Permit IIN
A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003-00502
8/20/03
y l n DEVELOPMENT SERVICES DATE I
r�I JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15055 SW SEQUOIA PKWY 140 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: 100 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: $ 45,000.00
Remarks: TI office remodel interior walls and accessible shower.
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 8/20/03 $433.30 Electrical Permit Required
[TAX] 8% State Tax 8/20/03 $34.66
Plumbing Permit Required
BUPPLN Pln Rv 8/20/03 $281.65 Framing Insp
[BUPPLN] Insulation Insp
[FLS] FLS Pln Rv 8/20/03 $173.32 Gyp Board Insp
Total $922.93 Final Inspection
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:
Pe rm ittee
Signature: �/
.. kr ,--' ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
- .
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. • A • : iut gPer -I I J 111.91ffiCre
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• _iii City of Tigard AUG 2 0 2003 Datereceived ;ail -0 Pernik no.: • , ra-3 -e2e2 , a.
- Project/appl.no.: Expire date: ,
Address: 13125 SW Hall Blvd, 61411,DB._9722.3
City ofrigard UP Phone: (503) 639-4171 TIGARD . Date issued: EMI Receipt no.: •
• •
Fax (503) 598-1960 BUILDING DIVISION Case file no.:' PayMent type: '
• -
Land use approval: 1&2 family: Simple • Complex: . .
. .
. -
TYPE OF PERMIT , . •
. . . ,
0.1 & 2 family dwelling or accessory 0 Co , - ial/industrial CI Multi-family ' Ca New construction ' - 0 Demolition
'0 Addition/alteration/replacement . . • enant improvement Cl Fire sprinkler/alarm 0 Other: - • . . .
JOB SITE INFORMATION
' .
Job adds: 11 le _fe ,,,,e, 2 0 - '..714,.. 0 .2 ,. 4,1 Ye .. _ Bldg. no,: .. . _ Suite no.
Lot
• . 6 1 - Blocic .. . -- -- Subdivision: -/ - --7 - 'r - ... - ---- Tax map/tax lot/account no
.: - " - • ' - • " ' ,
Project name: • e O e -- . r ..-_ . --
, . _
Description and location of wo . On premises/special conditions /445 esa-- -Re_ .71c/ ti --e-- •
. . .
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Pactrust• - • - • • (Floodplain, septic capacity, solar, etc.) ,
F-- - Mailing address: 15350_ SW__Se.uoia ..Pkwy..,_ _1300 _ t&tifamilydwellingi--. ----I------ ---- •- -- - - -:----- ---- ,- - -
. - -
City: j or an. • . State: OR ZiF: 9 valuation of wort5.......... ........ $ ', '.
) 3 Phone:5624-56300-1Fax6E47-4,1.54E-mail: No. of bedrooms/baths - '
; . Owner's representative: Den n i s Pagni Total number of floors ,
H Phone: S ame - Fax: S . e s E • ' . New dwelling area (sq. ft.) .
APPLICANT Garagekarport area (sq. ft.)
• Name: PacTrust •• • • • . •• .- . covered porch area (sq. ft.) - .
-•
' Mailing address:1 53 5 0 SW Sequoia Pkwy., #300 Deck area (K b ft)
Qty: Portland }State: OltjaP; 97224 Other structure area (scl. ft-) - .
ComnterelallIndustriallmultl-family:
3 3 Phone:6 2 4 _6300 Fax624-775' &mall:
Valuation of work -....-..- $ -
CONTRACTOR
. 4 - 41 - .,..„ . Existing bldg. area (sq. ft.)
Business name: . reen K.:vp.e -
New bldg. area (s q. ft.)
Address: r5 3 50 SW Sequoia Pkwy., #300 - Number of stories . -
City: Portland. I state: OR I zsP: 97224 ' • -
Type of construction
D3 I Phone624-7717 I Fax: • E-mail: I
_ Occupancy group(s): • Existing:
CCB no.: 1:;11:2:8 /5 y 94, -:- ci/ r p)
City/metro lic. no.: . . •
Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Boaid under
•
Name: John Romish . provisions of ORS 701 and may be required to be licensed in the
'
Address: 1 53 50 SW Sequoia Pkwy. #300
jurisdiction where work is being performed. If the applicant is •
City: Portland • - Istate: OR I 7 ZIP: 9 7 2 2 4 exempt from licensing, the following reason applies:
Contact person: I Plan no.: "
D31 Phone:624-6300 Fax:6 24 _775. E-mail:" ohnril.act usti..com • -
ENGLNEER
Name: . Contact person:' . Fees due upon application $ . . -
' Address: -,: - - Date received: .
City:
'State: IMP:. Amount received $
• Phone: I Fax: I E-mail: Please refer to fee schedule.
I -,.. I hereby certify I have read and examined this application and the Not all jurialictions accept credit earth. please call jurisdiction for Mare &Amadeu.
attached checklist. All provis14 of I. • s and ■rdinances'goveming this CI visa 0 MasterCard
work will be complied ' speci . herein or not. Credit card munber . -1---L---
Expires
Authorized signatu . . - . Date: 0/er Name of cardholder as shown oa credit card
Print name: 4 71) 1 1 - _ - .1 ..., • .....- . Cardholder signature $
Mmmt
Notice: This permit application expires if a permi is not obtained within 180 days after it has been accepted as complete. 440-4613 (6000/COM)
, 9
14 ?)O6 033 /
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIViSIC1N Business Line: (503) 639 -4171 MST
—
Received Date Requested
/D - AM PM 2 ` 0 050a --
Location /SO55 U O i a PkI^DY Suite I
Contact Person Ph ( ) -26 a 9 SSCp PLM
Contractor Ph ( ) SWR
.DIN ) Tenant/Owner ELC
F g ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: - 1" _ SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear k G^^ � �
r^'� O � ✓ �7 a� e G1"e 1ri ve-v . /6_5Y-e.
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
0
la PART FAIL
BING /
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 El Please call for reinspection RE: lj Unable to inspect — no access
Fire Supply Line
ADA Date /
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL