Permit . . .
.
4,, CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00306
� y � DEVELOPMENT SERVICES DATE ISSUED: 6/28/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00200
SITE ADDRESS: 16364 SW 72ND AVE B -08
SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: 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: $ 400.00
Remarks: Fire sprinkler TI, additon of (2) fire sprinkler heads.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone:
Phone: 620 -4020
Reg #: LIC 64174
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/28/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchan 6/28/2004 $5.00
Total $67.50
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 • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ( 3) 246 -6699 •r 1- 800 -34 44.
Issue y: �, / isll - / l!,,_
Permittee
Signature: o / /`r ,g Arm _, rL
' CaII 639 -4175 by 7 p.m. for an inspection t he next business day
Building Permit Application UP FOR OFFICE USE ONLY
City of Tigard Received A ae
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: rb Permit No.: 4 „, _
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 id;i Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By:
S See Attached I orm t on for
Internet: www.ci.tigard.or.us Notified/Method:
(Cji, Supplemental Information
TYPE OF WORK REQUIRED DATA: I- 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
fri • ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling K ommerc ndustrial
Valuation: $
El Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION • Total number of floors:
Job site address: / v 1 New dwelling area: square feet
City/ State/ZIP: ` • 0 411; - Garage/carport area: square feet
Suite/bldg. /apt. no.: il• ( 6 Project name: do Ilf 2& ' i `• _S r Covered porch area: square feet .
Cross street/directions to jo site: i Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DE ON OF WORK work indicated on this application.
A ( t/L.•I - 10 1 Q j c „ n / k0 •3 Valuation: $ � OO
r�J��� -l' (� lLJ J Existing building area: square feet
New building area: square feet .
PROPERTY OWNER I 0 TENANT Number of stories:
Name: ---- Pac''AS 7 - Type of construction:
Address: Occupancy groups: •
City /State/ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
,(APPLICANT ❑ CONTACF PERSON
] . NOTICE
Business name: 1) Q_ f r-c... All contractors and subcontractors are required to be
Contact name: O 1/0 /'�� T licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ) (4 7 -! Q 11 `` •• � � � S La jurisdiction in which work is being performed. If the
City /State/ZIP -- f (ay\g) , c� 9 -72a� applicant is exempt from licensing, the following reasons
apply:
Phone: '' - )x ow p --C4 02_6 Fax: : (0 7O
E -mail: u
CONTRACTOR•
Business name: i) 2 [ 7 � ,
BUILDING' PERMIT FEES*
Address: 1 A ! 5 c 74 / Acl
/ State/ZIP: Please refer to fee schedule.
Cit
y ` ' , `�
c Ci r '7, �� Fees due upon application - 5C) Phone:503 (.0636--4467 7) Fax 3 — c s '
CCB lic.: (0 Li Amount received
Aa.....4...2 Da te received: e:Authori2ed signatur). This permit application expires if a permit is not obtained
N (• r within 180 days after it has been accepted as complete.
Print name _ r' J) LCD' /IJ(/ at .rty Date: Ca >� • Fee methodology set by Tri- County Building Industry
7 Service Board.
i.\ Building\ Permits tBUP•PermitApp.doc 12/03 440- 4613T(11 /02 /COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING- inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP v?Od S — 06 304
Received Date Requested AM PM BUP
/
Location / 6 3 (o L( 7 a 4-0 Suite / MEC
Contact Person ,Z' Ph ( ) 6 ZO ' WO- 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
Framing
Insulation
Drywall Nailing -
F ir e S /I ' m _ 1 ITh1h�•� �'
Fire Alarm . " � ' -
Susp'd Ceiling
Roof
Other:
Itlr�?� 1
• SS PART FAIL
• LUMB G
Po • :earn
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 . I
At■-vor'
Rough In i
UG/Slab W 1 Ng 1
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 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL