Permit r -J
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00395
� i � DEVELOPMENT SERVICES DATE ISSUED: 8/7/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DA -00100
SITE ADDRESS: 11308 SW 68TH PKWY 2ND FL
SUBDIVISION: ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS 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: 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: $ 23,000.00
Remarks: Fire Alarm /suppression.
Owner: Contractor:
BENENSON 68TH PARKWAY OREGON ELECTRIC GROUP
KEY LLC, THE 1010 SE 11TH AVE
BY FIRST AMERICAN TAX VALUATIO PORTLAND, OR 97214
WORCESTER, MA 01615
Phone:
Phone: 234 -1001
Reg #: Fi8TF9900 00001995
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 6/25/03 $264.10 Smoke detector insp
Misc. Inspection
[TAX] 8% State Tax 6/25/03 $21.13 Final Inspection
[FLS] FLS Pln Rv 6/25/03 $105.64
Total $390.87
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: > - -(
Pe rm ittee ` %� '�
Signature: — --- '
Call 639 -4175 by 7 p.m. for an inspection the next business day
. , . it - Ro- 7 -, 770 ,,/ 6
-. RUC 7 - of 1 5b
Building Permit Application O I l l C E USE
ONLY
Date received: Permit no
'' t City of Tigard ► . �✓ 3
"'� Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: d Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex: V
TV PE OE PERM IT
O 1 & 2 family dwelling or accessory %Commercial /industrial O Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement ' Tenant improvement 0 Fire sprinkler /alarm 0 Other: E
Job address: 6 / / N/ Bldg. no.: Suite no.: c
Lot: I Block: I Subdivision: Tax map /tax lot/account no.:
Project name: J6 7jifi G �). 177 ,
Description and location of work on premises /special conditions:
(() rd, '4. /. .(,! !/'it: k; e �! ,
OWNER FOR SPECIAL INFORiIATIOiN', USE CHECKLIST
AS - '( F loodplain ,septiccapacity, solar, ctc.)
Name: / . .
Mailing address: 1 & 2 family dwelling:
City: IState: IZIP: Valuation of work $
Phone: IFax: I E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage /carport area (sq. ft .i ` „, ,,4
Name00 E ) F-t e!j/Q /L Covered porch area (sq. ft.) t
Mailing address: Aye) / /779 Deck area (sq. ft.)
City: /R) 71.11,Alb I State() 1 ZIP 7d / L/ Other structure area (sq. ft.)
Phone i Fax :e'-y") ail: Commercialliudust ' 1 /multi - family:
Valuation of work or..e U )C) $
Business name:Q/71 c-/.4-27Q/ c-/.4-27Q/ L ��/ Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.)
Address: Ida) S /1 / ,/� _
7� Number of stories
City: AV .77.4 6 Av S I Stateco I ZIP:�7 f i'l Type of construction
Phone: L4-26- Fax:2 /- CS . 1 E -mail:
Occupancy group(s): Existing: A
CCB no.: �(» —
New:
City/metro lic. no.: Gf Notice: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.: —
Phone: Fax: E -mail:
Name: Contact person: Fees due upon application $ ” ),c
Address: Date received: vI
City: I State: IZIP: Amount received $ -a -C`'7
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have - ad and examined this application and the N Atuisdictions accept credit cards please call jurisdictirp formation.
attached checklist. • 11 p t visi a t . • ws and ordinances governi g thi &V isa 0 MasterCard (�
work will be com ,lied i h
p� erein or not. Credi card umber. AK! ".1 11 " J / Expires � ea
Authorized signs , re: . �i / Date: on c edit card
i •! /' , L V � 1 �� /,
Print name: C 'hi 4 !' gT.F ' rc WOW Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as c plete. 440-4613 (6/00 /COM)
6°6 �,,, , 1 , o
L 2 `'- L
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
� 1 — vo 3 9
Received o2 • s ?` Date Requested 1 /2 103 AM PM BUP
Location 1 / 30 2 ` 4 Suite 414 MEC
Contact Person r1a- l G -1 6� Ph 5 l 7— szD ce PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 77 •+Val C04 ELC •
Footing ELC
Foundation Access: // 11
Ftg Drain ELR V � �Z
Crawl Drain
Slab Inspection Notes: _ SIT
Post & Beam 1 P C{ /a rrvi
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear d PP � �/d L 6
Framing !� v�l
Insulation I/ �i J p,4 c/ v s z ti ,e r7
Drywall Nailing
Firewall //► Z 00 s v f 7-. 77
Fire Sprinkler , H
ire arm A /V l P/1/ el,
L sp'd Ceiling
Roof
Other:
Final C P 4 /?C/J r op 5 S r /Z/7 Z
• SS PART FAIL
• '' BING S /`7 GKe DGrec%oP -J
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
• - Nice
Ro. •h -In
UG/ .b
Low
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
(lip PAR FAIL
n Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line 2 y�
ADA Date / z 'o Inspector /1Q114,1 13 - /4LOG /< EXt
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the Job.site.
PASS PART FAIL