Permit CIT O TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00352
� DEVELOPMENT SERVICES DATE ISSUED: 7/22/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 200
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 -1HR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 4,500.00
Remarks: TI, demo & new walls for office.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES MATTHEW OLSON CONSTRUCTION
15350 SW SEQUOIA PKWY #300 -WMI 5320 SW DOVER LANE
PORTLAND, OR 97224 PORTLAND, OR 97225
Phone:
Phone: 503 - 892 -0066
Reg #: MET g 2
00002036
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 7/22/2004 $91.30 Electrical Permit Required
TAX 8% State Surchar 7/22/2004 $7.30
Sprinkler Permit Required
[TAX] ! Framing Insp
[FLS] FLS Pln Rv 7/22/2004 $36.52 Gyp Board Insp
[BUPPLN] Pin Rv 7/22/2004 $59.35 Final Inspection
Total $194.47
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 (50 , • • • ; • or 1- 800 -33 - "44.
Issued 1 _ ■ / , _ :/ A AtiV .
Permittee 411111111ft /
Signature: X 7 Apr
Call 639 -4175 by 7 p.m. for an inspection the next business day
fi -01/62 z Z - d Cie
City of Tigard
BuildingPermit Application OFFICE USE ONLY
Date received: 7 0 0 ef Permit no.: 0035
t " ���f Project/appl. no.: x • date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: B J Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ C mercial /industrial 0 Multi - family . New construction ❑ Demolition
0 Addition /alteration/replacement enant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: a w e _ , 40 Bldg. no.: Suite no.:
Lot: Block: Subdivision. Tax map /tax lot/account no.:
Project name: P� 1 - ` , 2 4 mil
Description and location of work on premises /special conditions: _ f • , 1 a. e--
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
(Floodplain, septic capacity, solar, etc.)
Mailin • address: (f e ..-j j o /��, As , &et family dwelling:
�� Sta - &/Z ZIP: J ��,, Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: 4 ,01101 1 nriMIg IP i Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
MI ` f _� Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $ et560
Business name: 4.41/ eV, �/ Existing bldg. area (sq. ft.)
Address: 5320 & t LF /G ' New bldg. area (sq. ft.)
�� ZIP: -'72-7,5
Number of stories
Phone: $b3 B DO(es• Fax: 2 ODi i E -mail: Type of construction ////L
CCB no.: 0 Occupancy group(s): Existing:
New:
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: - provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER OFFICE USE ONLY
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All U •visions of laws and ordinances governing this 0 Visa ❑ MasterCard
work will be complie./I rth, wh- sp- ' . -d herein or not. credit card number. / /
Authorized si atur w,� ` �s,�� Expires
gn Date: J 7' Z� N ame of cardholder as shown on credit card
Print name: /VLiit/
Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6 /00 /C0
CITY 1 V 24 -Hour
Inspection Line: (503) 639 -4175
INSPE (VISION Business Line: (503) 639 -4171 MST
j BUP 10.6 DD S So
Received Date Requested q.0 AM PM BUP z4- co 377
Location S , j� Suite 2 o o MEC 2 4 -
Contact Person Ph ( ) 367— a ( OS PLM
Cont Ph ( ) SWR
Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewa
e i
Fire Alarm
aS _ Susp'd Ceiling Roof
Oth : JAW- _WI
"AS PART FAIL �
PLU :ING
- st & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS FAIL
CHANICA
Rough -In
Gas Line
Smoke Dampers
PART FAIL
TRICAL r�
Service ■
Rough-In
Low Voltage
A.V�r , V -�`�'7 -
Low Vo I
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