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Permit CTY TIGARD SITE WORK PERMIT • I r„ DEVELOPMENT SERVICES PERMIT # : SIT2001 -00010 �i' DATE ISSUED : 5/25/01 . + Lsr „ � __ -^4' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11560 SW 67TH AVE PARCEL : 1S136DD- 001-86 2- SUBDIVISION: WEST PORTLAND HEIGHTS ZONING : MUE BLOCK: LOT: 004 JURISDICTION : TIG • CLASS OF WORK: PAVING ?: Y RESO. NO: TYPE OF USE: COM GRADING ?: Y VALUE: $120,000.00 EXCV VOLUME: cy LANDSCAPING ?: Y FILL VOLUME: cy SITE PREP ?: Y ENG FILL ?: STORM DRAINS ?: Y SOILS RPT REQD ?: Y IMPERV SURFACE: sf Remarks: Site work permit for new office building. Owner: FEES GREEN, JOSEPH W PO BOX 759 Type By Date Amount Receipt PORTLAND, OR 97207 PRMT CTR 5/25/01 $822.30 27200100000 PLCK CTR 5/25/01 $534.50 27200100000 5PCT CTR 5/25/01 $65.78 27200100000 Phone: FIRE CTR 5/25/01 $328.92 27200100000 Contractor: Total $1,751.50 JOE GREEN INVESTMENT INC PO BOX 759 PORTLAND, OR 97207 Phone: 503 - 678 -6266 Reg #: LIC 57652 Required Inspections Erosion Control Insp 846 -8444 Excavation Grading Paving Insp Strm Drain Insp Culvert/Catch Basin San Sewer lnsp Manhole /Cleanout - PVT Domestic water line inspect. Landscaping lnsp Final Report Eng'd Grading Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be don n accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, o . w• suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by ! e Or-t• Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -1180. •; (ay obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. Permittee Signa re: 4. Issue y: ARAM- - Cat IZ%.0 Call (503) 639 -4175 by 7:00 P.M. for an inspection needed the next business day .�_. �r i 2 B Permit Application A Date received: s / 0/ Pemut no.:c5/ / -000 /0 r � iy? City of Tigard - Project/appl. no.: Expire date: ` ° City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 one: (503) 639 -4171 Date issued: By:. Receipt no.: e. Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: c r.) k goon - / S 1 &2 family: Simple Complex: TYPE OF PERMIT , 0 1 & 2 family dwelling or accessory U Commercial/industrial 0 Multi - family New construction O Demolition 0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other: JOB SITE INFORMATION Job address: // Sire) 40 0 7 - 4 Bldg. no.: Suite no.: Lot: I Block: (Subdivision: I Tax map /tax lot/account no.: Project name: cmE A) n,K4 Cf. Oyu✓ `.V7A) Description and location of work on premises/special conditions: /1 tape 411 —, 'OWNER . - ; FOR SPECIAL.INFORMIATION, USE CHECKLIST Name: e -, (Floodplaii septic capacity, solar, etc.) Mailing ito ,e 74- 1 & 2 family dwelling: City: p f fit?!.,/ IS Q (ZIP: 0 7 Valuation of work $ Phone: ct9 ? j 7e2f, 'tIFax: cl t.-e_ I E -mailz , j ut . ING m No. of bedroos/baths Owner's representative: SA Aji , 1 Xetal number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT ' Garage carport area (sq. ft.) Name: rho. Te.P/v/ Covered porch area (sq. ft.) Mailing _ e Deck area (sq. ft.) ®ff I'�j Other structure area (sq. ft.) hone:S'03 (7 b 2 Fax: c'q� E-mail: /ep,.1"6T j7VG Commercial/indus tri a1/multr family: P c Valuation of work $ \ 2�c;c. i} < ,- ; _CONTRACTOR � - Existing bldg. area (sq. ft.) Business name: tie 9l�ON� ..- dPJ /i.,60...- ��� Addres . 7c-9 New bldg. area (sq. ft.) City. c f f � N _,/ 1s I ZiP y/ Number of stories 6L6(I Fax: , f 9,-e E -mail6 e / Type of construction Phone: SW Z 7 r�'''� 6 � • upancy group(s): Existing: CCB no.: ,c74 2- S - -0/ Lr . New: City/metro lit. no.: G j 1 Notice: All contractors and subcontractors are required to be ' ARClliTECT licensed . 'tensed with the Oregon Construction Contractors Board under Name: f ,i Fpm UN' provisions of ORS 701 and may be required to be licensed in the Address, 2;' . A r ■r� /` / e jurisdiction where work is being performed. If the applicant is �m' .' j IP: _ exempt from licensing, the following reason applies: Contact person: 47. , / - Plan no.: Phone:So 3.2c/, , 3§ Fax5p3 -2ygdt -mail: _ ENGINEER .:. Nam: ( / orA i9 1/e'r Co l . ct pe Fees due upon application $ Address �, i e ... Date received: • /�1ZIAT Wal ZIP :. INI' Amount received $ Phone: So - 2/e. 0 '2 ! Fax: 'mail: Please refer to fee schedule. I hereby certify I have • .. 4 d : amin:. , s application and the Not all Jurisdictions accept credit , please call jurisdiction for more information attached checklist. All p . isi'ns of 1. 1 d ordinances governing this 0 Visa 0 MasterCard work will be complied wi hether s ,':f ified herein or not yiy0, Credit card number / / Expires Authorized signature: !- Date: Name of cardholder as shown on credit card $ Print name: - ( / J 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 (6A0/COM) c. SITE WORK PERMIT CHECK LIST Commercial and Multi - Family: Complete ENTIRE form. Residential: Complete SHADED areas only. • Excavation Volume: cu. yds. Grading Volume: (Soils report required for >5,000 cu. yds.) cu. yds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum density) cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other Total new impervious area including all buildings, sidewalks, and paving: sq. ft. . Site Utilities Plumbing Work: Complete the "TAN" Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" attached. The following must accompany this application: Site Plan with Vicinity Map Parking (including ADA) and showing ADA compliance Lighting Plan Grading Plan and details Landscaping Plan Erosion Control Plan and details Retaining Structures Site Utility Plan and details Soils Report (if required) (showing connection to approved system) i : \dsts \forms\sitecheddist.doc 12/21/00 r CITY OF TIGARD BUILDING DIVISION PERMIT #: SIT2001••00010 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5!25/2001 Phone: (503) 639 -4171 tact Inspection Requests (24 Hrs.): (503) 639 -4175 `'f L INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7 :05AM PAGE: 14 11560 SW 67TH AVE SITE ADDRESS: CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 044 TYPE OF USE: PROJECT NAME: GREEN OFFICE COMPLEX DESCRIPTION: Site work permit for new office building. OWNER: PHONE #: CONTRACTOR: JOE GREEN INVESTMENT INC PHONE #: 503-678-6266 Inspection Request Scheduled For: Date: 7/1712006 Pour Time: Code # Inspection Description Confirm # Contact # Message 499 Final inspection 032993-01 503 - 806 -3004 Y Corrections /Comments /Instructions: r E tip a ----- 1 Ilf:i■ &Mr ---7- . PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL • CALL FORINSPECTION ❑ ADDIT NAL ES ASSESSED 0■4 �'} Inspector: , I : Date: v Phone #: (503) 718 - Z/ CITY' OF TIGARD �� BUILDING DIVISION PERMIT #: z 1 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 „.. „.. ' J --. INSPECTION WORKSHEET FOR DATE: c2(Z7 ® T IME: PAGE: , SITE ADDRESS: t ( <co / CLASS OF WORK: SUBDIVISION: / LOT #: TYPE OF USE: PROJECT ON: DESCRIPTION: OWNER: (�� PHONE #: E �� CONTRACTOR: ' ( t � PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 4qc S tre_ Foi& — Corrections /Comments / Instructions: j l l2( Fe_ Ft "-- LO • • '.: Ts" /. Pcv. (' FO-c EU &-U _el>--1 kig-- i' ori 1.0,,E ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: Phone #: (503) 718- 1 j741r CITY OF TIGARD 24 -Hour o BUILDING • Inspect lire: (503) 639 -4175 INSPECTION DIVISION . Business Line: _ (503) 639 -4171 MST BUP Received //__ Da at �-- teRequested 1 1 AM PM BUP Location _// & 0 Oi) ( 7 444- u Suite MEC Contact Person t& • a/M-4/ Ph (_,) k 9 (3 3'4 PLM Contractor �..- Ph ( ) - SWR BUILDING Tenant/Owner - ELC Footing /I Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: IT 1 — 00 LO Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear • Framing w-= =��= Insulation Drywall Nailing • Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof a / / A • — � Other: ` Final PASS PART FAIL PLUMBING Post & Beam - Under Slab Rough -In 61 ' - ` ` / dliv Water Service Sanitary Sewer Rain Drains Catch B- sin / Manholl , -- • -r *an rAi 11 5 .1 ■‘ffMr vP Other: Fi PART FAIL ANICAL Zit Post •& Beam Rough -In j;/ / /" 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: El Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date Inspector Ext Other: Final DO I OT 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: i (14639 -4171 MST BUP Received Date Requested -.AS AM PM BUP Location / /.c& /I 4ve Suite MEC Contact Person �'►�l�" Ph (Ce cr ) SD3 SD7— 8'33 PLM Contractor q•/• ' - pc.-44 Ph ( ) SIAM .Te a nt/O C wner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain • Cp 2D D/ - D OO! O Slab Inspection Notes: Post & Beam Shear Anchors / Ext Sheath/Shear t 1 eCk% t ' Int Sheath/Shear Framing Insulation Drywall Nailing Firewall • Fire Sprinkler Fire Alarm ! - �� Susp'd Ceiling — — /� — Roof Other: - Final PASS P T FAIL Beam - - Under Slab Rough -In Water -- • ' -- 'am Drains Catch Basin / Manhole y e c Storm Drain Shower Pan Other: Final c eo PASS FAIL MECHA AL - 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 PA RT FAIL SITE 111 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approa /Sidewalk Date ?5/6:3 Inspector Ext Other. S Final - DO NOT REMOVE this inspection record from the Job site. _ PASS PART FAIL - ITY OF TIGARD 24 -Hour ` ' . BUILDING Inspection Line: (503)639 -4175 • _ • INSPECTION Business Line: - (503) - 4171 MST BUP Received Date Requested 9-26) AM PM BUP Location 11 ( CO ALL Suite MEC Contact Person 2"r ! JJ �rt vt 4/1. Ph ( 50 ' cS v 7 — F3 3 5`PLM Contractor �� c `vt.(,�d'1•Ph ( ) SWR BUILDING Tenant/Owner ELC • Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SI f — 05 QC) 1 C� Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation �j / Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling .0" '' i � � Roof Other: `L L 21 11 l i � i/ ii/ Final PASS PART FAI • UMBIN `1' i1 ' ; ;;% !' j i►��� /I Post & Beam Under Slab Rough -In Water Servic t unitary Sewer, Rain I •' , Catch Basin / Manhole Storm Drain Shower Pan Other: Final PART FAIL 'CHANICAL Post& Beam Rough -In - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service - Rough -In UG /Slab Low Voltage Fire Alarm Final Li 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 Approach /Sidewalk Date w i Inspector 0 Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL