Permit CI TY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00282
444- II DEVELOPMENT SERVICES DATE ISSUED: 6/25/2004
I
;- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12909 SW 68TH PKWY 400 PARCEL: 2S101AD -03200
SUBDIVISION: TIGARD OFFICE BUILDING 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: 2 -1 HR 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: $ 1,344.00
Remarks: FPS TI, relocating (16) heads and adding (8) heads.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE & COMMUNICATIONS
15350 SW SEQUOIA PKWY #300 -WMI 601 NE 157TH AVE.
PORTLAND, OR 97224 PORTLAND, OR 97230
Phone:
Phone: 503 - 408 -0670
Reg #: LIC 147063
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/16/2004 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 6/16/2004 $5.00
[FLS] FLS Pln Rv 6/16/2004 $25.00
Total $92.50
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
calli 503) 246 -• • '9 or 1- 800 -332- 344.
cek Iss ed By: J Y
Perm' - i '
Signature: . L � ,
Call 639 -4175 by 7 p.m. for an ins . - ction the next business day
/2 9 sw 6 1 " /K wT
;, pett!" Des. G �etr a
B Permit Appl FOR off ICE USE °NI_v •
City of Tigard U ti Received birth ` '
(� DateBv: PermitNo.: -• �/♦ r . —y i
13125 SW Hall Blvd., Tigard, OR 97223 view / '
Phone: 503.639.4171 Fax: 503.598.1960 n � 1 " Plan Re A Plan Re : (� 2 �� of 8 Other Permit:
Inspection Line: 503.639.4175 l u 1- 6 LOO„ ■ I,L �' II I Date Ready /By: Juris 65 See Attached Checklist for
Internet: www.ci.tigard.or.us - Notified/Method: / (q Supplemental Information
CITY O
V144- 31°N 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
I Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:/ 909? to OLk rK; .L,� New dwelling area: square feet
City /State/ZIP.��r' -f -ja 1 r 7 a�-y Garage/carport area: square feet
Suite/bldg. /apt. no.: 1160 Project name /Q�gr 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: I 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.
i CD(J2. e- Valuation: $ /3 4z-t
U't-c..
Existing building area: square feet
CT(1
New building area: square feet
❑ PROPERTY OWNER I E 1 NANT Number of stories:
Name: // orta�Q_ ��r � Type of construction:
Address: "`� Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
ti■APPLICANT ❑ CONTACT PERSON NOTICE
Business name: H-ek rg g cin All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: , 7 7� jurisdiction in which work is being performed. If the
City /State /ZIP: _ 6c` 49-4:2; / applicant is exempt from licensing, the following reasons
/- � / apply:
Phone: )Cl//,�,,�.��br,,� �— (../Cop Fax: : � CIJ r loss
E -mail:
CONTRACTOR
Business name: D C Val. BUILDING PERMIT FEES*
Address: )14.795
(4 77 sw 7p� J�t Please refer to fee schedule. O ces City /State/ZIP: '� 9 7aac/ 9a , So
`` Fees due upon application
Phone: ) &90 —(l Fax: (50 CYJo O
— 05
cow-7 • Amount received
CCB lic.: (�i
Date received:
Authorized signature This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name . p2c6 -y-AQ, Date: • Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Permits \BUP- PermitApp.doc 12/03 (((/// 440- 4613T(11/02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTcONt*VISION Business Line: (503) 639 -4171 MST
l ` / BUP <3 ZSZ
Received Date Requested k)( PM BUP
Location ( ,,,,��� Suite 4 MEC
Contact Person MAT r Ph ( ) r 3 6 7 2(o6 PLM
Contractor Ph ( ) SWR
�/i M
BUILDING Tenant/Owner PI1 ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fir wal[_ -
Fire Sprinkler 1
Fire Alarm , `. �
Susp'd Ceiling -.— = —
Roof ilk
Ot
a � v
PASS PART FAIL 1,4
ING .4_
Post & Beam 1. wining/
Under Slab
Rough -In Tr
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 E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 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