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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00112 ; �y;� DEVELOPMENT SERVICES DATE ISSUED: 3/11/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00100 SITE ADDRESS: 11308 SW 68TH PKWY SUBDIVISION: ZONING: MUE 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: 3N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 79 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: $ 50,000.00 Remarks: Phased project & phased occupancy. Owner: Contractor: BENSON CAPITAL IN LINE COMMERCIAL CONSTRUCTIO 1708 3RD AVENUE PO BOX 5837 NEW YORK, NY 10017 ALOHA, OR 97006 Phone: Phone: 519- 3970(CEL) Reg #: §&T5117 33885 FEES LIC REQUIRED INSPECTIONS Description Date Amount Mechanical Permit Require [BUILD] Permit Fee 3/11/03 $470.80 Electrical Permit Required TAX 8% State Tax 3/11/03 $37.66 Sprinkler Permit Required [TAX] Framing Insp [BUPPLN] Pln Rv 3/11/03 $306.02 Gyp Board Insp [FLS] FLS Pln Rv 3/11/03 $188.32 Final Inspection Total $1,002.80 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 • - - I - rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 1 e 0 through OAF452- 001 -010 You may obtain a copy of these rules or direct questions to OUNC by calling :03) 246 -6699 or 1-8 0- 332 -24 Issued = : _ �1!� , 4 ../ , Pe mt ittee Signature: _ J A ___, _,► , Call 639 -4175 by 7 p.m. for an inspection the next business day s , �_ + Building Permit Application OFrICF Ls' I.1 R �r • Date received: / i _ Permit no.: j i/i /_I ,.�,� City of Tigard Project/appl. no.: 41 Exp' =date: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Date issued: ism Receipt no.: Fax: (503) 598 -1960 Case file no.: - Payment ym type: Land use approval: 1 &2 family: Simple Complex: 1 l' I' F: 01 l'1:1011 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition 0 Addition /alteration/replacement tii'Tenant improvement 0 Fire sprinkler /alarm O Other: .10I3 SI IT 11\1.0101A 1 ION Job address: , 0 , It fragagnililli Bldg. no.: Suite no.: ' ., Lot: Block: Subdivision: Tax map /tax lot/account no.: Project name: iL..a , • . r., . L. a, , . • i . , 1._. 0 . 4 .: . Description and location of work on premises /special conditions: 1 1 3 6 7 i¢ - '(9© I 0 0 OWNER 108 SI'F( IM, INFOUN1A I10N. 11til: ( :111 : :C1A1.1S 1 Name: - -1! C ( hlutrdplain ,scpliccapacil■.strlar.cic.) 3. Mailing address: �' 7 firs 1 & 2 family dwelling: City:I -` _ - State ZIP M ! - _ Valuation of work $ Phone Fax: E -sail: � No. of bedrooms/baths Owner's representative: L L. 0 L F4 p QL,-, Total number of floors Phone: Fax: 1 / E -mail: New dwelling area (sq. ft.) , k1)1'1.1( AN I' Garage /carport area (sq. ft.) Name yi'Ljpi/ . 0,r7YN MC�,P.,A L, (°..t'+N`P1..- 40,i1O Covered porch area (sq. ft.) Mailing address: n : v ., _ Deck area (sq. ft.) ______ P.'� Statet7 , �' 1,. 1,111 Other structure area (sq. ft.) Phone: , UM= E -mail: CommerciaUiadostriaUmolti- family: ,, , _ CO N I It a ( :1O It Valuation of work 5O� C� $ �.e�rTar Business name: - Existing bldg. area (sq. ft.) ' ;� Address: I New bldg. area (sq. ft.) City: "tate: ZIP: Number of stories Phone: I Fax: I E -mail: Type of construction CCB no.: Occupancy group(s): Existing: ��/ New: I City/metro lic. no.: Notice: All contractors and subcontractors are required to be AR( 111 - 1 •14. 111Ws I G NI• :It licensed with the Oregon Construction Contractors Board under !'i MM 1 � r �, provisions of ORS 701 and may be required to be licensed in the Address: • ti J. r a � a � r jurisdiction where work is being performed. If the applicant is - ' � ZIP: aj%g exempt from licensing, the following reason applies: Contact person w' • l7 . Plan no.: Phone: . n �7 IN E -mail: F: :NGLNI'Llt ()Hitt' l ;si: ONL1 Name: Contact person: Fees due upon application $ Address: Date received: City: 'State: ZIP: 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 credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard work will be co ,plied with, whe r specified herein or not. Credit card number. / Expires Authorized signs n _,t,, Date: 2 J -- -7,3 Name of cardholder as shown on credit card $ Print name: /) d (s r Nil F i p'. rit f / Ffry) 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 (6/00/COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION.�.y i Business Line:,- (503) 639 -4171 MST Received Date Requested / � AM PM ZC�03 G'7/ Os Location /1 30 5? 8/q4"- r / ICyi Suite MEC Contact Person . Ph ( ) 5l ' — 3 1 7S' PLM Contractor Ph ( ) SWR UILDIN Tenant/Owner ELC Foo ELC Foundation Access: Ftg Drain gee, v ,c.i ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Pfri S a / G� Drywall Nailing //---�� / Firewall s� / " /c / e /LS v'a --%-) -' ! / sr 7s s Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: SS • ART FAIL PL.'= G 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: LI Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Data "Mg d ' Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL