Permit ,. _,.
`CITY OF TIGARD BUILDING PERMIT
PERMIT #:
, DEVELOPMENT SERVICES DATE ISSUED: 1610/03 2 -00551
AI- 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 13333 SW 68TH PKWY 3RD F PARCEL: 2S101 DA -00104
SUBDIVISION: FARMERS INSURANCE ZONING: MUE
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FIRST: sf N: S: E: W:
TYPE OF USE: SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 1,500.00
Remarks: Tenant Improvement
Owner: Contractor:
F I G HOLDING COMPANY QUADRUS INC
REAL ESTATE ACCTG 4647 SW HUBER ST
4680 WILSHIRE BLVD PORTLAND, OR 97
LOS ANGELES, CA 90010
Phone:
Phone: 293 -8931
Reg #: MET g0g0400042552
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Framing lnsp
[BUPPLN] Pin Rv 12/24/02 $40.63 Gyp Board Insp
[FLS] FLS Pl.n Rv 12/24/02 $25.00 Final Inspection
[BUILD] Permit Fee 1/10/03 $62.50
[TAX] 8% State Tax 1/10/03 $5.00
Total $133.13
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: C 1 .. -' r i
Permittee
Signature: e C p tom.
C.)
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application
� . rt ;, Date received: Permit nt (P,Z0,.. -p-t S SI
,y City of Tigard
� Project/appl. no.: Expire date:
Address: 13125 SW Hall Blvd, Neggifita on line
City of Tigard Phone: (503) 639 -4171 D i B I Recei no
addJil �O llli� l
Fax: (503) 598 -1960 ryry ] Case file no.: Payment type:
ZOOZ V 330
Land use approval: 1 &2 family: Simple Complex:
T• PE e! ^;::RM1T W
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
❑ Addition /alteration/replacement III Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
N
JOB SITE INFORMATION
Job address: 1333 6LA.3 Logr4-k - - p‘4...f - _t..00. L J Bldg. no.: Suite no.:
Lot: I Block: Subdivision: � Tax map /tax lot/account no.:
Project name: �( yl/\eC -.) 1 y` SLR (k4l.LP__, C-t ( 1.,Le
Description and location of work on premises/special conditions: ,rCk. F 10 0 C - (.0 Y\-‘7 LA- (2
"fie m t).,,�.�(, I e. 1 A - 6•--\ \ L I � •.
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: cL rAe_iS IY�.SINr G re, LA �, ( Floodplain ,septiccapacity,solar,etc.)
Mailing address: 1 •3333 �A c - VGur 1 & 2 family dwelling: '
Cit 1 rc 0 I State: O t . IZIP: q 1 -2,2, Valuation of work $
Phone: 505 - 1.o Zp - 'Fax: I E -mail: No. of bedrooms/baths
Owner's representative: C, r- t e , ,So r\ e Total number of floors
Phone: (p2D D b Fax: E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: \ �� . Covered porch area (sq. ft.)
Mailing address: ( 1 � 3 1� )e4 S� . Deck area (sq. ft.)
City: Pork \ e I State:C T ZIP:1 Lit Other structure area (sq. ft.)
Phone: 2. ?) - .2) 3 ( Fax: L' 3 -S9 r E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ /3 Dd
Q �� ' lJW ^u Existing bldg. area (sq. ft.)
Business name: t 1 V‘-t-- . New bldg. area (sq. ft.)
Address: `'� ( o 4 -] S lip I e {' �4- . Number of stories
City: �n c %4 QLy\A. State: Old ZIP: q 1 2,11
Type of construction
Phone: .2,c13- 813 1 Fax: p �j E -mail: Occupancy group(s): Existing:
CCB no.: ef544 pc-i New:
City /metro lic. no.: 2_55 2 Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER 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: I 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 $
Address: Date received:
City: 'State: ZIP: Amount received $
Phone: 'Fax: 1 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 ❑ Visa 0 MasterCard
work will be complied i,ith, whether .pe ified herein or not. Credit card number: Expires /
Authorized signature: _ _ l & L . t!''te: 2,- ` -02 Name of cardholder as shown on credit card
$
Print name: KA A. .'NK_ _I7' -1 A SiA.n 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 (6ro0/COM)
s2/3 - 4 — e, 3 — 8q31) puv has
Commercial Plan Submittal
,L Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
**"New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \fors \COM- matrix.doc 9/24/01
\ITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP g —4.0 55
Received Date Requested / _ �� AM PM BUP
Location 1 3333 6 b _ ` ,oi' Suite JAW FIA4 MEC
Contact Person P ( ) 776 7 4 (5 - 4 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner , ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
wa a
- Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
O t h � PART FAIL
ING
/
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 fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date / I 7 7. l 7 / 0 Inspector Ext
PP
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
, BUP d S��(
Received Date Requested 1 — Z Z ' AM P BUP
Location i�W
s 33 �°�`� � Suite 342 F MEC
Contact Person Ph C; '7 4sY PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner "" �ivJ 9 fld- ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
IaFi�I'
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
•
PART FAIL
• -NG
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: ❑ Unable to inspect — no access
Fire Supply Line
A
Approach/Sidewalk Date / ' 2L J Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
d BUP
Received Date Requested — � o AM PM BUP o7 - D ,5 - 67
Location / 3 3 3 3 G 0 Suite MEC
Contact Person - Ph ( ) Se! G — 7 S t PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 9-71/ ELC
Footing f-ettievL- Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors � �.� � � ‘. V ? fatl �
Ext Sheath/Shear lJ�-
Int Sheath/Shear
Framing
Drywall Nai i .46
Fir wall J MU
Fire Sprin er -
Fire Alarm
Susp'd Ceiling
Roof
Other: • • .
• PART FAIL kick
Post & Beam ' C- ��
Under Slab
Rough -In r..
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 El Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line ••
ADA Date Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL