Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2003 -00157
a - t w * DEVELOPMENT r S O ER 9 SERVICES
639 -4171 D ATE ISSUED: 4/3/03
SITE ADDRESS: 06650 SW REDWOOD LN 370 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
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: 3 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: $ 6,000.00
Remarks: Tenant modification of corridor.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES H L GREEN
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 Framing Insp
[BUILD] Permit Fee 4/3/03 $100.90 Gyp Board Insp
[TAX] 8% State Tax 4/3/03 $8.07 Susp C Final Inspection
[BUPPLN] Pin Rv 4/3/03 $65.59
[FLS] FLS Pin Rv 4/3/03 $40.36
Total $214.92
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 -00 -: I 0 thro • • OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
call' • g (503) 246 -6699 o - 800 - 332 344.
ssued By: .... ,._ �1 ' VtJJ L!/
- rm ittee ' . Alp. ,
Sig - : ------- 411■ SAMOI // Ar — /' /
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/ Call 639 -4175 by 7 p.m. for an inspection the next business day
'` • . . ' BuildingPermitApplication
41,41 City of Tigard Datereceived: A 1 Q :1 Permit no : ,3 -GtS /s 7
Address: 13125 SW Hall Blvd, Tig. -. e • 97223 Project/appl.no.: date:
City ofT igard Phone: (503) 639 -4171 Date issue Receipt no.: .
B
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 lesTenant improvement 0 Fire sprinkler/alarm 0 Other:
JOB SITE INFORMATION :
Job address: ,, fp I Si Al.,, /4, / /,d ��:1 Bldg. no.: all Suite no.: _
Lot Block: - Subdivision: Tax map/tax lot/account no.: 7
Project name: ,g%/Q Af /,� .
Description and location of work on premises/special conditions: —../'. iii d/� ri S i ;' ' '
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Pa cT ru s t (Floodplain, septic capacity, solar, etc.)
Mailing address: 15350 SW Sequoia Pkwy. , 11300 1 & 2 family dwelling:
City: Port 1 and State: O R PP: 97224 Valuation of work $
5031 Phone:' 624- ; 6'3 UQ CJFax6.24 -77 -mail: No. of bedrooms/baths .
Owner's representative: Den n i S P a g n i Total number of floors
Phone: Same Fax: Same 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 50 SW Sequoia Pkwy ., #300 Deck area (sq. ft.)
City: Portland I State: 0 R J ZIP: 97224 Other structure area (sq. ft.)
. 5031 Phone:6 2 4 - 6 3 0 0 Fax6 2 4 - 7 7 5' E-mail: Commerclal/mdustriallmulti- family: O'
CONTRACTOR Valuation of work $ l4
Existing bldg. area (sq. ft.) �'Z►Z': .
Business name: H.L. Green l
Address: 15350 SW Sequoia Pkwy. , #300 New bldg. area (sq. ft.)
City: Portl and State: OR I Ea 9 7 2 2 4 Number of stories
- Type of construction
503 ) Phone6 2 4- 7 717 I Fax: J E -mail:
CCB no.: 41328 Occupancy group(s): Existing:
New: E
City/metro lit. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: John R om i sh provisions of ORS 701 and may be required to be licensed in the
_ Address:15 3 5 0 SW Sequoia Pkwy. 300 jurisdiction where work is being performed. If the applicant is
_ r ZIP:9 7 2 2 4 exempt from licensing, the following reason applies:
City: Portland I State: O R
Contact person: l Plan no.:
. 503) Phone:624 -6300 Fax:624 - 775 ' E - mail: - ohnr@iactrusti..com
ENGINEER
Name: Contact person: Fees due upon application $ •
Address: • . Date received:
City: JState: JZIP:. Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all jurisdictions accept credit cards please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied 114, heth r may .'• herei or . ot. credit card number: � ues
/
Authorized signatu :r ✓ I / �
// /' • / ///
..I
Authorized Name of cardholder as shown on credit card
Ur � $
Print name: ..-/A' . i � AO ,./ is
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4404613 (6A0K:OM)
CITY OF TIGA 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 3 -0Q/s7
Received Date Re nested ` � AM _PM BUP
Location / Dl e / Suite � - MEC
Contact Person Ph ( ) 3-57 - a S3 ff PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 3, ) ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: g SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART 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 577 o /Q3
Approach/Sidewalk Date / Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL