Permit �.
A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00633
� DEVELOPMENT SERVICES DATE ISSUED: 10/28/03
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S101 DC -00200
SITE ADDRESS: 13535 SW 72ND AVE 165
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
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: 3N : 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: $ 630.00
Remarks: Tenant Improvement - add 1 pendent sprinkler head.
Owner: Contractor:
PACIFIC NW PROPERTIES LTD PTNSHP AFP SYSTEMS INC
9665 SW ALLEN BLVD STE 115 19435 SW 129TH
BEAVERTON, OR 97005 TUALATIN, OR 97062
Phone:
Phone: FAX- 692 -1186
Reg #: 5015692-908 LIC
FEES LIC REQ�II2E INSPECTIONS
Description Date Amount Sprinkler Rough -In
[TAX] 8% State Surchari 10/28/03 $5.00 Sprinkler Final
[BUILD] Permit Fee 10/28/03 $62.50
Total $67.50
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 -00jthro.ugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ) 246 -669 b 1-800332-2344.
Issu By i U . 1 1
Perm ittee -- ( .1
Signature: ^ - , •'�kV ( l (g 1
Call 639 -4175 by 7 p.m. for an inspection the next business day
OCT-4-03 03:36PM FROM-Automatic Fire Protection 5036921186 T-072 P.001/001 F-605
Building Permit A p p li c a t i o n • - • - - mno.weJoiri
Receved
D /4. 697 03 Building A ,
Permit No.: ujewg ....e6
City of Tigard
Date/By:
&41k#, Planning Approval
Other
Permit No.:
13125 SW Hall Blvd. Plan Review Other . -
Tigard, Oregon 97223 Date/py: Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 --. itr''.:VIlec Post-Review Land Use
, L e■ 1 ' Date/By: Case No.
Internet: www.citigard.or.us Contact Jur, El See Page 2 for
24-hour Inspection Request: 503-639-4175 Nam/Method: '0, Supplemental Information
•
• • • TYPE OF WORK . • .. • ...- '..FtEt:ITT.IRED DAtAt•': ''• • ' • '
El New construction fl Demolition • - - • I& 2 FAMILY DWELLING
•
. ...
Ezt
Addition/ drerreplacement El Other: . .
• . • ." " • -- 'CATEGORY OF CONSTRUCT ... - .• : .. . • '.. .: Note: Permit fees•• arc based on the total value of the work perforrned. Indicate
El 1 & 2-Family dwelling ' dusirial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the worlc indicated on this application.
111 Accessoiy Building 111 Multi-Famil
fl Master Builder Other: Valuation $
. . ..s•.: . :Z, ...JOBSITEINFORMATION andLOCATION ' . ..• — No. of bedrooms: No. of baths:___
Job site address: iSc s„...1120.,a..ig-_ Total number of floors
- New dwelling area (sq. ft)
Suite #: I ki4 1 Bldg./Apt.#: Garage/carport area (sq. ft.)
Project Name: Covered porch area (sq. ft)
Cross street/Directions to job site: Deck area (sq. ft)
Other structure area (sq. ft.)
• '.. - : '..,:.:.: :: : ,:-...•••:. REQUIRED DATA:. ••;.w..,..;•1:..4: - . : •
: : • • " ••: .. — • •
Subdivision: . .
: 1 Lot #: . ... . .... . . , . .. . , . ,...,.. .
Tax ma&arcel #: Notc: Permit fees ° are based on the total value of the winic performed. Indicate
• . %:• • •,. .:. : .: -ADESCRIPTION OF WORK . • ..._ : • •• • ..1- the value (rounded to the nearest dollar) of all equipment. materials, labor,
overhead and profit for the work indicated on this application.
li.Lcs" (
\ \ Valuation $ C...
UP* ) Existing building area (sq. ft.)
New building area (sq. ft.) _
Number of stories
.. El q'ROPERTY OWNER :' . 0:1 •TENANT...••••• ,..::77.7, Type of construction i
Occupancy group(s): s Existing:
Name: . New:
Address:
City/State/Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: I Fax: licensed with the Oregon Construction Contractors Board under
1 121.••APPEICANT;:::-. ' ' .........:-:. : .1:•.0 CONTACT PERSON • : -••••• . provisions of ORS 701 and may be required CO be licensed in the
Business Name: z,( w 5 :4( -
jurisdiction where work is bcing performed. If the applicant is exempt
iNC-1
Contact Name: , ASN(..ke" ‘ , 1‘.4 (" I \ 0 I ...A from licensing, the following reason applies:
4Sc i2
Address: fi
. IP , j --
—
City/State/Zip: T Au. (5,7Z. '1
Phone: gjS.- Q7-92E4 I Fax: g! - 6,92. )18,( _ . -, , ...„ .. ..:.....,., ... - . . . . -..,......,:........ :. .. . .. • .
. : • - . .......: . •- '.:: mumpitAGkEttmEr-ig -..,'.:: - :. • '-•
E-mail: . ...., :,.. • . . -..... .:.. ,.. • ... , : : • • . •
Business Name: Pkj- G-L5 t WC- - Fees due upon application $ C.6 -
Address: Vi4rSI-) 1 .-,....i l' (IVE
CiV/State/Zip: 17A A.L.. 4t1,72 . Q11 t‘c:a Amount received $
Phone:Q-612.q7R4 I Fax: 4g5S.-CA2- lig,(,:, Date received:
CCB Lic : ( 4 . . . - - • • ■ . ■ - - - - -
Authorized ilk Notice: This permit appliCati011 expires if a permit iS not obtained within
Signature! N'k' kk Date:1 - tao days after it has bcen accepted as complete.
'Fee methodology set by Tri-County Building Industry Scrvice Board.
(Please print name)
iMstsTerrnit Forms\EtidgPermitApp.doc 01/03