Permit ; CITY OF TIGARD BUILDING PERMIT
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PERMIT #: BUP2007 -00654
I ' - COMMUNITY DEVELOPMENT DATE ISSUED: 12/21/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 350 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: DELTEK
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: 137 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 6,500.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Contact #: PRI 503 - 892 -0066
Phone: FAX 503 - 892 -0067
Reg #: LIC 66070
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/21/2007 $98.25
[TAX] 8% State Surcha 12/21/2007 $7.86
[BUPPLN] PIn Rv 12/21/2007 $63.86
[FLS] FLS Pln Rv 12/21/2007 $39.30
Total.. $209.27
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 Utili 'fication 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 direc estio to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu d By: 1 1 it L Permittee Signature:
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.
• M
Building Permit Application FOR OFFICE USE ONLY
City of Tigard CEIVED Received l MIE � Pe P. i
DateB ( ..- r.7-�
° 13125 SW Hall Blvd., Tigard, O 23 Plan Review
If Phone: 503.639.4171 Fax: 503.59 J 2 1 / Date/B : C�� �� Other Pe 'l:
T I GARD Inspection Line: 503.639.4175 (�p�j� Date Ready :y: El See Attached Checklist for
Internet: www.tigard - or.gov GOOF CIU D ot Notified/Method: Supplemental Information
BUnDiNGINI g°
TYPE OF 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
A Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /,,a 9 f—/„ _, a 7 j 4 7/�- -) New dwelling area: square feet
City /State/ZIP: 7, ,, Hes.• d Ore 9 , �� h Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: �� /T'C.../ 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. sva•____
Valuation: $ ‘
Existing building area: 1 square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: y / /
Name: PacTrust Type of construction: --2r
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:
City /State/ZIP: Portland, OR 97224 Existing:
Phone: (503)624 -6300 Fax: (503)624 -7755 New:
® APPLICANT ® CONTACT PERSON
NOTICE
Business name: PacTrust All contractors and subcontractors are required to be
Contact name: Dennis Pagni licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15350 S.W. Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
City/ State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 624 -6300 Fax: : (503) 624 -7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name:
�-Jr /law G oel_____ BUILDING PERMIT FEES*
Address: (Please refer $o fee schedule
City / State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.: Total fees due upon application:
Amount received:
Authorized signature: This permit application expires if a permit is not obtained
l within 180 days after it has been accepted as complete.
Print name:
- f Date: Z 0'� * Fee methodology set by Tri County Building Industry
Service Board.
L\ Building '.Permits'BUP- PennitApp.doc 03/21/06 440- 4613T(1I /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Bl)E� ?qG7- GOE�r�4
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12121/20;17
,� ;
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 -4175 'iL�
INSPECTION WORKSHEET FOR DATE: 7J2W2008 TIME: 7 :00AM PAGE: 4
SITE ADDRESS: 12909 SW 601 PKWY 35() CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503. 892 -0066
Inspection Request Scheduled For: Date: 2/20/2008 Pour Time: •
Code # Inspection Description Confirm # Contact # Messa. - µt,it
299 Final inspection 065297 -01 503 - 956-6290 a e_44.1...4_____
Corrections /Comments /Instructions:
14. - - --1-- E PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL II CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: Date: 4 Phone #: (503) 718-
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 131)0.007 -00654
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2112007
Phone: (503) 639 -4171 u �m :
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' W IL
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7:02AM PAGE: 10
SITE ADDRESS: 12909 SW 68TH PKWY 360 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 603-892-0066
Inspection Request Scheduled For: Date: 112412008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 063868••01 203 - 307 -2106 a" 741
Corrections /Comments /Instructions:
PASS T a •ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
L rA CALL FOR INSPECTION ❑ ADDITI• AL FE- ASSESSED
//
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Inspector: Date: Z L i06 Phone #: (503) 718- L-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: B1JP2007 -0065
13125 SW Hall Blvd., Tigard, OR 97223 - • DATE ISSUED: 12/21/2007
Phone: (503) 639 -4171 4"N� ���
Inspection Requests (24 Hrs.): (503) 639 -4175 `'II
INSPECTION WORKSHEET FOR DATE: 1/23/2008 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 12909 SW 68TH PKWY 350 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503892 -0066
Inspection Request Scheduled For: Date: 1/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 063757 -01 503307 -2105 //11
Corrections /Comments /Instruction •
k to k ---- V (
t.
❑ PASS A P. 'TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t� L ' • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / -7 3 04hone #: (503) 718 - or