Permit ,,
A . -, BUILDING PERMIT
ITY ®TIGARD PERMIT #: BUP2004 -00279
^ DEVELOPMENT SERVICES DATE ISSUED: 6/24/2004
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S136DD -00200
SITE ADDRESS: 11560 SW 67TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 004 JURISDICTION: TIG
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: 5N : 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: $ 13,800.00
Remarks: Fire protection
Owner: Contractor:
GREEN, JOSEPH W MCKINSTRY COMPANY
PO BOX 759 5400 NE COLUMBIA BLVD
PORTLAND, OR 97207 PORTLAND, OR 97218
Phone:
Phone: 331 -0234
Reg #: MET 44�� 00 0 0 g 01179
FEES LIC REQUIRED INSPECTIONS ,
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/15/2004 $177.70 Sprinkler Rough -In
[FLS] FLS Pln Rv 6/15/2004 $71.08 Sprinkler Final
[TAX] 8% State Surchari 6/15/2004 $14.22
[BUILD] Addl Permit 6/24/2004 $177.70
Total $440.70_ .
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 -669• or 1- 800 - 332 -2344.
/ .
Issued By: / �
Permittee
-
Signature: _ _
/
Call 639 -4175 by 7 p.m. for an inspection the next business day
r5C .5 k.) 6 /' 'W
Fire Protection Sy ,,- ; i
6* 0F loc 0 a
Buildint•Permit Application FOR OFFICE USE ONLY
City of Tigard i V Recei DateByve:d
bI/ I PemutNo.?4,T�g/�)y��
�.� o(»7J
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie 1 / . ^� ����''//
Phone: 503.639.4171 Fax: 503.598.1960 G! Y (., i- 1) �:.. ,_ . L i i 11 th Date/By: 1 !. i ' - , Other Permit:
Inspection Line: 503.639.4175 L:)",..! t. �, ,,, "'. I,. Date Ready /By: /_ t� Juris: ® See Page 2 for
'� /'l� v t�1� 4 �" o y Supplemental Information
/ EA pp
IV
TYPE OF WORK REQ ' l A: 1- AND 2- FAMILY DWELLING
A 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: $
El Accessory building ❑ Multi- family Number of bedrooms:
1:1 Master builder ❑ Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
1{ ;Iva
Job site address: ... 4_3.4 1: 00 r (. J 6f7. A VC New dwelling area: square feet
City/ State/ZIP: 'T e7A-f(C" . 0R- , 9 7'Z23 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: •r 4 ,-„J &I I �.Tj /"J6- Covered porch area: square feet
Cross street/directions to job site: E,, t o , /'T' r-,4/ (p7774./r Deck area: square feet
Other structu 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.
/■1 (.t ilk[:- SFg i z 6 / Sn-e(-l_ sls Valuation: $ �3i $[7t7
Existing building area: square feet
New building area: •) 5Z square feet
IN PROPERTY OWNER ❑ TENANT Number of stories: 7�-
Name: 4 e Type of construction:
Address: Occupancy groups: ,
City/State /ZIP: Existin g: .
Phone: ( ) Fax: ( ) New: 6
X APPLICANT ,gr CONTACT PERSON NOTICE
Business name: mL ^STI° Y (otfripfb&'' All contractors and subcontractors are required to be
Contact name: e - M- ,.Ip(Z licensed with the Oregon Construction Contractors Board
c � , � pp under ORS 701 and may be required to be licensed in the
Address: -5- (� O OJE C. o l�ir•t A ylLJ1 A jurisdiction in which work is being performed. If the
"' jZfl.,A J1) / OR_ . �'7Z 18
applicant is exempt from licensing, the following reasons
City/State /ZIP:
apply:
Phone: (5, 3) 33) . t7 z39 Fax:: (503) , 3 , �9a e,,,,
E -mail:
CONTRACTOR
Business name: ML14 N e, o' Co BUILDING PERMIT FEES*
Address: 5 N t co w f y r l 6 hci 6i—tip
Please refer to fee schedule.
City/State/ZIP: 1 - 1 O g, , 9 - 7'Z1
Fees due upon application
Phone: (51 1-3) , O Z3 `I - Fa • 3) -3: 1, Cage ( ,
Amount received
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete. 0
Print name: . OF /A/{ � I Date: (p, i S , o * Fee methodology set by Tri-County Building Industry 1
"' 1 Service Board.
i:\Building\Permits \FPS- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
1
Fire Protection Permit Check List
Describe work to be done:
1.) ,® New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
El Repair
Number of sprinkler heads: 1 `f 0
Additional description of work: Ned,- sPeA -'x_- s'?s-r •,
L ogg -rep 977 2. r@ •rr..Avoter, Acrizie i s 14 64616
Type of System Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
g Wet ❑ Dry
Additional Standpipes 41,
Information: Hazard Group L.164
T
Density , 1
Design Area Soo
K. Factor
Sprinkler Project Valuation: $ i gjva
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ /kJ/A-
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
•
Project Valuation Subtotal (A, B & C): $ t 3,
Permit fee based on valuation (see attached chart): $ L ?7.70
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $ 7 / ,o ff
TOTAL: $ Am3 ,
Plan review requires a completed application and 3 sets of plans at submittal. Plan review
fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon
licensed fire suppression engineer, or NICET level "3" technicians.
i:\ Building\Forms\FPSchecklist.doc 12/24/03
C
CITY OF TIGA RD
BUILDING DIVISION PERMIT #: BUP2001 -00279
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: &240.004
Phone: (503) 639 -4171 ,:roggiovaiilt,
Inspection Requests (24 Hrs.): (503) 639 -4175 , 1.
INSPECTION WORKSHEET FOR DATE: 6 / 9 /200 6 TIME: 7: PAGE: 4
SITE ADDRESS: 11560 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 004 TYPE OF USE:
PROJECT NAME: GREEN OFFICE COMPLEX
DESCRIPTION: ire I _ 1
OWNER: PHONE #:
CONTRACTOR: MCKINS I RY COMPANY PHONE #: 331 -0234
Inspection Request Scheduled For: Date: 6/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Finial inspection 03/48903 503- 800 -3004 Y
Corrections /Comments / Instructions:
i
le Aw— IR— .
Ants ! .0vpr
,,
CE
F ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FO' INSPECTION ❑ ADDIT ; NAL FEES ASSESSED
I
0 --. 9' 1►
Inspector: Date: Phone #: (503) 718 --2—�
CITY ®F TIGARD 24 -Hour
BUILDING Inspectiora,•L (5) 639 -4175 MST
INSPECTION DIVISION Business Line: - (503) 639 -4171 Q
Received Date Requested 6 AM PM
Location / (-S U 6 7` Suite
Contact Person (`/� Ph ( ) a° 9 — 5 PLM
Contractor Ph ( ) SWR
_ �UILDIN Tenant/Owner ELC
Footing
Foundation ELC
Access:
Crawl ELR
Dr —�
Crl 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:,
Fi
AS 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
PASS PART FAIL
SITE Please call for- reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA �/ t
Approach/Sidewalk Date �1 In spector v V Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY.,OF TIGARD 24 -Hour
- BUILDING - Inspection Li ' 09 - - _
:7
INSPECTION DIVISION Business Line: (503) 639 -41 } MST
. Received 1 Date Requested AM PM BUP
Location 1 1 5 (32 0 S "&J 6 7 /1 i'C. Suite MEC
Contact Person CA 0 Ph ( ) a� D q - 69 PLM
Contractor '� Ph ) SWR
IL Tenant/Owner �J e- -' -' NA-4 — ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear .
Int Sheath/Shear G
Framing .?--0 6
Insulation / '
Drywall Nailing w _ -
Fi rewal l t ,4-
1 Spria110 - le r 19
Fire arm Al l Ceiling . 21 -
Sus
P
Roof
Other:
Final -
PASS PART L /�
PLUMBING / V ga..r / 0 • 0 Q
Post & Beam / ±
Under Slab
Rough -In alp
Water Service 4'
Sanitary Sewer --
Rain Drains r i .- . 4,..
Catch Basin / Manhole - a
Storm Drain •
Shower Pan f
Other: •
/ /61 - 1 /-$2-- `
Final
PASS PART FAIL `
MECHANICAL 7 e c-,.,,_ \r e ;
Post• & Beam r
Rough -In • �l
Gas Line /� -3 Smoke Dampers 4 F �� 4'11
Final
PASS PART FAIL
ELECTRICAL
- ' Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE D Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line � .� / r -
/' ��/ fi t.
ADA Date ` 7/ 7 Inspector ��� Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site. .
PASS PART FAIL