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Permit .‘ , . A, C ITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00265 NJ ; 4 DEVELOPMENT SERVICES DATE ISSUED: 6/29/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DD -00200 SITE ADDRESS: 11560 SW 67TH AVE 333 SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE BLOCK: LOT: 004 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: 36 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: $ 20,000.00 Remarks: Tenant Improvement. Owner: Contractor: GREEN, JOSEPH W JOE GREEN INVESTMENT INC PO BOX 1 PO BOX 1 DONALD, OR 97020 DONALD, OR 97020 Phone: Phone: 503 -806 -3004 Reg #: LIC 57652 FEES REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUPPLN] Pln Rv 6/7/2004 $152.95 Electrical Permit Required FLS] FLS Pln Rv 6/7/2004 $94.12 Sprinkler Permit Required [ Framing Insp [BUILD] Permit Fee 6/29/2004 $235.30 Gyp Board Insp [TAX] 8% State Surchari 6/29/2004 $18.82 Final Inspection Total $501.19 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: , %11 / / . Permittee Signature: i Call 639 -4175 by 7 p.m. for an inspection the next business day ppiiir w 6-7-T" Alla C IVE® - Building Permit pp ica ton FOR OFFICE USE ONLY City of Tigard JUN 7 2004 Date/By: Received PermitNo.1/ /10 O -L7 13125 SW Hall Blvd., Tigard, OR 97223 P lan Review, rl/( / � � Phone: 503.639.4171 Fax: 503.6 TY TIGARD / „0/� wt,IA Date/By: e 6,..t / 5 1 Other Permit: Inspection Line: 503.639.4175 7'1-11-•• D ate Ready/By: 04e l!l Juris: 10 See Attached Checklist for Internet: www.ci.tigard.or.uS BUILDING DIVISION N otifie etho Supplemental Information 1 ' a,. `' i, TYPE "'OF WORK c '' ,- RED' DATA : ANDTFAMILY DWELLING , • r: • C 84,1ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ' ` .i d CATEGORY O)E CONSTRUCTION xb,''--Alz >� work indicated on this application. ❑ 1 and 2- family dwelling �,. ' g ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder E Other: (- Number of bathrooms: ` < "� � x q^ JOB�''SITE 1NFORMAT AND LOCATI , . s Total number of floors: Job site address: 1 i ��D .\r ` /e.7 ' 714 A-4/ C New dwelling area: i square feet City/State/ZIP: A kro L)R Garage /carport area: -=-�� square feet Suite/bldg. /apt. no.: 33 3 Project name: 6, R 1 1 Covered porch area: square feet Cross street/directions to job site: 3 A ko t K Deck area: square feet Other structure area: square feet REQUIRED DATA COMMERCIAL USE'CHECKLIST': Subdivisi t1/ /p. I Lot no.: N /� 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 equipment, materials, labor, overhead, and the profit for the , r� '- , fi° „„ 4 ., D E SC RIP T I O N O �V :4' work indicated on this application. ` • e yrf te n� .1- MpiovArnai 45 Fu/ 0 1 '� S � Valuation $ Existing building area: square feet New building area: square feet x { ;( OWNE i ° ' ' � ' s p , ... TEN ,.� n h Number of stories: A . Name: t � 6, ecstis. • Type of construe ,; Address: p. lJ0d i Occupancy groups: City/State/ZIP: o A t 4 ) 62 1 7020 Existing: Phone: (5 0)6 300H Fax: (63) 479 2447 New: - s} a APPLICANT ' -. ' `' CON` ACT PERSON' '' Business name: All contractors and subcontractors are required to be Contact name: ,---- . cj 70 - , Z licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: v i jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State/ZIP 00,140 OR 4170-20 6 apply: Phone: � — 1.,__ Fax:: (y'dg L- E-mail: „.. J /ptl,.,_@ C01>e,M /'zw5 I f e 4 )J. C! - e r,Yrl x a _ > '-',.-.=.:-:,- wr _ "z•: `w7 CONT RA CTOR ” ` ., ,..'., ..:, 2 .... - ... Business name: l' e iT if e . 24,./- - tv"...„4 01 I 'BULDING PERMIT FEES* Address: Q 0, spik Please refer to fee schedule. • City/State /ZIP: ©O>7ej 3 OR 't P� Fees due upon application a 9 7 , Q `7 Phone: (58 gob _ j.,/ Fax: ( , 3) 6,`7$ _ (924 6 / - I Amount received a L/7, Q 7 CCB lie 5-7 `/' 7 9( O t/ Date received: Authorized signat 111 ('his permit application expires if a permit is not obtained Q ` witIi180 days after it has been accepted as complete. Print name: ;fly / _��� Date: (v /7 i 4)* ee�ethodology set by Tri- County Building Industry (� �' ce Board. i:\Building \Permits \BUP- PemutApp.doc 12/03 440- 4613T(1I /02/COM/WEB) Building Division 1 1. 'Plan Submittal Requirement Matrix =--' Commercial & Multi - Family - New, Additions or Alterations City of Tigard a T ype of Submittal 3 ' "',of Plans 4 F d.h (Includes new; additions; and alterations) M Re uitred at l t 7 S C q • s 3 S t$ J y f Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) 2 Building 1* Fire Protection System 3 ** Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue) * For over - the - counter commercial tenant improvements, submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i:\ Building \Forms \COM- PlanSubReq.doc 12/24/03 . .. ..._ ,. CITK.OF,TIGARD -. ---- BUILDING DIVISION PERMIT #: BUP2004-00265 - .- 13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 6129/2004 Phone: (503) 639-4171 Alk ,1 . ' Inspection Requests (24 Hrs.): (503) 639-4175 t INSPECTION WORKSHEET FOR DATE: 11/29/2006 TIME: T04AM PAGE: 1 SITE ADDRESS: 11560 SW 67TH AVE 333 CLASS OF WORK: SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE: PROJECT NAME: GREEN OFFICE COMPLEX DESCRIPTION: Tenant Improvement. OWNER: PHONE #: CONTRACTOR: JOE GREEN INVESTMENT INC PHONE #: 603-678-6266 Inspection Request Scheduled For: Date: 11/29/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 040398-01 503-006-3004 Y ' Corrections/Comments/Instructions: ----' , 0 ---- ---- " W 4,If ' • ' ----- , • F . PASS fl PARTIAL APPROVAL 0 CANCEL El NO ACCESS n FAIL 0 CALL F.R INSPECTION E ADDITIO AL F ES ASSESSED Inspector: 1111 i V Date: ' CI- i' l Phone #: (503) 718:24--Z3 CITY. OF.TIGARD \ BUILDING DIVISION PERMIT # pQ y—o 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 d r, -14(1F Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 1 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 6 ( , 7 — CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: l— T 2 4,0' . DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 7 0 (v Pour Time: : Code # Inspection Description Confirm # Contact # Message .�S F6C-3°o`f G Corrections /Comments/ Instructions: ._.--- _-----------\/ Allib - ------ e - \_., _ . J tt 222– 1 PASS F PARTIAL APPROVAL CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL OR INSPECTION n ADDITI NA FEES ASSESSED dr■P /2 Inspector: I Date: a Phone #: (503) 718- WAT CITY ®F TIGARD 24 -Hour - e ,' _BUILDING Inspection Line :1503) 639 -4175 • ealpf INSRECTIO,N DIVISION 0 Business Line: (503) 639 -4171 ii) , / -- ' C p T Received Date Requested / g AM �� �� PM BUP c' � Location / l 56 v (4, 6 Suite 33.3 MEC Contact Person Ph ( ) g6&-3004/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: / ELC Ftg Drain l Q l ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors - Ext Sheath/Shear Int Sheath/She- D-6 / ;� (��� . k 6/ \`� U y , i ) Framin [ i / ns anon �= Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: • F Fin - 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 El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: El Unable to inspect — no access Fire Supply Line f ` � AADApp oach/Sidewalk Date k C / Z � o I nspec t or `��' '" �- - Ext Other: Final DO. NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24- Hour.. • Inspection Line: (503) 639 -4175 11 BUILDING MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP 2063 - 'Dd Received Date Requested / " 9 AM PM BUP O ( — O Location / r C7a 6 6 7 Suite 3-33 MEC Contact Person Ph ( ) '() 6 -3 e-. T PLM Contractor Ph SWR BUILDING Tenant/Owner - ELC Footing . Foundation ELC Access. Ftg Drain 1 `T �� �� ` ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear _ . Int Sheath/Shear Framing Drywall Nailing Firewall ._._- ' LCD V -■KAA, ?FE■akt\-- J Fire Sprinkler Fire Alarm Susp'd Ceiling � , Roof - . , .�. 4. . Other: - - Final PASS PART FAIL �, PLUM NG 1 7 M� , y l , _ Post & Beam 0 v, op- � , � -� .. �''�. ' - 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 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please ca, for rei r spection RE: _ 0 Unable to inspect - no access .. Fire Supply Line .-‘ Approach/Sidewalk Date • SA Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL - CITY OF TIGARD 24 -Hour .,. r° gibe BL!4LDi0� Inspection Line: (503) 639-4175 MST INSPECTION `VISION Business Line: (503) 639 -4171 L Received Date Requested 16 — / / AM PM BUP Location 1/ ,5 U 6 t -' Suite 3 3 3 MEC Contact Person. 96 Ph ( ) Foe, -300 y PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Ft "'""n � - -- _ ELC Drain Access: 9 ,�,(�V— 3 9a ELR Crawl Drain _ / ` Slab Ins •'. ction Notes: - .. SIT Post & Beam ` Shear Anchors _ >� _:.,.�: ,- Ext Sheath/Shear Int Sheath/Shear (� 0Q : i �� '2A0 0 14 - 003 a e Framin• 9 " v .1isu atio • � - k (, - A-` � Drywall Nailing Firewall � j ih Ki Fire Sprinkler tfJ� Fire Alarm t (NVkAm \ Susp'd Ceiling �� Roof l r" ` if Y� c-c„ -f�- ,3 S. �� 4 Other: ` Final ` - PASS PART dip '.......-----____.---.. PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer / Rain Drains �� ' Catch Basin / Manhole ��� %� /.,gf�r„� =�/ffi Storm Drain rd I IV 1 Shower Pan - Other: • Final PASS PART FAIL MECHANICAL kik _ � _ I!` Post & Beam -I r - 111 , Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE LJ Please cal or re' spection RE: 0 Unable to inspect - no access Fire Supply Line -.1 ADA �� � li Ext Approach /Sidewalk Date I nspe .13017 ' ' Other: Final - DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour . .. 1B6ILSIrvG i . Inspection Line: (503) 639 -4175 i MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP ' ' u Received `� T � " Date Requested 10 � AM PM BUP ° — o ff' " = `� Location // S&t' j(,c) 7. Suite / MEC Contact Person Ph (-5V- ) !' 3d i PLM Contracto . Ph ( ) SWR . BUILDIN Tenant/Owner � . r, II _'� - . ��Ii % i t_ ELC Footing . Foundation Access: ELC Ftg Drain s L 3c .A ELR - Crawl Drain Slab Insp tion otes: SIT Post & Beam ."-/.4.,_1„t 1.14_49,70-/v-ac. Shear Anchors R4-e-01---4 07\J Ext Sheath/Shear e hear � Framin -- Emulation Drywall Nailing Firewall Fire Sprinkler ----- rill Fire Alarm / .� Susp'd Ceiling 1 i �� � � t��=� Roof Other: /� Final ' 4L - 16 ail ' 'C ( 1S ( bE ` PAS PART AIL PLU N Post &Beam 11 j ; Under Slab r i'� Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole i Storm Drain ��� � � " Shower Pan A Final tIP PASS-RAW FAIL HANNA Rough - as ne Smoke Dam Final PASS ART AIL ELEC l Service Rough -In UG/Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 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 CITY OF TIGARD 24- Hour._ • tavj . Inspection Liner (50'3) 639 -4175 111 fga INSPECTION DIVIS Business Line: (503) 639 -4171 MST BUPa � Received _ Date Requested '.--- ` - 7 AM PM BUP q�- ',,ice /i Location i�U 7 Suite 3 3 3 ME C % ' , ' ' iiif Contact Person ct'e Ph ( ) Ste)-300 T PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: v FOc( Ftg Drain 6 !�, = ELR Crawl Drain Slab Inspec ' _ • • es: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ¢�r (i F' 2 � - 00 3' • 4 Fra C 7/ v � � ELC- G — CO l ko Drywall Nailing Firewall Fire Sprinkler w �' e I / Ccw /3 eCb okf - - Susp'd Ceiling Roof Other: Final PASS PAR '' PLUMBING Post & Beam Under Slab ( cc V Rough -In Water Service - Sanitary Sewer ( -—- Rain Drains - Catch Basin /Manhole - Storm Drain Shower Pan Ar - . . IPillila Other: Final , 1' ir & M PASS PART FAIL i ! � MECHANICAL ` \ +I - Post Beam Now �/ Gas Line n , Smoke Dampers � I 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 El Please call for. reinspection RE: Q 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 CITY OF TIGARD _ 24-Hour U!LDlNG. C Inspection Line: (503) 639 -41 r _ c INSPE'ICD Business Line: (503) 639 -4171 / BUP a Received 'Date Requested ` / AM PM . BUP Location //5 60 7 -J Suite 333 MEC c3663"66 Oaq Contact Person Ph ( ) RO6 PLM Contractor Ph ( ) SWR BUILDING. - . Tenant/Owner ELC Footing Foundation ELC Access: a t4.,e 6 , _ Ftg Drain /0 ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors �. EC) Ext Sheath/Shear / ! / n —�—C. Int Sheath/Shear t� Framing Insulation ng Firewal ire prinkler Fire Alarm �-� A Mail 1111 f'd Ceiling ��% `���� mogr ' i Roof A �1_... ' t�►1 Other: 1�77 . • ' - - Final _ PASS - FAIL PLUMB or .,.am . / ___ l�T l -- . Post & Beam ��7 /� 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 reinsp:, tion RE: fl 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