Permit - • . • i.j� tU
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00436
�nall DEVELOPMENT SERVICES DATE ISSUED: 7/21/03
1- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 310 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
t BLOCK: , LOT: 002 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: 2 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 5 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 20,000.00
Remarks: New office space. •
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:
Phone: 624 -7717 •
Reg #: LIC 41328
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 7/21/03 $235.30 Electrical Permit Required
[TAX] 8% State Tax 7/21 /03 $18.82 Framing Insp •
BUPPLN Pln Rv 7/21/03 $152.95 Gyp Board Lion
[BUPPLN] Final Inspection
[FLS] FLS Pln Rv 7/21/03 $94.12
Total $501.19
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: l )..ZZ.Z.6A..>
Permittee j 1
Signature: � ��/1�7/ -� / ./ / /A��
7 '
Call 639 -4175 by 7 p.m. for an inspection the next . e • . - ss day
•
A • -B di ggFerni$Appiicati®ii - -- - - -=- �
- Datereceived •7 / -03 Permit no.
City of Tigard
ii I X0 3 -. 004 ,
;; 4!):1 1 11 . :-
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Pmjeedappi.no.: Expire date
City o gard Phone: (503) 639 -4171 Date issued: B Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1&2 family: Simple Complex:
TYPE OF PERMIT •
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration /replacement Tenant improvement 0 Fire sprinkler/alarm 0 Other: -
JOB SITE INFORMATION .
Job address: 4p / .tO $ L / ... . �:�,; Bldg. no.: 1� Suite no.
Lot: r lock: Subdivision: Tax map/tax lot/account no.:
Project name: E` �'.�' ��2' — _� .
Description and ocation of work on premises/special conditions: .Sii -.' - _Jr--; ∎ __"� .i�'.."
,
OWNER FOR SPECIAL INFORMATION, USE CHECI:LIST =
Name: P a cT ru s t (Floodplain, septic capacity, solar, etc.)
Mailing address: 15350 SW Sequoia Pkwy., #300 I & Z family dwelling:
City: Portland ' State: OR (ZIP: 97224 Valuation of work $
5031 Phone:56 6300 OIFax624' -7'Jhi No. of bedrooms/baths
Owners representative: D e n n i s P a9 n i Total number of floors
Phone: Same Fax: S a e E-mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: P a c T r u s t Covered porch area (sq. ft.)
Mailing address:15 3 5 0 SW Sequoia Pkwy ., #300 Deck area ( sq • R')
City: Portland State: OR I ZIP: 97224 Other structure area (sq. ft.)
503 1 Phone{ 24- 6 3 00 Fax6 24 - 7 7 5' E -mail: Commercialrmdustrial/multi- family: ��
CONTRACTOR Valuation of work $ 4 r . - �
Existing bldg. area (sq. ft.) 770 S,f
Business name: H.L. 6 r e e n New bldg. area (sq. ft.)
Address: T5350 SW Sequoia Pkwy., #300
-
City: Portland I state: 0 R1 ZIP: 97224 - Number of stories ;:t242!!'
503 ) Phones 24 - 7 717 I Fax: I E-mail: Type of construction
CCB no.: 41328 Occupancy group(s): Existing:
City/metro tic. no.: New:
Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: J oh n R om i S h provisions of ORS 701 and may be required to be licensed in the
Address 15 3 5 0 SW W Sequoia Pkwy. . #300 3 0 0 jurisdiction where work is being performed. If the applicant is
city: Portland [State: OR I ZIP:9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: Plan no.:
503) Phone: 624-6300 Fax:624 -775 E-mail: ' ohnr@ actrust 1 . com
Name: Contact person: Fees due upon application $
Address: - • . Date received:
City: (State: ZIP:. Amount received $
Phone: Fax: I E -mail: Please refer to fee schedule.
. I hereby certify I have read and examined this application and the Not all jurisdctioas accept credit cards, please call ju isdictioa for more information.
attached checklist All provisions of laws and ordinances governing this 0 visa 0 MasterCard
work will be complied w: . ethe , • - j,,; herei , of Credit card number I
Expires
Authorized signature:'] ��' - / -r% . e: 7--/4--e9,3 Name of cardholder as shown oo credit card
Print name: Cardholder signature $
Cardholder Amormt
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (641OlCOM)