Permit •
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00337 •
° COMMUNITY DEVELOPMENT DATE ISSUED: 10/17/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S135AB 00900
SITE ADDRESS: 10200 SW GREENBURG RD 700 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Fire alarm TI.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION _
CLASS OF WORK: FPS FIRST: sf N: S: - E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 74 BASEMENT: sf AREA SEP. RATED:
STOR: 7 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 4,500.00
Owner: Contractor:
SHORENSTEIN REALTY SERVICES CAPITOL ELECTRIC CO, INC.
ONE SW COLUMBIA ST #300 11401 NE MARX STREET
PORTLAND, OR 97258 PORTLAND, OR 97220
Phone: 503-412-4800 Contact #: PRI 503 - 255 -9488
FAX 503 - 255 -1966
Reg #: LIC 48748
FEES
REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUILD] Permit Fee 10117/200€ $83.95
[TAX] 12% State Surcha 10/17/200€ $10.07
[FLS] FLS Pln Rv 10/17/200€ $33.58
Total $127.60
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 503146.6699 o 8 @c. -32.2344.
, I
Is ued By: 1 ' a L i i / Permittee gnature: ��
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
F6 tw 11Q }O- S E NTtc-
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Building Permit Application
Fire Protection System p FOR OFFICE USE ONLY Recei City of Tigard
CEI` Date/By: � O dS / Permit No.: Pb,
t
M
ved
'1 13125 SW Hall Blvd., Tigard, OR 97223 �1JJ Plan Review A
Phone: 503.639.4171 Fax: 503.598,96a
Date/By: s � ' o ice Other Permit:
TIGARD Inspection Line: 503.639.4175 (L, 0 8 2008 Date Ready /By: 1ud�s �/ ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: /71 C.R Supplemental Information
►► CITY OF TIGA�
TYP£ REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ 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 ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10200 SW Greenburg Rd. (Five- Lincoln) New dwelling area: square feet
City/State /ZIP: Tigard., OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 700 Project name: Farmers Insurance T.I. Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Install Fire Alarm Notification Devices In Tenant Space Valuation: $4500
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Shorenstein Realty Services Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: --ve,____. Y q(( licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: Capitol Electric Company, Inc. (Please refer to fee schedule)
Permit fee: 83.95
Address: 11401 NE Marx Street
State surcharge (12% of permit fee): 10.07
City/State /ZIP: Portland, OR 97220 0
FLS plan review (40% of permit fee): 33.58
Phone: (503) 255 -9488 Fax: (503) 255 -1966 (Due upon application.)
CCB lie.: 48748 Total permit fees: 127.60
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name: Dan Wilson Date: 10/3/08 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Permits \FPS- PemtitApp.doc 03/23/06 440- 46t3T(11 /02 /COM/WEB)
CITY OF TIGARD —
,_. . Apo
BUILDING DIVISION PERMIT #: I3UP200t3- 00337
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/17/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' ° 'II'�
INSPECTION WORKSHEET FOR DATE: 10130/2008 TIME: 7: 00AM PAGE: 19
SITE ADDRESS: 10200 SW GREFNOURG RD 700 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTI Firs, ala�.i - ��
OWNER: SHORENS$ REALTY SERVICES, ` PHONE #: 503 - X112 -4800
CONTRACTOR: CAPITOL ELECTRIC CO, INC. Y 1 ` PHONE #: 503,255.9488
P.
1.
Inspection Request Scheduled For: Date: i(113i11 ?008 Pour Time: 10 ?��1 /
iyt fr
Code # Inspection Description Confirm # Contact # Mes :ge (_: 6D
299 Final inspection 077378 -01 371 - 5,06.3072 / /YY //
Corrections /Comments / Instructions:
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F -, SS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
III FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 04 1 P hone #: (503) 718 -