Permit 4 , ,
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00603
#�A DEVELOPMENT SERVICES DATE ISSUED: 10/7/03
` ' - II 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 15985 SW 72ND AVE PARCEL: 2S111 DC 00701
SUBDIVISION: FANNO CREEK TRACTS 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 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: $ 10,000.00
Remarks: Tenant improvement to convert retail space to beauty salon.
Owner: Contractor:
PACIFIC REALTY MK CONSTRUCTION & TRADING LLC
15350 SW SEQUOIA PKWY #300 PO BOX 33864
PORTLAND, OR 97224 PORTLAND, OR 97292
)
Phone: 503 - 624 -3000
Phone: 503 - 335 -3726
Reg #: LIC 133894
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 10/7/03 $139.30 Electrical Permit Required
TAX 8% Tax 10/7/03 $11.14 Sprinkler Permit Required
[TAX] Plumbing Permit Required
[BUPPLN] Pin Rv 10/7/03 $90.55 Framing Insp
[FLS] FLS Pin Rv 10/7/03 $55.72 Gyp Board Insp
Total Final Inspection
$296.71
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 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (50 . a• • • 99 or 1- 800 - 332 - 2344.
Issued B % , =%aQa/i/ 1 /i-IL
Pe rm ittee
Signature: 4 - -
Ca 1 639-4175 by 7 p.m. for an inspection the next business day
1
Bur din Permit A • • n FOR OFFICE USE ONLY
Received Building
S Date/By: /O 7 D 5 Permit No.: & Q3- YY
Cl of Ti and Planning Approval Other
`J Tigard Date/By: Permit No.:
13125 SW Hall Blvd. 00 Plan Review Other
Tigard, Oregon 97223 Date/By: /Q -7- OJ /5S Permit No.:
Phone: 503- 639 -4171 Fax: 5G3, 9811%60 BDid. 1 "*1H 1 i;i' D Post view Land Use
Internet: www.ci.t G DIMS
®®III Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 5W639 -4175 Name/Method: Supplemental Information
TYPE OF W(3
New construction Demolition - ' A FQUI L DATA:'
El New 1 FAMyL SG RWELI.ING
❑ 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 ❑ 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 $
�, , .JAB.SITE, 1 0 LA • TION and LOCATIOx , , . No. of bedrooms: No. of baths:
Job site address: j Sq$r S tt9 7L' - 4 #U t° Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: law Set.l.tu Po. e e Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
5 U.) U Boo ,JFS �£Q R Other structure area (sq. ft.)
( O P-E&oa. i3.0 g t N E SS T'/ - ItEQ D DATA: r -
Subdivision: Lot #: COMMERCIAL - USE CHECKIT
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
• :DESCaTPTION WORK :• the value (rounded to the nearest dollar) of all equipment, materials, labor,
r -
overhead and profit for the work indicated on this application.
' 1QA -1- 1 I M Pmou eit- C til'T
Valuation , ..O00 $
Existing building area (sq. ft.)
New building area (sq. ft.) 3iE
Number of stories
'V : PROPERTY OWNER - . L,E3 TENANT Type of construction EtrEEE
Name: i± c-j Fie Rah LT{ cSS�1' A--1" L {> Occupancy group(s): Existing:
Address: irre v y
au A P kw4 300 New:
' S
City /State /Zip: 13>o WI tiirt.l P,o2., 'fl /29-
Phone(.Snv - 3oo42. Fax: &gyp ' 'b 2¢ -- 7753 NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
ErAP .'LICANT. _- • ' I❑ CONTACT PRRSON' provisions of ORS 701 and may be required to be licensed in the
Business Name: 14 v 071 t3rr "MA- p) 0 4,- jurisdiction where work is being performed. If the applicant is exempt
Contact Name: .4- 4J-,-.3d+ (jj from licensing, the following reason applies:
Address: 4333 iU€ SA-N 0.4 &L v D
City /State /Zip: ('p{x:r I,EN. , p Q ( 72 13
Phone: (b 3)53S' 3"44, Fax:
E -mail: �BUILDIN PPRM[IT.PiES* .. , .
Plea r' to fee schedule •
- . _ CONTRACTOR;
Business Name: Mv &t jr - t i , t ( TL cictp ( (�' Fees due upon application $
Address: 4635 JE � Dy g / U D T
City /State /Zip: p - -LA-IU . p-2 Ci 72./3 Amount received $
Phone: U 3) 3 37.6 Fax: Date received:
CCB Lic. #: A 35 gqq_
gnature:
S / / / Date: to 1 q 103 Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
V14 A- NSF Lam{ *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03
•
„ ymlr Plan Submittal Requirement Matrix
Commercial & Multi - Family
City of Tigard New, Additions or Alterations
TYPE OF SUBMITTAL # of Plans
T. _ (IncIOdes New;. Mdditrons or Alterations) Req
. Y .SuPmlttal-
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.
i:\ Building \Forms \PlanSubMatrix.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection, Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
/ BUP - D U 4'03
Received Date Requested 6 ° " 3 AM PM BUP
Location /57 7 Suite MEC
Contact Person F. ( ) 7.9- - 0 000 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain L Q �( a 3 (.(S ELR
Crawl Drain / ` -
Slab Inspection Notes: R SIT _.
Post & Beam
Shear Anchors f9,e4 u Veto 42 4 •4 4, • dk
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm a e V 7% _
Susp'd Ceiling
Roof
Other:
;qtr
414 1 ART FAIL
• IN
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 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA x
Approach/Sidewalk Date /2 /J v 3 Inspector 76)-11 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 - .00 d
Received Date Requested 1 < / AM PM BUP
Location / 1 ' 5 7a Suite MEC
Contact Person Ph ( ) 9.)."-00.0? PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Acce ss i-6 /aC/�
Ftg Drain — T ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
rr�wall ^ �
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: ,
f
l�) PART , FAIL
— '•
��7 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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date //// �/
Zl v 3 Inspector 76'7N Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL