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Permit A CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2002 -00048 ,�, DEVELOPMENT SERVICES DATE ISSUED: 2/14/02 _ 13125 SW Hall Blvd., Tistard, OR 97223 (503) 639 -4171 PARCEL: 2S112DD -00200 SITE ADDRESS: 15862 SW 72ND AVE SUBDIVISION: OREGON BUSINESS PARK III ZONING: I -P BLOCK: LOT: 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: : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 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:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 20,000.00 Remarks: New ADA access to existing building. Owner: Contractor: PACIFIC REALTY ASSOCIATES H L GREEN 15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD PORTLAND, OR 97224 STE 300 q z� 2 Phone: Tl rnone'. qZ4 7 7'1 7 4 Reg #: LIC 41328 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Appr /sdwlk Insp PRMT CTR 2/14/02 $244.90 27200200000 Final Inspection 5PCT CTR 2/14/02 $18.82 27200200000 PLCK CTR 2/14/02 $152.95 27200200000 FIRE CTR 2/14/02 $94.12 27200200000 Total $510.79 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1- 800 - 332 -2344. Perm ittee Si! • . ure: ' ' 4 t . A _.i. // 1 g -' - sued By: st�l'. / ► y �U �'�`�`c - ( � Call 6 • , . 175 by 7 p.m. for an inspection the next business day BuiTdingPermitApplicalioa • Datereceived: ;{ '' 0 Petmitno.: (��p�po't-4o g s 1,i; .v . City of Tigard . . cityo 8arid Add SW Hall Blvd, Tigard, OR 97223 Ftojecdappl.ao.: Expiredater Phone: (503) 639-4171 - Date issued: By:. I Receipt no. Fax: (503) 598 -1960 Case file no.: Payment type: • • - - Land use approval: 1&2 family: Simple Complex: •TYPE OF PERMIT - _ U 1 & 2 family dwelling or accessory 0 Commercial/ industrial 0 Multi- family 0 New constzuc Lion 0 Demoli .o . O. Addition/alteration/replacement. a .Tenant improvement 0 Fite sprinkler/alarm 0.Other. ." // - i.,/,....#".41 4.7/ JOl3 SITE INFORMATION - Job address �% i _ I „n Bldg. no.:. ,All Suite no.:. IT ∎!2;f;: Lot Blocic Subdivision: i` %vV : i L� g; .. tax lot/account no.: Project name: I P' A Descri • tion and location o work on premises/special conditions: .. ..r�t�' i/,ttrf�i�� OWNER FOR SPECIAL INFORiMATION, USE CHECKLIST Name: PacTrust. • • ( Floodplain , septic capacity. solar, etc.) . Mailing address: 15350 SW Se • u o i a Pkwy., :300 t &Zfamily dwelling: City: o r t an. . State: 0 R ZIP: 97224 Valuation of work (503 Phone: 6.2446300 ,_ iT. r3� �a;'_„ . No. of bedrooms/ baths ......................_....__.. $ • Owner's representative:. D e n n i s P a• n i Total number of floors .. �� - .. �... i Phone: Same . u.. E -mail: New dwelling area (sq. R) _. ... APPLICANT Garage/carport area (sq. ft.) Name: P a c T r u s t. . • . Covered porch area (sq. ft.) .»... Ming address:1 5350 SW S e r u o i a Pkw ., #300 Deck area (Sq• ft-) •••....•..... City: Portland state: O R ZIP: 97224 Omer structure area (sq. ft.) »• ..- µ-- -• (5 03 Phone:6 24- 63 00 Fax6 2 4- 7 75 ' E-mail: Commeicial/linda riaUmuld- family: 0- CONT RACTOR Valuation of work...—. ............................... $ / ■� /./ -° Business name: H.L. 6 r e e n Existing bldg. area (sq. ft.) Address: 153 50 SW S e r u o i a Pkw ., #300 New bldg. area (sq. ft) ... City: Port and State: t R ZIP: 97224 Numberof stories ..... (50 3 1 Phone 24-7717 Fax: E-mail: Type of construction CCB no.: 41.328 . Occupancy group(s): Existing: City/metro lit. no.: New: Notice: All contractors and subcontractors are required to be ARCHITECT /DESIGNER licensed with the Oregon Co ;,�. �, ? _ � � Construction Contractors Board under r • ` 1 e ; :. • , >, :,o . , _ ' . . y .. provisions of ORS 701 and may be required to be licensed in the Address: 15 3 5 0 SW Se r u ` 7 � . IC'''' - - - - ' - t i jurisdiction where work is being performed. If the applicant is City: Portland State: OR ZIP•:9 7 2 2 4 exempt from licensing, the following reason applies: Contact person: Plan no.: ( 50 3 1 Phone: ' - .301 Fax:624_775' mail: - ohnr @ usti r .com ENGINEER Name: 4.../i1,20 '.. li;o "Ill pew: Fees due upon application ..... $ Address: , ` ✓ Date received: ®'• �� �� � /' State: ✓A� ZIP:. J Amount received $ Phone: 2. , j M E -mail: Please refer to fee schedule. I hereby certify I . ve read and examined this application and the ' Not ad jmisdictioru accept credit cads, please call juriscection for more information' auached checklist. All provisions of laws and ordinates governing this Cl visa 0 Maste:(ard work will be complied wi w • ther s • -.Ted herein or .. • t cram cart! numbe / / Authorized signature: /We /7 , ;// �; ''/ �, -) Name or cardboldcr.'down on credit cad Expires $ Print name: l> /� i cadbotder signanne Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (&001COM) • A ,, Over-The-Counter (OTC) Building Permit p , \ Building Check List AI City of Tigard Description of Project: A1 6-7,J ,4f A-t,i S 4-o ex ,-s f_.',. S 1- 4/ av' . .: GENERAL INFORMATION Class of Work:* iQ, (..I- Floor Areas (sq. ft.): Exterior Wall Construction: Type of Use:* n First floor: N: S: Type of Construction: Second floor: E: l W: Occupancy Group: 73 Third floor: Openings Protected Y/N ?: Occupancy Load: Total sq ft.: N: S: _ Stories: Note: Combine total floor area for _ E: E: Height: all floors above third floor and Roof Construction: Floor Load: add to the third floor s . ft. Fire Retardant: Basement: Basement: Area Separation Rated: Mezzanine: Garage: Occu. Separation Rated: REQUIRED ITEMS Fire sprinlder: Handicap access: )[x� Smoke detector: Protected corridors: Fire alarm: Parking spaces ( #): Notes: INSPECTIONS 1 FEES DUE Footing/foundation Firewall $ ,25 Permit Fee Post/beam structural Smoke detector $ / S, R Z State Surcharge Shear wall Misc. inspection $ / 5 •'S Plan Review Fee Masonry y� Approach/sidewalk $ 914 , 1 Z FLS Plan Review Fee Framing $ Additional Permit Fee Insulation Sprinlder rough -in $ Additional Plan Review Fee Gyp board Fire alarm $ Investigation Fee Suspended ceiling Sprinlder final $ Misc. Fee Final inspection $ Hourly Rate Fee $ Hourly Rate State Surcharge $ Sl b , 79 Total Fees Due *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK: ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. i:\dsts\forms \OTC- BUP.doc 01/03/02 CITY OF TIGARD 24 -Hour ; 1 BUILDING Inspection Line: (503) 639 -4175 tree. INSPECTION DIVISION Business Line: (503) 639 -4171 MST /`,� BUP 2�o occcft� Received Da: Requested ` -;.8) AM PM BUP • ,. q c ✓ / • Location f ��J � / �� " Suite MEC • Contact Person / b 2 D Ph ( ) 3/o 8 8 PLM Contract Ph ( ) SWR • UILDI Tenant/Owner ELC Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear f �� - Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fin ; \ PAS RT FAIL r ; PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain \)/e 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 111 Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line Date /c- I cf Z Inspector Ext ot, e ,. Yti "7W 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 p� : OUP .9 006 q Received • Date Requested .3 - 5 AM PM BUP Location /,S 'YQ ? 7 Suite MEC Contact Person Hoz-AA-et,d, Ph ( ) d9 6 S PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC - •o n.► ELC o Drain Access: 6// Ftg Drain CS C - 77/ ELR Crawl Drain Slab Inspection Notes: 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: F'•: • J•ART FAIL ' =ING Post & Beam - _ - -- - -- Under Slab Rough -In '1 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 ADA / Approach/Sidewalk Date 3 5 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 ) BUP Received Date Requested � AM PM ; BUP Location 1 Z ? °� l�'�'� Suite MEC Contact Person / Ph ( ) Zoo C - ? 5Z PLM Contractor Ph ( ) SWR I'IILDI Tenant/Owner ELC g ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes:5 �� /Y/ --Q SIT Post & Beam ` Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof jl Other: Fi - � e PART FAIL MBING 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 111 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date //Vf'' 2 , — Ctor l Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL 1