Permit " { C ITY OF TIG BUILDING PERMIT
PERMIT #: BUP2004 -00017
4 I. �,r141 DEVELOPMENT SERVICES DATE ISSUED: 1/20/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S113AB 01400
SITE ADDRESS: 07358 SW DURHAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE 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: 49 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: /0, 600. 06
Remarks: TI, relocate walls.
Owner: Contractor:
•
PACIFIC REALTY ASSOCIATES C.A. GREEN
15350 SW SEQUOIA PKWY #300 -WMI 15350 SW SEQUOIA PKWY. #300
PORTLAND, OR 97224 PORTALAND, OR 97224
Phone:
Phone: 503 - 624 -7717
Reg #: LIC 156496
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 1/20/04 $139.30 Electrical Permit Required
[TAX] 8% State Surcharl 1/20/04 $11.14 F Framirami g r Permit Required
ng lnsp
[BUPPLN] PlnRv 1/20/04 $90.55 Gyp Board lnsp
[FLS] FLS Pln Rv 1/20/04 $55.72 Final Inspection
Total $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- 04104hratigh AR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin. 03) 246 -6699 0 1- 800 - 332 -2344. Ai"
Is - ued By: _ rI �,
Perm" -- / 7'
Signature: f. r /. %j . �� i'#.' ��
/ Call 639 -4175 by 7 p.m. for an inspection the next business day
si
D a tereceived: / pb D91 Permi tno.:
u ,. 1 III' City of Tigard s �.•• r. ,>
1- - -- - Project/appl.no.: .ire date:_
City ogard Address: 13125 SW Hall Blvd, 9
Phone: (503) 639 -4171 Date issued: 4 By , Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.:' •aymenttype:
Land use approval:
BUILDING DIVISION- 1&2 family: Simple Complex: • °'TYPE OF PERMIT . ` `;- r
01 & 2 family dwelling or accessory , Commercial/industrial 0 Multi - family 0 New construction ❑'•Demolition -
• 0 Addition/alteration /replacement .. )(Tenant improvement 0 Fire sprinkler/alarm 0 Other.
• JOB SITE INFORMATION
Job address: j', . ,, , 7 ) - .. v i. Bldg. no.: Suite no
Lot: Block: Subdivision: � - Tax map/tax no.:
�
Project name: ! .4 A,�PI'!�'�/ G ralIM -
Description . !d location of work on premises/special conditions: _. ; i iroe / / / r
.mod. .
OWNER _ _ FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Pa CTrust' . ( Floodplain ,septiccapacit
. Mailing. address:_ 15350-SW Sequoia Pkwy. , -#300_ -1: & 2 dwelling: _ _ ___ _. _ _ __ _ __ _
City:. Portland ': State: OR IZIP: 97224 Valuation of work $
5 63 1 Phone :' ; 6?24 .4- (I0 1 Fax62_4 : --7 %:5.0 -mail: No. of bedroomslbaths
Owner's representative: Den n i S P a g n i Total number of floors .
Phone: Sa . Fax: .Same . E-mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: P a CT r u 5 t .. • Covered porch area (sq. ft.)
Mailing address:15 3.5 0 SW . Sequoia Pkwy ., #300 Deck area (sq' ft.) •
City: Portland 1 State: OR ' ZIP: 97224 Other structure area (sq. ft.)
503 Phone:6 2 4 - 6 3 0 0 Fax6 2 4 - 7 7 5' E-mail: Commercial industrial /multi- family:. �y�y
CONTRACTOR r ._ Valuation of work $ .
Business name: Green) / / •
Existing bldg. area (sq. ft.)
Address: E5 3 5 0 W S e q u di a Pkwy . , # 3 00 New bldg. area (sq: ft)
Number of stories
City: Portland . I State: OR I ZIP:
97224 Type of construction
503 Phone 24-7717 I Fax: I E-mail:
CCB no. 41328 8 Occupancy group(s): . Existing: , .S " 2-'
New: t s"'"2-
City/metro lic. no.: Notice: All contractors and subcontractors are req to be
ARCHITECT /DESIGNER , • licensed with the Oregon Construction Contractors Board under
Name: J o h n R o mi s h provisions of ORS 701 and may be required to be licensed in the
Address: l 5 3 5 0 SW Sequoia Pkwy. #300
jurisdiction where work is being performed. If the applicant is
exempt from cens
licensing, the following applies:
City: Portland I State: OR IZIP :9 7 2 2 4 p g° ow g reason pp
Contact person: ' I Plan no.:
503) Phone:624 -6300 Fax:624- 7755E "ohnr @ actrust, t .coin
ENGINEER
Name: Contact person: Fees due upon application $ •
Address: „ • Date received:
City: [State: ZIP:. Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction fix more information.
attached checklist_ All provisions of laws and ordinances 'go .• ruing this 0 Visa O MasterCard
work will be complied wi r whe J . •'f ...herein .r L _ Credit card number: Expires
/
`� Expires
Authorized sign. �� i ,G�/�� ,�! _ 2 2 N of cardholder as shown on credit card
Print name: ki ii . . 41/1101 41/1101 ;l / • �y $
Cardholder signature Amount
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/COM)
CITY OF TIGARD 24 -Hour
' BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP UCH —y 00(7
Received Date Requested / AM PM BUP
-7
Location / 3' 3 a Suite B LA � 1 � MEC
Contact Person l Ph ( ) �� ` P7s PLM
Contractor h ( ) 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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Oth `t jl
dicrox PART FAIL /NW 11•111. � 11•111. : ING J
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 r reins ection RE: /" a• to inspect — no access
. Fire Supply Line R Inspector kt � rk Ext
`' ADA
Date Approach /Sidewalk ,
l 1 * `
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL