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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00408 Ai DEVELOPMENT SERVICES DATE ISSUED: 7/22/03 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 PARCEL: 2S113AC -00101 SITE ADDRESS: 16655 SW 72ND AVE 800 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I -P BLOCK: LOT: 029 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: 12 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: $ 2,000.00 Remarks: Rack storage. Owner: Contractor: PACIFIC REALTY ASSOCIATES NORLIFT OF OREGON INC 15350 SW SEQUOIA PKWY #300 -WMI PO BOX 68348 PORTLAND, OR 97224 7373 SE MILWAUKIE EXP PORTLAND, OR 97268 Phone: Phone: 659 -5438 Reg #: LIC 67294 FEES REQUIRED INSPECTIONS Description Date Amount Framing Insp [BUILD] Permit Fee 7/14/03 $62.50 Final Inspection [BUPPLN] Pln Rv 7/14/03 $40.63 [TAX] 8% State Tax 7/14/03 $5.00 [FLS] FLS Pln Rv 7/14/03 $25.00 Total $133.13 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 . i • . •699 or 1- 800 - 332 -2344. ; - / Issued = : ' si i_ Pemtittee Signature: I( X % (..// 6e4 Call 639 -4175 by 7 p.m. for an inspection the next business day /66S3 s w ? pp coPr 14F ix • Building Permit Application . . FOR OFFICE USE ONLY Received Building �s `� �® Date B _ Permit N . "�3 -.0 VO • G City of Tigard GV V Planning Approval Other Date/B Permit No.: � 13125 SW Hall Blvd. L p Plan Review Other Tigard, Oregon 97223 �41 Date /B : Permit No.: O `k Phone: 503- 639 -4171 Fax _598 -196 »a<ei t it `- Post Review Land Use W J�"" ,���� L� 6.1-1‘ ' Date/B : Case No. Internet: www.ci.tigard.or.us OF Contact Juris.• ® See Page 2 for 24 -hour Inspection Request: `o �- ICA\I` Name/Method: Su • • Iemental Information N- TYPE OF WORK REQUIRED DATA: ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING ❑ 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 0 Multi- Family -(--\) ❑ Master Builder ❑ Other: Valuation $_ JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: - ( - 1,2 J(: X / 445-5'. od S S i✓ 7 a hj Total number of floors New dwelling area (sq. ft.) Suite #: goo Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: Copy 1j-/J ,t J & Covered porch area (sq. ft.) Cross street/Directio to job site: Deck area (sq. ft.) Other structure area (sq. ft.) REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: I Lot #: Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, �f overhead and profit for the work indicated on this application. q eI/S 0 p /P L Al Valuation $ )N0190 1 f r7 Existing building area (sq. ft.) New building area (sq. ft.) Number of stories / V l_ PROPERTY` OWNER � ❑ TENANT Type of construction Name: / , l /a G 4-(` ,-- S Occupancy grou Existing: New: Address: City /State /Zip: Phone: Fax: NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under �t APPLICANT ® CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: p(/pr / Fie 7 o 7 Ore/ ar) jurisdiction where work is being performed. If the applicant is exempt Contact Name: 3c ar rer' i L Li , from licensing, the following reason applies: Address: 7 3 23 S0 11/ wP c/Aie 2� XV • City /State /Zip: pork-Ian s ( 0Y2 9 7 .. 2 Phone: spa 5 4--30(.43 Fax: 6 r3 4 944 BUILDING PERMIT FEES* E -mail: Please refer to fee schedule. CONTRACT R �q Business Name: d orii D le /n� aeyep, Fees due upon application $ Address: 7 3 93 $ ;:- n/1 'f �uk4i e F c0 . City /State /Zip: pod-- IRii, al/2, 9) >3-2. Amount received $ Phone:30 5/ y -3o H 3 Fax: Date received: CCB Lic. #: 6 7 2_,61 `.. / 7 - / - ©S' Authorized / / ice `/' / Notice: This permit application expires if a permit is not obtained within Signature: J/li�,, Date: 7/345 180 days after it has been accepted as complete. I an Je « r ( Az- *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 Plan Submittal Requirement Matrix Commercial & Multi- Family City of Tigard New, Additions or Alterations TYPE OF SUBMITTAL # of Plans (Includes New, Additions or Alterations) Required at Submittal 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 _3- dcD �" !/ ob Received ^ Date Requested ! AM PM r •' B,UP Location fg 701 .414 Suite 3 MEC Contact Person Ph ( ) 5 / ! --3Q /3 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 fer,_ 4 Int Sheath/Shear Framing Insulation Drywall Nailing Firewall �`�—�� _ r te ��L . Fire Sprinkler _ "`�� `f`l Fire Alarm r Susp'd Ceiling Roof „ _ Q Other: t Fi <Mk• •ART FAIL ' = 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 O Approach/Sidewalk Date (Z q f Inspector \ Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL