Permit � / CITY OF T BUILDING PERMIT
PERMIT #: BUP2005 -00142
1� DEVELOPMENT SERVICES DATE ISSUED: 4/21/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S136DA -00100
SITE ADDRESS: 11308 SW 68TH PKWY 1ST FL ZONING: MUE
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: New notification appliances, new horn /strobe in break area lower level room 142, new strobe upper
level room 253.
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: 3N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1,082 BASEMENT: sf AREA SEP. RATED:
STOR: 2 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: $ 800.00
Owner: Contractor:
BENENSON 68TH PARKWAY DTS SYSTEMS, INC
KEY LLC, THE 7905 SW NIMBUS AVE
�BY FIRST AMERICAN TAX VALUATIO BEAVERTON, OR 97008
1OonCESTER, MA 01615
Phone: 503 - 643 -3127
FEES Reg #: LIC 134056
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/13/2005 $62.50
[TAX] 8% State Surcharq 4/13/2005 $5.00
[FLS] FLS Pin Rv 4/13/2005 $25.00
Total $92.50
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 -33 344.
Issued By: j z l __)S Permittee Signature: ?yz . CGr 7
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.
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Buildiltig Permit Al t � -' °'r• E,D ' ,, MI s
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City of Tigard L)ate ....-2,,e- Permit No
13125 SW Hall Blvd., Tigard, OR 9722 1 7 . 0 Plan Rey ren" j. 15 h(!
/
Phone: 503.639.4171 Fax: 503.598.IP��tR ./.474‘..y e i. tl Date/By: tV a Other Permit: � j
Inspection Line: 503.639.4175 ' - g Date Reads By km, 0 See Page 2 for
p
Internet: www.ci.tigard.or.us v O ? '�11C7iN " Notified Akthod it I,- Supplemental Information
Glj VAIG °1��1®
TYPE OF WORK 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
\\irk indicated on this application.
CATEGORY OF CONSTRUCTION 11
❑ I- and 2- family dwelling ® Commercial /industrial Valuation: $
El 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: 11308 Southwest 68 Parkway New dwelling area: square feet ,
City / State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: Providence Data Center Covered porch area: square feet
Cross street/directions to job site: See Attached Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COM1 lERCLYL -USE CHECKLIST
Subdivision: Lot no.: Permit tees* are based on the value of the tvork 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 New Notification Appliances to revised floor plan.
Valuation: $ 8 Dv 1
New Horn/Strobe for modified Break Area Lower Level Room 142. Existing building area: square feet
New Strobe for revised use of upper level room 253 for Conference Room Use. New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories: 0 2
Name: Type of construction: 3 jf
Address: Occupancy groups: 8 / a5 2 . ' (i
City /State/ZIP: Existing:
t __.'0.---
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: DTS Systems, Inc. All contractors and subcontractors are required to be
Contact name: Drexel White licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 7905 Southwest Nimbus Avenue jurisdiction in which work is being performed. If the
City/ State/ZIP: Beaverton, OR 97008 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 643 -3127 I Fax: : (503) 643-6194
E -mail: dwhite@dtssystemsinc.com
CONTRACTOR
Business name: DTS Systems, Inc.
BUILDING PERMIT FEES *
Address: 7905 Southwest Nimbus Avenue
Please refer to fee schedule
City/ State/ZIP: Beaverton, OR 97008
Fees due upon application
Phone: (503) 643 -3127 Fax: (503) 643 -6194
Amount received 902_ j )
CCB lic.: 134056 4 2 s , 5-- -6
Date received: e/ — 1l -())
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Merle . White Jr. Date: * Fee methodology set by Tri- County Building Industry
Service Board.
is tBuiiditrg \PemiltsWPS- PertmtApp.doc 12/03 440- 46I3T(1l/071COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00142
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/21/2005
Phone: (503) .p39 -4171 ard4�ap ICI I
Inspection Requests (24 Hrs.): (503) 639 -4175 `: _..
•
INSPECTION WORKSHEET FOR DATE: 5/9/2005 TIME: 7:10AM PAGE: 93
SITE ADDRESS: 11308 SW 68TH PKWY 1ST FL CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PROVIDENCE
DESCRIPTION: New notification appliances, new horn/strobe in break area lower level room 142, new strobe upper
level room 253.
OWNER: BENENSON 68TH PARKWAY, PHONE #:
CONTRACTOR: DTS SYSTEMS, INC PHONE #: 503 - 643 -3127
Inspection Request Scheduled For: Date: 5/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006313 -01 503-463-4500 N
Corrections /Comments/ Instructions: 751(
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Illir r plair ! v Niii
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED . --
Inspector: IWO Date:S C #: (503) 718 -