Permit 4,, Cfl'Y O TIGARD
BUILDING PERMIT
PERMIT #: BUP2003 -00024
���, DEVELOPMENT SERVICES DATE ISSUED: 1/15/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC 00100
SITE ADDRESS: 15705 SW 72ND AVE
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
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: S1 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: $ 4,766.00
Remarks: Installation of rack storage less than 12' in height.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES CSP DESIGN BUILD
15350 SW SEQUOIA PKWY #300 -WMI CHRISTOPHER SCOTT PETERSON
PORTLAND, OR 97224 13215 -C SE MILL PLAIN BLVD #10
VANCOUVER, WA 98684
Phone:
Phone: 503 - 358 -8853
Reg #: LIC 150173
FEES REQUIRED INSPECTIONS
Description Date Amount Framing Insp
[BUILD] Permit Fee 1/15/03 $91.30 Final Inspection
[TAX] 8% State Tax 1/15/03 $7.30
[FLS] FLS Pln Rv 1/15/03 $36.52
[BUPPLN] Pln Rv 1/15/03 $59.35
Total $194.47
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 -00 hrough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 246- or 1- 800 - 332 -2344.
a
Issued,By: _1 u�la;
.. ,, I/L:. � $�
Pe rm ittee
Signature: ' '
r
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application OFFICE USE ONLY
Received Building ' /
�� Date/By: /45, 03 Permit No.: ooh —A2 ?
City of Tigard Planning Approval Other
y Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 / hint li'"" Post - Review Land Use
Internet: www.ci.tigard.or.us �__ Date/By: Case No.
24 -hour Inspection Request: 503- 639 -4175
Contact Juris.: Su See Page for
p Q Name/Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
21 Addition/alteration /replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling IN Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address o 76,6 S) 'l 2+46 Total number of floors
Suite #: 1 570 3 Bld /A t. #: New dwelling area (sq. ft.)
g p 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:
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
1NALl` QAl e� n _ overhead and profit for the work indicated on this application. ,
� Valuation $ 41 r ' , (
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER 1 ® TENANT Type of construction
Name: MIl C,oIF $Rote Iola._ Occupancy group(s): Existing:
Address: iS 1(0.5- W -121,1-121,1b Ai).€... New:
City/State /Zip: ,4- e2 °) 27
Phone: Fax: NOTICE: All contractors and subcontractors are required to be
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
CONTRACTOR Zvi Business Name: O 5 1 1 G t1 mot i t. IN Fees due upon application $
Address: 13Z6- C SE MILL- P4rtM 616,
City/State /Zip: VAN ,Q/1 WA • qh(o g 4 Amount received $
Phone: X3.358 -
6K 3 I Fax: 593 j 4s - /00 Date received:
CCB Lic. #: i i Son 3 I P IG(/
Authorized Notice: This permit application expires if a permit is not obtained within
I Signature: / ' Date: J ^7 180 days after it has been accepted as complete.
_ , r 1d u C *Fee methodology set by Tri -County Building Industry Service Board.
(Please 4 'nt name)
is \Dsts\Permit Forms\B1dgPermitApp.doc 01/03
•
looh�i�,�\ Commercial Plan Submittal
o
c 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 \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24-ri
BUILDING Inspection Luia. �_ _ - 75 MST
INSPECTION DIS1ON Business Line: (503) 639 -4171
• BUP °D 7
Received Date Requested /' '' AM PM BUP
Location / IOC `j'�t' Z1, Suite MEC
/. /
Contact Person ��'Wl s Ph (3P7) 3- " fS 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4t,k-e ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: / 6/ , > SIT
Post & Beam /�
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
. il2 .ART 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Li Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA (�
Approach/Sidewalk Date / — 5 Inspector /G) Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL