Permit (,qt,NT 7) *srV� *)14t • z /f /o:
A ---- - *
CITY OF T I GA R D i 4:40 • BUILDING PERMIT
DEVELOPMENT SERVICES SSUE 1/28/02
#: BUP2002 -00020
�"a in • DATE ID
13125 SW Hall Blv Tigard, OR 97223 •
(503) 639 -4171
SITE ADDRESS: 15862 SW 72ND AVE 200 PARCEL: 2S112DD -00200
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: 5N : sf N: S: , E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 15 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: $ 80,000.00
Remarks: TI for expansion into vacant space on the first floor and second floor.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300 RR g7�
Phone: 503 - 445 -1202 TI F A one'. � f 2 f 4
Reg #: L!C 41328
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
PLCK CTR 1/23/02 $237.77 27200200000 Electrical Permit Required
Sprinkler Permit Required
FIRE CTR 1/23/02 $146.32 27200200000 Plumbing Permit Required
PRMT CTR 1/28/02 $365.00 27200200000 Mechanical Insp
5PCT CTR 1/28/02 $29.26 27200200000 Framing Insp
Gyp Board Insp
(additional fees not listed here) Final Inspection
Total $1,352.34
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. ,
Pe rm ittee
Signature: j 47 . /
Issued By _,(6:)5 ale-y
Ca 9-4175 by 7 p.m. for an inspection the next business day
' /4 L,4; . . ..
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.....1b.,_ . BuiidingPermitApplicatioi�t
1 ;j: City of Tigard Date>eccived: / % /�. Pennitno. gliNeoa- giat7aa '-
fl'8a� Address: 13125 SW Hall Blvd, Tigard, OR 97223 Ptojecdappl.na.: Expire date:
o Phone: (503) 639 -4171 - /4 Date issued: By, 1 Receipt no.: : c
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 18:2 family: Simple Complex: . t*'�,
1'
TYPE OF PERMIT
Q 1 & 2 family dwelling or accessory 0 Commercial/industrial Q Multi - family 0 New construction 0 Demolition i;
QAddition/alteration/replac ement v Tenant improvement 0 Frye sprinkler/alarm Cl Other. • t >s
JOB SITE INFORMATION `
Job address: / . '' Y' S ,ig,A/O ',//.. Bldg. no.: ' ° Suite no.: 2
Lot 1 Block Subdivision: / J Tax map/tax lot/: -• "'no.:
Project name: /1�.C)/4 � / > ::S .S'1i� / A'
Descri .tion and 1. / .. i of work on premises/special conditions: _ f pl-, AZ' /1/ c./.4=
OWNER FOR SPECIAL INFORMATION. USE CIIECKLIST
Name: PaCTrUSt (Floodplain, septic capacity. solar, etc.)
Mailing address: 15350 SW Sequoia Pkwy., #300 Y & zfamily dwelling: t.
City: Portland ' Jstate: 08 lzIP: 97224 Valuation of work ............ "........ $ -.6 i /1,4_%/
(503 I Phone: 624 63QQ ^_JFax5 4 -7754E -mail: No. ofbedrooms/ baths _.... "......"............ "._ '
Owner's representative: De n n i s P al n 1 Total number of floor:; " -- ,
• Phone: S a e Fax: E -mail: New dwelling area (sq. ft) .. ". til
Garage/carport area (sq. ft.) ,. • Name: p a c T r u s t Covered porch area (sq. ft.) ..... ". ..... " " ". "... `�
.
Mailing address:15 3 50 SW Sequoia Pkwy . , #300 Deck area ( SO• ft "...... "•••..... .... -•"•••••
City: Portland State: OR J ZIP: 97224 Other ammo= area (sq• ft-) —•
(503 Phone:6 2 4 - 6 3 0 0 Fax6 2 4- 7 7 5' E -mail: CommerciaUindas rtal/multi- family:
CONTRACTOR Valuation of worst .... $ ,rim
Existing bldg. area (sq. ft.) y j , 4 �/"�
Business name: H.L. Green New bldg. area (sq. ft.)
Address: 15 3 50 SW Sequoia Pkwy., , # 300 _
��
" " " " " "' "' " " " " " " _
City: Portland J Stare: OR J zap: 97224 Number of stories
(503 Phone 24-7717 Fax: E-mail: Type . ...
of construction ....... i�� ''
I J
CCB no.: 41328 Occupancy group(s): Existing: .
New: ri
City/metro lic. no.:
Notice All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Boai+d under
Name: J o h n R o m i s h provisions of ORS 701 and may be required to be licensed in the
Address: 15350 S W Sequoia Pkwy . #300
jurisdiction where work is being performed. If the applicant is
City: Portland 'State: 0 R Iz>P:9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
(503)Phone:624 - 6300 Fax{24 -775' :nail :'ohnr @ s.com
ENGINEER
Name: Contact person: Fees due upon application $ M , 0
Address: . • Date received:
City: !State: !ZIP:. Amount received $
Phone: J Fax: 1E-mail: Please refer to fee schedule.
I hereby c e r t i f y I h a v e read and examined this application and the ' Na u i s on accept and cads, please adt jurisdiction for mote iefotmanoa.
attached checklist. All provisions of laws and ordinances governing this O Visa o MasterCard
work will be complied wi wh er spec' red herein or not. °edit Cd nu / /
Expires
Authorized signature: 11/ .,-r ./� - g , 3" 7 eZlame of audholder as shown on amt ma S
Print name: / . I t/ _ .' ca rdholder a Amoaot ■
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/C014)
/ate i'cn/ a 3 7, 7 7
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION, Business Line: (503) 639 -4171 MST 066..2-0 BUP
Received Date Requested a2 /2-7 AM PM' - BUP
Location /5 2 7 2 , {- Suite -(
Contact Person Ph ( ) r?-6 c � S� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
►u
nsulation
"a Nailing S r^^ ,
Z11:.1%, . 1.9-// c' D 2 /< e.U
e prinkler
usp'd Ceili ,
Other:
g PART FAIL 77/0 �' L_
• • MBING ( Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer =
Rain Drains
-
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
P. . :T FAIL
- ough -I s
Smoke Dampers
____ 1 'ART FAIL
TRICAL
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: El Unable to inspect - no access
Fire Supply Line
ADA /
Approach/Sidewalk Date v Inspector 7N\ Ext
Other:
Final DO OT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TI D 24 -Hour .
BUILD! Inspection Line: (503) 639 - 4175
BUP
INSPECTION !SION Business Line: (503) 639 -4171 MST
1 11
3 ,06> 006 .2_6
Received Date Requested AM .P�l MEBUP 02 4 Z - mo `
o 73
Location • l Rv 2- Suite -' Y \ C t C 002 —c ,51
Contact Person 8 0.4.1 cLi Ph ( ) g 6 a 9 575 : 6 PLM
Contractor Ph L SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Ate ex.Q.L i C ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
)
Framing
Insulation
Drywall Nailing � /
Fire i e. ZC,YJ 2.-- Oc.V 7
ire S rinkler
ire arm , L g_ -.Z &od1
Susp'd Ceiling l.1
Roof
•I L.
ina - r, "-
PART FAIL
k •' ' BING
Post & Beam _
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
—
Final
PASS AIL
SEC
4 00
Pos
Rou. -In
Gas L'.e
Smoke Dampers
ink
PART FAIL
CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 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 D �l ' / D7 _Inspector Ext
Approach/Sidewalk 1 /
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL