Permit h
A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00238
� i� � DEVELOPMENT SERVICES DATE ISSUED: 6/4/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -00800
SITE ADDRESS: 15055 SW SEQUOIA PKWY 120
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: 39 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: $ 91,935.00
Remarks: TI
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
[BUILD] Permit Fee 5/21/2004 $700.54 Electrical Permit Required
[TAX] 8% State Surchari 5/21/2004 $56.04 F Permit Required
Framing Insp
[BUPPLN] Pin Rv 5/21/2004 $455.35 Gyp Board Insp
[FLS] FLS Pln Rv 5/21/2004 $280.22 Susp Ceilng lnsp
Total Final Inspection
$1,492.15
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
952-001-0011 • • • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ) 246 -669• ,r 1- 800 -332- 344.
Issu d By L 'a i
Permittee ,
Signature: / r
Call 639 -4175 by 7 p.m. for an inspection the next business day
ISo5S JW segthom yd
„ FOR OFFICE USE ONLY !
Building Permit Applicati EC E I D , ,
City of Tigard Received 9 i! D Pemut No.: A --e 3 $
13125 SW Hall Blvd., Tigard, OR 97223 , 1 ; / Other Permit: Plan
Phone: 503.639.4171 Fax: 503.598.1960 MAY 2 G;. ;. ,; , I 1 'r \ Date/By: eW b _ I _0 65il
Inspection Line: 503.639.4175 Date Ready/By:
, el See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: / ( � . Supplemental Information
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y: TA. ,. AND 2 FAMII.Y DWELLING
„0 Demolition Permit fees* are based on the value of the work performed.
❑ New construction Indicate the value (rounded to the nearest dollar) of all
e - Addition/alteration /replacement Other: 'r . t ' � yy t f - equipment, materials, labor, overhead, and the profit for the
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❑ 1- and 2 -family dwelling mmercial/mdustrial
Number of bedrooms:
Multi -famil
❑ Accessory building ❑ Multi-family
❑ Master builder ❑
Other: Number of bathrooms:
, a • I ., r ; , rw:., . ,.11ii =: - =41•M.. p (�lii � ir-4 Total number of floors:
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City/State/ZIP: p / ,,,j ! OR G' '''7g...2.—(1. .� Garage/carport area: square feet
Suite/bldg. /apt no.: Project name: 'rays. na c iFu. r+ Covered porch area: square feet
Cross street/directions to job site: — s (ota,.}- tp,,.) VIA.* Deck area: square feet
Other structure area: square feet
r ?.ICE UI)t'E0, 0,, T.Ad CCO1VI1t RCIAL .USE CHECKLIST
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
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r'' �11+1 indicated on this +t' :I��: ���:�� rl.•...�t4.�ty. �;` y ,� ... ..i, ti v,'�I,, �: ! s �. ;,'.. /. work i application.
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. : , , J n '- Valuation: $ �/ I G�� r7
,J p .+ Existing building area: " ''' - square feet
4v�vlm r.�`1.1.s nt.cf+'o a ssat^. I� t�itr 19 �l
. New building area:
tf� �� � l �� square feet
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. — r, - r . f. pri:; :;: ° , I `•�r t ... I.uti ; •: Number of stories
• h , , .'•PROPS 1'],.i - iv ,,:,:r: 4 . ` •a. F� ,' ••...:14;;-..;:"24,7,:',..-:i, 1 i ^ ' •iiTE1 t 11, T P ;,r;. - "'i ) she
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Name: PacTrust Type of construction: V•IV
Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing: �j
Phone: (503 ) 624 -6300 Fax: (503 ) 624 -7755 New: / ,3
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Business name: PacTrust All contractors and subcontractors are required to be
n licensed with the Oregon Construction Contractors Board
Contact name:
.614 el/is P�.. I 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 I Fax: : (503) 624 - 7755
E -mail:
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"' H�'!�ln=Y':7i:;':!iw "qI,., .; r..,.3rilfS7'J .3�'+?.`f1;9:.Fr ?•:::
Business name: Robert Evans Co., Inc. :∎4 ;'K'' kr
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
CCs tic.: 14426
Date received:
Authorized signature: This permit application expires if a permit is not obtained
..4"..-t .--1 r•.6 - within 180 days after it has been accepted as complete.
Print name: De 1] /� `� Date: 5 lot • Fee methodology set by Tri -County Building Industry
Y' ��l / J Service Board.
i:\ BuildingWermits \Bl1P- Penni1App.doe 12/03 430.46I3T(II /O2/COM/WEB)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION- DIVISION Business Line: (503) 639 -4171 MST
BUP X 00 y --od al3e
Received 1 Date equested (7 AM ` PM BUP
S •
Location l 6 Suite / - MEC
Contact Person op4/ Ph ( ) 7 3� 7 / PLM
Contractor Ph ( ) - SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 1 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot• -
4 .0. - " (- 1.
PART FAIL
•PLU = ING -IJ,�-�_4 •,
- •s & Beam I V
Under Slab
Rough -In _ I�'��
Water Service
Sanitary Sewer WisallNin'INWV0 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
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL