Permit 7,1 4 : CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT E ISSU D: BUP2008-00058
DATE SSUED: 2/26/2008
TIGARD 13125 SW Hall Blvd., Tigani, OR 97223 503.639.4171 PARCEL: 2S101AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 1 7 O ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: COMMON CONFERENCE
Project Description: TI
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: 2N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 25 BASEMENT: sf AREA SEP. RATED:
STOR: 4 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: $ 11,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone: Contact #: PRI 503 892 - 0066
FAX 503 - 892 - 0067
Reg #: LIC 66070
FEES •
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/26/2008 $126.85
[TAX] I 2% State Surcha 2/26/2008 $15.22
[BUPPLN] Pin Rv 2/26/2008 $82.45
[FLS] FLS Pln Rv 2/26/2008 $50.74
Total $275.26
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 the - rules or direct questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
Issued By: _ �� Pe rmittee Signature: _
i
f
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
BIGilding Permit Applica s4 / OR OFFICE USE ONLY
City Of Tl and Received Wire* n ! Permit No.: , 6
13125 SW Hall Blvd., Tigard, OR '' � ' c� � Plan Review i�7/
Phone: 503.639.4171 Fax: 503.5':.1960 `� I+ n � ',jP ` la DateB : I � 'r ���� Other Permit: • Inspection Line: 503.639.4175 -V ;: f ��� - .II_, Date Ready /By: Jur i El See Attached Checklist for
Internet: www.ci.tigard.or.us r\ � `' o G
� n\\
\ \ Notified/Method: U Supplemental Information
TOO WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
dition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
...----- • work indicated on this application.
CATEGORY OF CONSTRUCTION
Valuation: $
❑ 1- and 2- family dwelling Commercial /industrial
El Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION 1 "7 0 Total number of floors:
Job site address: � g : � J de /�L 7 � " New dwelling area: square feet
City /State /ZIP: � / ,L t �C / ,W .92�� Garage/carport area: square feet
Suite/bldg. /apt. no.: /90 tProject name ems �� ..��e Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: 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
DESCRIPTION OF-WORK work indicated on this application.
/I (( / Valuation: $ // I aD
// Existing building area: square feet
New building area: square feet
VX1ZUPERTY OWNER ❑ TENANT Number of stories: y (,,..))
Name % ' tom Type of construction: a z
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT 'CONTACT PERSON
NOTICE
Business name: „g526!---77726/ c'—r-' All contractors and subcontractors are required to be
Contact name: Sh" licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City / State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax::( )
E -mail:
CONTRACTOR
Business name: /yJA /J / � / BUILDING PERMIT FEES*
Address: /—' / �/'�
Please refer to fee schedule.
City /State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
&4 70
Amount received
CCB lie.:
L �Q' Date received:
Authorized signature: /I( ( / `� / r/ This permit application expires if a permit is not obtained
gy- 7 l /r 6 within 180 days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri County Building Industry
Service Board.
i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008 -00068
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2008
Phone: (503) 639 -4171 Avwr°''
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: 7/14/2008 TIME: 7:OOAM PAGE: 9
SITE ADDRESS: 12909 SW 68TH PKWY 170 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503-892 -0066
Inspection Request Scheduled For: Date: 7/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message �/
287 Suspended ceiling 072587.01 503 -966- 6290l/'CO�
Corrections /Comments/ Instructions:
- C' 5
® It i r d
❑ PASS �j � r ' ° ' • • e e ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ! / ®8 Phone #: (503) 718- 1–
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008 -00058
13125 SW Hall Blvd., Tigard, OR 97223 AP lk DATE ISSUED: 2/26/2008
Phone: (503) 639 -4171 Aradop
Inspection Requests (24 Hrs.): (503) 639 -4175 "_..
INSPECTION WORKSHEET FOR DATE: 6/27/2008 TIME: 7:01AM PAGE: 2
SITE ADDRESS: 12909 SW 68TH PKWY 170 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503.892 - 0066
Inspection Request Scheduled For: Date: 6/27/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 071959-01 503-956-6290 6 ?M
Corrections /Comments/ Instructions:
PKA-K /ht e-, R'S P 1 - F en) / 6‘b i -
gin. -' _ FA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL A //, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: Z � Phone #: (503) 718 - LZ e/X
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: SW2008.00058
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26120013
Phone: (503) 639 -4171 r , II
Inspection Requests (24 Hrs.): (503) 639 -4175 J 11.
/
INSPECTION WORKSHEET FOR DATE: fill.; 2008 TIME: 7 :00AM PAGE: 32
SITE ADDRESS: 12909 SW 66TH PKWY 170
CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: COMMON CONFERENCE
DESCRIPTION: 11
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503- 892 -0066
Inspection Request Scheduled For: Date: 811212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 074050 -01 503-956-6290
0
Corrections /Comments /Instructions:
`.vI _.s- I/ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I•-
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 65 / 2 /06/ Phone #: (503) 718- 2-.KW