i Total number of floors
• Phone: a A _ a , , Fax:. A _ E -mail: New dwelling area (sq. ft.)
APPLICANT . Garage/carport area (sq. ft.)
Name: PacTruSt Covered porch area (sq. ft.)
Mailing address: 15350 SW Sequoia Pkwy. , #300 Deck area (sq. ft.)
City: Portl and : I state: OR I Z>P; 97224 Other structure area (sq. ft.)
Phone: 624 -6300 Fax: 624 -7 755 E-mail: Commercial/industrial/multi-family:
CONTRACTOR Valuation of work $ 32, 93
Existing bldg. area (sq. ft.) /2 / /)6O CP
Business name: H. L . Green Co.
New bldg. area (sq. ft.)
Address: - • 15350 SW Sequoia Pkwy., #300 Number of stories
City: Portland 'State: OR I ZIP: 97224 Type of construction V
Phone: 624-7717 1 Fax: 624-7 7 5 51E-mail: Occupancy group(s): Existing: a/14 " 1
CCB no.: 41328 New:
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: Rona 1 d ,' M . Te s c h provisions of ORS 701 and may be required to be licensed in the
Address: 15350 SW- Sequoia Pkwy.,. #300 jurisdiction where work is being performed. If the applicant is
City: Port l and _ State: OR . I ZIP: 97224 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: 603 -5461 Fax624- 7755 E -mail: ront @pactrus 1 p. Lum
ENGENEER
Name: NA Contact person: Fees due upon application $
Address: . Date received:
City: (State: ZIP:. Amount received $
Phone: 1 Fax: 1E-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 s • aws and ordinances governing this r3 visa 0 MasterCard
work will be complied i s' wh t r s • . if ed • - . 'n or not. credit card number. / /
/ Expires
Authorized signature- /i _ . 1 Kr. Date: Name of cardholder as shown on credit card
Print name: 0 NA (1) 11). • - - $
.
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (643QICOM)
)
Over - The - Counter (OTC) Building Permit
A pit ,„„, ;��1 Commercial (structural) Building Check List
City of Tigard
Description of Project: a•-- e/ .r✓�.�/- - *�y � L--
GENERAL INFORMATION
Class of Work:* Floor Areas (sq. ft.): Exterior Wall Construction:
Type of Use:* First floor: N: S:
T p of Construction: s , Second floor: E: W:
Occupancy Group: '� Third floor: Openings Protected Y/N ?:
Occusanc Load: �, Total sq ft.: N: S:
Stories: NM= Note: Combine total floor area for _E: E:
Height: INTAMMI all floors above third floor and Roof Construction:
Floor Load: /� add to the third floor sq. ft. Fire Retardant:
Basement: Basement: Area Separation Rated:
Mezzanine: ( Garage: Occu. Separation Rated:
REQUIRED ITEMS
Fire sprinkler: S / - Handicap access: cr �
Smoke detector: / u Protected corridors: � �/• �
4 —e
Fire alarm: 7 .S Parking spaces ( #): ,vow
Notes:
INSPECTIONS FEES DUE
Footing /foundation Firewall $ 3 v3, 3c Permit Fee
Post/beam structural Smoke detector $ !2 ' •'- Plan Review Fee
Shear wall Misc. inspection $ 2?, Yew State Surcharge
Masonry Approach/sidewalk $ /37 - - F4—
Framing $ Additional Plan Review Fee
Insulation Sprinkler rough -in $ Investigation Fee
Gyp board Fire alarm $ Misc. Fee
Suspended ceiling Sprinkler final $ Hourly Rate Fee
Final inspection $ Hourly Rate State Surcharge
$ 73i Total Fees Due
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs,
awnings or canopies); REP = repair.
i: \dsts \forms \OTC - BUP.doc 07/30/01
CITY OF TIGARD 24 -Hour r •
BUILDING ` Inspection Line: (503) 639 -4175
,MST - •
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP a- °OZ ' 000 /
Received 1:. Date Requested (—o &( AM PM SUP
Location !' / 4' o Suite MEC
Contact Person 3s as Ph ( ) PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain � QQ
Slab Inspection Notes: SIT
Post & Beam
•
Shear Anchors d , —
Ext Sheath/Shear
Int Sheath/Shear
, Fra :' el
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi
�-� 'ART FAIL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA l
Approach/Sidewalk Date Z 7 / l ) Z-- Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OFTIGARD 24 -Hour •
•
Inspection Line: (503) 639 -4175
BUMPING
INSPEC TIQ VN DIVISION Business Line: (503) 639 -4171
1
BUP 2-ODa 6 000
Received qv- 07 Requested / — g AM PM ElUP
Location �., _ 'G %lf0/Z/ f' ' C- MEC
Contact Perso Ph ( ) ' —357 .;--S38' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner I'- X I S ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: - FR I SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear • '
Int Sheath/Shear
Framing
Insula •1
rywall Nailing
irea
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
*ART FAIL
�• NG
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 J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE L Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk
Date 7 Z`) - Z) Z Inspe or Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
GITY•OF TIGARD 24- Hour " -
•' Line: (
Inspection Li503) 639 -4175
BUILDING-1,, •--- ` ,,.
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
���" ( cOC=1 a.' 6c)06
Received Date Requested Z Z U AM � , 1 M BUP
Location /6/6,6 f) .' 4 Suite F-(4 MEC
Contact Person Ph ( ) L 351 .. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 6A i / kJ 5 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain •
Slab Ins ecti Notes: fJ SIT
Post & Beam N/) W6 T"Q/'( 1( Q 44-
Shear Anchors 511 Tl
Ext Sheath/Shear 0 ----k--,---
Int Sheath/Shear / J nsf elation /4 /VI : 8 ?-C, d d- - 60 vd- /
Drywall Nailing
Firewall
Fire Sprinkler A � `Y � r c J-,--C Alarm /� A � � ^
Susp'd Ceiling `
Roof 1e■-- , .7LQJ 0 -e.--
Other:
Final
C A - `•r -- \.A...) "Q - P
PASS ART FAIL �
PLUMBI
Post & Beam
Under Slab
Rough -In o `"" C-e ' \A-e-e—SL_ Q,..4---u....3_
Water Service
Sanitary Sewer Lk-e— Y
Rain Drains
Catch Basin / Manhole L!`17 `-1,.". L.--ck_A. 6-.-v--e a.
Storm Drain
4
Shower Pan
Other:
Final ` `--\/
\
PASS PART FAIL
MECHANICAL S S pa,. 17LL e- ��
Post & Beam _ y
Rough-In
Gas Line ` G
Smoke Dampers �'�R _.�
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 III Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA Approach/Sidewalk Date ?b/e 2 " Inspector �� Ext3 (
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY 'OF TIGARD 24 -Hour
BUILDING."' o Inspection Line: (503) 639 -4175
e '� M
INSPECTION DIVISION Business Line: (503) 639 -4171 4 25 odon
Received Date Requested Zz ' AM Z P M BUP
Location � �¢ (4 R
R01400 l Suite FIAA4-7 MEC
Contact Person JU Ph ( ) 357 �53� PLM
Contractor Ph ( ) SWR
BUILDING Tenant /Owner J G1 JC S Z4\16 • ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain t SIT
Slab Inspection Notes:
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
a ai mg ) •
Firewall trl� —C� a
Fire Sprinkler
Fire Alarm n „
Susp'd Ceiling _ V�•K —�
Roof
0th =
F/
PART FAIL
P 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 D 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 ^� ' n -
ADA Date ,) V ° Ins ector ` � E>$ 15
Approach/Sidewalk / P
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
_CITY OF TIGARD 24 -Hour
— Ins ection Line:
BUILDING (503) p ( ) 639 -4175 A MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP ,2-O0 0000 !
Received Date Requested AM PM . BUP
Location - • • / . • to MEC
Contact Person r 4 .y Ph ( 3.5 a 5 ? PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: f f SIT
Post & Beam ,, n '�� ,/
Ext Shear ea Anchors
C %� �—C 24 J i 17 WI �ll.G(
Ext Sheath/Shear �� U rl -d
Int Sheath/Shear
min
nsulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ,4
Susp'd Ceiling
Roof
Other:
CD PART FAIL
P • 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 beA-xt 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
Fir ADA /G� Approach/Sidewalk Date Inspecto Ext
Other:
Final DO NOT REMOVE this In _ e on record from the Job site. •
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 r -
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
�./ BUP D-06 6000 /
Received Date Requested l — c 2 3 AM PM BUP
Location - ► d.-�� Suite FL-6/1/ MEC
Contact Person /1 Ph ( ) 3.3 c 53e PLM
Con Ph ( ) SWR
E�UILDIN Tenant/Owner ELC
`Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
w�IfNail
Fire
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P APART FAIL
PLUMBING
Post & Beam
- Under Slab
Rough -In
Water Service
Sanitary Sewer I
Rain Drains
Catch Basin / Manhole
Storm Drain
Other: Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough-In Line
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 LI Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA J
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
BUP 66 00
Received Date Requested S _ AM PM BUP
Location uite MEC
Contact Person ' �' Ph ( ) PLM
Contra • Ph ( ) SWR
UILDIN a Tenant/Owner ELC
ELC
• • _ • ion Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam •
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
e./ A1/4./
Firewall
Fire Sprinkler
Fire Alarm
1
Susp'd Ceiling
Roof
Other:
4 PART FAIL
P = 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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA , I/O
/ �
Approach/Sidewalk Date Ins Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL