Permit h a -CITY OF TIGARD BUILDING PERMIT
PERMIT # : BUP2008 -00205
° COMMUNITY DEVELOPMENT DATE ISSUE 6/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 112 D C - 00100
SITE ADDRESS: 15675 SW 72ND AVE ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG
PROJECT: BRIDGEPORT DISTRIBUTING
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: 5N sf N: S: E: W:
OCCUPANCY GRP: SR2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 92 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 12,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LN
PORTLAND, OR 97224 PORTLAND, OR 97225
Contact #: PRI 503 - 892 - 0066
Phone: FAX 503 - 892 - 0067
Reg #: LIC 66070
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 12% State Surch 6/16/2008 $16.08
[BUPPLN] Pln Rv 6/16/2008 $87.10
[FLS] FLS Pln Rv 6/16/2008 $53.60
[BUILD] Permit Fee 6/16/2008 $134.00
Total $Y90.78
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 i • • cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of the - ules or direc • ue 'ons to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is - ued By: 1 `,4„. 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.
•
B uildi n g Permit Application , FOR OFFICE USE ONLY
City of Tigard EW RReceived Permit No.: >r � �� 13125 SW Hall Blvd., Ti ar d, OR 972'13 ' �� Plan Revie — i� " � g Phone: 503.639.4171 Fax: 503.598.1960 1' I 1 20 ED 08 Date/B : J AY. 1��, t r. Other Permit
T I GA RD Inspection Line: 503.639.4175 JU Date Rea. •• : y: Jura: ® See Attached Checklist for
Internet: www.tigard- or.gov OF T1GpRp Notified/Method: Supplemental Information
art TYPE OF 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.
El 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building 1=1 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / ,p 2 .5 ---- - / 2 A.. I: _4 , Q . New dwelling area: square feet
City /State/ZIP: / ` j...i , / 2 � ,i .� 7 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name pt 47 ,q 27 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.
`' y -- A. / ` . As* � " - r Valuation: $/ 0
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: PacTrust Type of construction: y.....
Address: 15350 S.W. Sequoia Pkwy., Suite 300 Occupancy groups:___
City / State/ZIP: Portland, OR 97224 Existing: ,,,, 9
Phone: (503)624 -6300 Fax: (503)624 -7755 New: AAA
® 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 I Fax: : (503) 624-7755
E -mail: dennisp @pactrust.com
CONTRACTOR
Business name: �(.t 4 7 - Ate � ��.�
J ,f �� BUILDLNG PERMIT FEES*
Address: /,` (Please refer to fee schedule)
City / State/ZIP: Structural plan review fee (or deposit):
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lie.: Total fees due upon application:
Amount 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: s0Qr ! �^ l J/\ 1 Date: • Fee methodology set by Tri- County Building Industry
C Service Board.
1:\ Building \Permits \BUP- PermitApp.doc 03/21/06 440- 4613T(1l /02/COM/WEB)
i OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008 00205
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/16/2008 .
Phone: (503) 639 -4171 it � An
Inspection Requests (24 Hrs.): (503) 639 -4175 4- "'!II.
/,.
INSPECTION WORKSHEET FOR DATE: 6/3I,%008 TIME: 7:00AM PAGE: 9
SITE ADDRESS: 15675 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARKIN LOT #: 002 TYPE OF USE:
PROJECT NAME: BRIDGEPORT DISTRIBUTING
DESCRIPTION: TI
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: MATTHEW OLSON CONSTRUCTION PHONE #: 503 -892 -0066
Inspection Request Scheduled For: Date: 6/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 072011-01 503-956-6290 c/4-■c—_
I = %a 4N1
Corrections /Comments/ Instructions:
t: P' : PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED .
Inspector: Date: 4 8 Phone #: (503) 718 - 2-SVfrie