Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00236
4 DEVELOPMENT SERVICES DATE ISSUED: 8/6/2004
" '�I Il 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00800
SUBDIVISION: PACIFIC CORP. CENTER 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: 148 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: $ 192,000.00
Remarks: TI w/ Exterior Canopy
Owner: ° Contractor:
PACIFIC REALTY ASSOCIATES ROBERT EVANS
15350 SW SEQUOIA PKWY #300 -WMI 1200 NE 48TH AVE. STE 1250
PORTLAND, OR 97224 HILLSBORO, OR 97124
Phone:
Phone: 503 - 648 -7805
Reg #: LIC 14426
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require Final Inspection
[BUILD] Permit Fee 5/21/2004 $1,103.10 Electrical Permit Required
[TAX] 8% State Surchari 5/21/2004 $88.25 P Plumbing Permit Required
[BUPPLN] Pln Rv 5/21/2004 $717.02 Slab Insp
[FLS] FLS Pln Rv 5/21/2004 $441.23 Framing Insp
(additional fees not listed here) Framing Insp
Framing Insp
Total $2,399.44 Gyp Board Insp
Susp Ceilng Insp
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 -: 332 -2344.
Issued By: 419.1 •_ ∎i .
Permittee
Signature: / - ,�� 0.-----__
Call 639 -4175 by 7 p.m. for an inspection the next business day
IP je
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Building Permit Application. — t NIt.A FOR OFFICE USE ONLY
City of Tigard Rec 1ff 6 ggle._IallintlEIM
13125 SW Hall Blvd., Tigard, OR 97223 ,1- ..‘‘IS Plan Review. I d .. Oa 00
Phone: 503.639.4171 Fax: 503.598.1960 thgt 2 — 4:411-17.'iit Date/By: b ' / /15,3 p Other Permit:
Inspection Line: 503.639.4175 t : Date Ready/By: .iii ' • El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: 107. Supplemental Information
0 i ,0
- cN Of -C1 0
s . c \INS
,:l. . i:411.,-,TiEott tr
nycvel DATA . AND.I_FAKELY DWELLING
!..":: :' ", ":_Z":I'•i ,,,• ...t, :!7 .: • .■ - •:. • . " ' ' • • " • •• •
[3 New construction 1,.-Erte-molition Permit fees* are based on the value of the work performed.
— Indicate the value (rounded to the nearest dollar) of all
„.0•1-cidition/alteration/replacement 1,JaCgr 7-
• r.erutett (rvyrbvemeot equipment, materials, labor, overhead, and the profit for the
ii
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. k - GAiiif.,'h66-$1eigkr...:71gif.iy;;V:?,*Nrg.;;;A;;Vtligi.F.400:0,,i work indicated on this application.
1 ,0::1:,,,,,,=-;-.75.,,,-4mr-•.,,,',.,;,.;,4,,,v;!,114r4!..,st.T.;:itii13-.1?.z,'::1),a,•-gi.,....1,Vii • Valuation: $
El 1- and 2-family dwelling Commercial/industrial
Number of bedrooms:
El Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms:
it•Wif w '1 '4 1 Total number of floors:
1Y,F.f.;et:N5';'..Y.. :
Job site address: f Go 5 5 $se_.te 00/A frwif , f t o 0 New dwelling area: square feet
City/State/ZIP: part (01,‘,1,,2 og e3-7 ) Garage/carport area: square feet
l .
Suite/bldg./apt. no.: Project name: p c ;6. i ztr c Covered porch area: square feet
Cross street/directions to job site: — 5-e.e_ to cakf Ian mxt..19 A ri A - i — Deck area: square feet
• Other structure area: square feet
iiiiii".iiketikmiii ' ..'.' s 'tiii fa,
L',4...00..,']:!( : ; A, ,...,, ,,...cIAL,u c ET
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.: equipment, materials, labor, overhead, and the profit for the
'.3....43':::::',.-:'..qi:.--AVi4P1':;Mlbl't,,V1',.`"4:,■iirislistl'agifiikia,:'41`4'iiitii;il'ANI,If%:1-?-i.:A"4.,,i;i.',l work indicated on this application.
'
Valuation: $ P949-.) 6
F LI/G/ -frivtaAelt I rielfttfhteit■Le.mt ie) ee 15(10 5:01 i—e ;
e44 Existing building area: /2)61'11 square feet
d4.49 1 61% MA.ei-ei i t assec . h vote- sii pi 144,113 ) .
p.e,e144,(4-) — see Rbi. fridyebtfk. 'du A. I, New building area: fri/el, square feet
3
It Number of stories : 1 sto rr
;.: ,,,..-:,.......i,.,......,...„,...,,,,Ai., q t.0 : „ * .!:-.L.,,&;,:.. , ,,,,,,,,.:„ ,...,,,,,p.■
Name: PacTrust Type of construction: tilki
Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing: ,
Phone: 603 ) 624-6300 Fax: (503 ) 624-7755 New: 15
;•.i:;' ii',./014.Pi El :-',-- - .)4 , , , p, , J: , .., 1 ,.4 , -.::'..:i. , .;,•,:' , ;:: , ;,::::, ,.,'. 1,.!...: , ' - • -- .. • • • , :-.-..., :-:. ' .-• . - • : • . - • '
i:!:,g.s< V,V1 :..y1 tj • j,...: . f.' , 1 .irla .1. . 7.14' , 11 :,, PP' ...:;...-1:::!?.i4:„.:,+:..!;:'; . NOTICE.-,.
Business name: PacTrust , All contractors and subcontractors are required to be
Contact nam e: • licensed with the Oregon Construction Contractors Board
pp...
A■vbtottg eknin, L under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: Portland, OR 97224 apply:
Phone: ( 503) 624-6300 Fax: : (503 ) 624-7755
E-mail:
1 - 1 . 1 P.,',„*. 'qrg,
.:.,,A. f•A'•,,m1.1 • ,m4or,1•SJal.."4I0V...laW.,446,:;,!rii.,,.,• , ,,, , , , q.tqrS!' 2.1
Business name: Robert Evans Co., Inc. ,c., NI - p - ‘ 4, 1 , I , ••.:! , ,. , . ,,, ;::;.BUILDING.,:: I PERNITT. FEES* . • •
Address: 1200 NE 48th Ave., Suite 1250 Please refer to fee schedule.
City/State/ZIP: Hillsboro, OR 97124 Fees due upon application
Phone: ( 503) 648-7805 I Fax: ( 503) 648-5883
Amount received
CCB lic.: 14426
.-
,...,
Date received:
Authorized signature: This apermit i sasnocot co mplete.
-- within 18 t ca
180 application after tion expires thpaisr been i f
e en
accepted
. Print name: 1
v s e aLn ,,, 1 , L _ Date: bp." to 1.) * Fee methodology set by T Building Industry
Service Board.
•
i:lilluildingTermitABUP-PerrnhApp.doe 12/03 • 4404613T(11/02/COM(WEB)
CITY OF TIGARD 24 -Hour
BU_ •fi Inspection Line: (503) 639 -4175 MST
INSPECTI JeiON Business Line: (503) 639 -4171 BUP
Received Date Requ ted C ?'"" ( AM P PM M I BUP
Location SD S ! ' ! � -�-� -� Suite / MEC
Contact Person 6444 Ph ( )675 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 0—/a--■eP
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
nay
• 'ASS PART FAIL STIMEIMIVIRLIM � i ��. f,
-ost & Beam
Under Slab
Rough -In Mir
Water Service N i I' , �
Sanitary Sewer / Rain Drains alof
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
Approach/Sidewalk Date Inspector Ext
Other: _
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL