Permit BUILDING PERMIT
CITY OF TIGARD PERMIT #: BUP2002 -00472
-0. ,\ DEVELOPMENT SERVICES DATE ISSUED: 11/5/02
.7.4.0-1U1 ' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16640 SW 72ND AVE B -10 PARCEL: 2S113AD -01900
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
BLOCK: LOT: 009 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: 3N : sf N: S: E: W:
OCCUPANCY GRP: F2 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 434 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: $ 216,000.00
Remarks: Tenant improvement B /F2 occupancy
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L. GREEN, HL CO. INC.
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA BLVD
PORTLAND, OR 97224 STE 300
TIGARD, OR 97224
Phone: 624 -7717
Phone: 624 -7717
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 10/25/02 $1,196.70 Sprinkler Permit Required
TAX 8% Tax 10/25/02 $95 Fire Alarm Permit Requirec
[TAX] Plumbing Permit Required
[BUPPLN] Pln Rv 10/25/02 $777.86 Framing Insp
[FLS] FLS Pln Rv 10/25/02 $478.67 Insulation Insp
Total Gyp Board Insp
otal
$2,548.97 Final Inspection
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 (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: 7 /11/a _
Pe rm ittee
Signature: /1A—tilAAAA)--____
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
- w Building Permit Application -
,; :ill? City of Tigard Date received: /0 , ‘ 9.-- Permit no.:74/ _ � f7�
Project/appl. no.: 7 xpit�,date:
t; Address: 13125 SW Hall Blvd, Tigard, OR 97223
City o f Tigard Phone: (503) 639 -4171 Date issued: B :/ � Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 20 Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
O Addition /alteration/replacement ,"tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: J 6'( 4-o St.J' '.2. .i A-V ?,sMe,P , Bldg. no.: 10(iic Suite no.:
Lot 1 Block: 'Subdivision: 'Tax map/tax lot/account no.:
Project name: l/.ert s Irt.cfu.strZta Ti
Description and location of work on premises/s . ial conditions: IzLeekivo clet.M, f r kro- , f "DA wo ( k / (A. k. I Ls 1) ooi'.
Ceti * _ ' L _ a e. � r as 50 _ 4 V4-C '
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
Name: PaCTrust (Floodplain, septic capacity, solar, etc.)
Mailing address :15350 S.W. Sequoia Pkwy. #300 1 & 2 family dwelling:
City: Portl and ISM: OR IMP: 97224 Valuation of work $
Phone5503 /624- 6300jFax624 -7755 1E-mail: No. of bedrooms/baths _
Owner's representative: Dennis P ag n i Total number of floors
• Phone: Same Fax: Sam - E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: PaCTrust Covered porch area (sq. ft.)
Mailing address: s - . . • - , i i Deck area (sq. ft.)
City: Portland State: OR i i . : R7224 Other structure area( .. ft.)
Phon5:03 624-6310 Fax • _ ' - E-mail: Commerciallmdustriallmulti- family:
CONTRACTOR Valuation of work $ a /Cv
Existing bldg. area (sq. ft.) Co`I 961
Business name: H. L. Green New bldg. area (sq. ft) --e-
Address: ]; 5350 S.W. Sequoia Pkvt,y. #1nn Number of stories Stt4.5t,e
City: ' , , r . State: 111: ZIP: 'ttr'.6(4 -
Phon803 /624 -7717 Fax: E -mail: Type of construction Vitt
Occupancy group(s): Existing: $/ j - 2
CCB no.: 41328 New: e1Fa-
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: Martin Hanson provisions of ORS 701 and may be required to be licensed in the
Address' 15350 S.W. SP u n i a k w # nQ jurisdiction where work is being performed. If the applicant is
q Y exempt from licensing, the following reason applies:
City: Portl and s :OR UP:97224
Contact personarti n Hanson Plan no.:
Phones l . _A - . • 1 Fax: , , _ E -mail: u , • t . • . • • u
ENGLNEER
Name: Contact person: , Fees due upon application $
Address: - Date received:
City: State: IZIP:. Amount received $
Phone: l Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Na all jurisdictions accept credit cards, please call jurisdiction for mote information.
attached checklist. All provisions of laws and ordinances governing this Qviisa 0 MasterCard
work will be complied with, w ether specified herein or not. credit card number: / - /
t+�
Authorized signature: Date: 1 •25-0Q Name of cardholder as shown on credit card
Print name: A4.r4rh /
$
r'1 Cardholder signature Aaauat
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (600000M)
•
•
SUBJECT: ACCESSIBILITY
BARRIER REMOVAL IMPROVEMENT PLAN
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionate to
the overall alteration when the cost exceeds twenty-five per -cent (25 %).
VALUATION of all renovation, alteration or modification being done
excluding painting, wallpapering. [1] $ v2 /&/20o
multiply: 25% Barrier removal requirement. .25
BUDGET FOR BARRIER REMOVAL (21$ 51
In choosing which accessible elements to provide under this section, priority shall be given to those
elements that will provide the greatest access. Elements shall be provided in the following order.
(a) Parking $ OK-
(b) An accessible entrance: $ ��--
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for $ � 00 7
each sex or a single unisex restroom: v
(e) Accessible telephones: $ O/�- - •
(f) Accessible drinking fountains: and $ S/ 09 7 r� -
(g) When possible, additional accessible �jDOO COVI t 5
elements such as storage and alarms: $ /0 "D 0 4,4 wrx/'-e_....'
TOTAL: Shall equal line 2 of Value Computation $ o•
is \dsts\fomu\access.doc
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
q BUP ° — � [ 7�
Received Date Requested l / AM PM
Location 1' (p ( 16 '7 cc ,414 Suite MEC
Contact Person (.�.�- U �' Ph ( • ) 3/ g 8 PLM
Contractor '' P ( ) SWR
BUILDING Tenant/Owner UL&4 1p ELC
Footing
Foundation ELC
Ftg Drain Access: • 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 / v
Susp'd Ceiling � . _c./
Roof
Other:
PASS FAIL (CIO �/„ 1
PLUMBI 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 / v. fir
ADA Date / / Inspector p Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL