Permit # BUILDING PERMIT
C ITY OF TIGARD PERMIT #: BUP2004 -00401
DEVELOPMENT SERVICES DATE ISSUED: 8/18/2004
..� AA, �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15575 SW SEQUOIA PKWY 140 PARCEL: 2S112DD -01600
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: 49 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: $ 62,000.00
Remarks: TI - new walls for offices.
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 8/18/2004 $536.44 Electrical Permit Required
[TAX] 8% State Surchari 8/18/2004 $42.92 P Permit Required
Plumbing Permit Required
[FLS] FLS Pln Rv 8/18/2004 $214.58 Framing Insp
[BUPPLN] Pln Rv 8/18/2004 $348.68 Insulation Insp
Total $1,142.62 Gyp Board Insp
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: - Zr_1,pd
Permittee ; _
Signature: /!/ j ' A;, / / / /ill,iAL
p Call 639 -4175 by 7 p.m. for an inspection the next business day
: .
.. _. -
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Rec Date c /B ived y: kV y -01" I Permit No./ 63 ody....00 vat 1
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revim
Phone: 503.639.4171 Fax: 503.598.1960
,.:11;:tt,i.,:r..rilfii\ Date/By: 5-40-011/65. Ot Permit:
Inspection Line: 503.639.4175 Date Ready/By: Juris: i 0 See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: f
1 Cr Supplemental Information
, ”i.; , !,,,' , .;',.' ,; .' .,':, , .',:',.,:r ,, ., : ;-' ;42 ;:i :- -:•:;:', 7. ! DWELLING
..;;; ' ',.:- " ;. - - .,' !. " i! ci 1 .,: '.' :1:' ', .":.' , . . . - , .,... , - • r, tri.r ,'; , ,' , .- vo , . ,: . :,,, ; ' '. ,, -, - ,,-.., .. ., , • . . • . : •
El New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
%Addition/alteration/replacement ID Other: equipment, materials, labor, overhead, and the profit for the
, •- .1:., , , ,.., , , ; , i . :;: . ; , : .,..,,, ,, ,. c At tp o ii - i v , - . .i 0 ,40 . , ,,, , ,r, ,, , , ;;; i: ;: ! :;,...,,. i: , .. , t ..E 7,, , -,,,;: work indicated on this application.
Valuation: $
O I- and 2-family dwelling Aommercial/industrial
Number of bedrooms:
0 Accessory building 0 Multi-family
Number of bathrooms:
O Master builder 0 Other:
'''' ‘'''■';'" .'"" • ' - . 1 .' 1, ,': 1, j , ' ,'
JOB SITE INFOliMATION:ANDI:10GATION'.:' 2' , '; ,■::, ... C ..,, i ' ;7 1 ■:r l'i Total number of floors:
Job site address: /S XX/ e fb i faea,49 pried v erl New dwelling area: square feet
City/State/ZIP: 7 - 44 04 7 ,) 2-frld Garage/carport area: square feet
Suite/bldg./apt. no.: /0 Project name: Saie244,11224,7y1j0 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDIIATAirOMMERCIAL7USE
Subdivision: 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 -..
I : ,.,' :..: .-' ,Dikiiiiiiiit0 ; ,,,z?.,,',.,.:;, , .:. : ::; - ,. ; ; , ,, work indicated on this application.
.._
A /_ -, ... Valuation: $ 2
Pry-
4 (1 "1 O 7 74W/Ifi / 7. Existing building area: " CAebquare feet
New building area: square feet
,•'!;''. iliooloy.,'ON04-it ::?' :::.,i., !,'!...:*,!:.',., p MANT:,;,,;,T.;,::.-!-.:: Number of stories: /
Name: PacTrust Type of construction:
Address: 15350 SW Sequoia Pkwy., Suite 300 Occupancy groups: /a13
City/State/ZIP: Portland, OR 97224 Existing:
Phone: (503 ) 624-6300 F ax: (503 ) 624-7755 New:
AP i!: :::;: ..:,.9:''; ::::`;',.:]*f': -,,,,.....,.:... NOTICE
Business name: PacTrust All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: 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 .' ,- .-- . .”::: ...: . , -;'; ',::....''.-::: . :,' :i ::;■,,':.': ••••1; . 'I ,: AA birpiei.,i,ii '•; ,,. y ,,,,,',:•--: .,!.,,.; F ,;:
Business name: Robert Evans Co., Inc. ':!:q:''.1 REES*
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
Authorized signature: . / 1A7,3 1 ,..X , 1
Ap
4
Date:" .4./,....4/7# D t s r ec e e r i m v e t d a :
pplication expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Ve 4/ ,/,,
* Fee methodology set by Tn-County Building Industry
Service Board.
iABuilding \Permits \BUP-PemitApp.doc 12/03 440-4613T(11/02/COM/WEB)
CITY OF TIGARD 24 -Hour
' BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/
BUP 20_
Received Date Reque ted ( lam q AM PM BUP
Location 0 Suite /IU MEC
Contact Person Ph ( ) (0 7 --3' 7/ PLM
Contractor P ) SWR
UIL Tenant/Owner ELC
0o ing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 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: torto
PASS PART FAIL
PLUMBING
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 for r inspection RE: Unable to inspect — no access
Fire Supply Line tor
Approach/Sidewalk Date Inspector �� `/ Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL