Permit g ' LO R N TF A! 9
4;ft / O BE �r o 9 SERVICES (503) 639 -4171 DATE ISSUED: 1/6/03
SITE ADDRESS: 12750 SW 68TH AVE PARCEL: 2S101AD -01300
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 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: $ 3,500.00
Remarks: Installation of fire alarm system.
Owner: Contractor:
HAMPTON BUILDING, THE LLC FIRE PROTECTION SERVICES
PO BOX 94 15100 SW 139TH
CAMP SHERMAN, OR 97730 TIGARD, OR 97224
Phone: 5541 - 595 -2495
Phone: 509 -3732
Reg #: LIC 121039
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[TAX] 8% State Tax 12/11/02 $6.54 Final Inspection
[FLS] FLS Pln Rv 12/11/02 $32.68
[BUILD] Permit Fee 12/11/02 $81.70
Total $120.92
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 (5 46=6699 or 1- 800 - 33344.
()
I ......, r
Issu d By: 1.. . ..: A , i 4 , i' r
Permittee 1 ,
Signature: , )A Q , 1 t. ( ((9.--.--\
Call 639 -4175 by 7 p.m. for an inspection the next business day
11 \ iii,
M
Building Permit A lication OFFICE USE ONLY
f City of Tigard Date received: /?- // 63 Permit no.: or a'0, ,i5 ; 3
r r
" Project/appl. no.: Yd;d date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 9'7223
Phone: (503) 639 -4171 riEC 1 2002 Date issued: L r Receipt no.:
Fax: (503) 598 -1960
CITY OF TIGARD Case file no.: Payment type:
Land use approval: RUILDING DIVISION 1 &2 family: Simple Complex:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory ❑ Commercial /industrial 0 Multi - family 0 New construction 0 Demolition
❑ Addition/alteration /replacement 0 Tenant improvement Wire sprinkler= ❑ Other:
.1014 SITE INFORi19AT10N
Job address: (a 7 $ 566) , S 'A- fLKt.J/4'f Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: 2 . O SoO 'Atr fPtr. 64n t 11) T 1 ni re"
Description and location of work on premises /special conditions: (A 17 Cita AlAtom sr5/ 65 11
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 7771 /rv/J guicO /46, LL.0 ( Floodplain ,septiccapacity,solar,etc.)
Mailing address: ?. 0- 'DX 1 & 2 family dwelling:
City: ' Oa ff 1 ' State: OR ZIP: 9 7-/ 30 Valuation of work $
Phone: (S'// NIZEMEROMEMBI No. of bedrooms/baths
Owner's rep - sentative: Total number of floors
Phone:ENV 4- "41EMIINERZEI New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: £6 '/Gp1 ' w71) _ (re tJ l GES Covered porch area (sq. ft.)
Mailing address: , 0 1 - Deck area (sq. ft.)
Egin State:D ZIP: / g = Other structure area (sq. ft.)
Phone: 93 s40- ± Fax( , AR , EMILMTIMES Commercial/industrial /multi family:
CONTRACTOR RACI'OR Valuation of work $ 3.5v 0,
Business name: 126 P/Lo, / a n) u t C S Existing bldg. area (sq. ft.)
Address: /370 (. /
New - ■ u New bldg. area (sq. ft.)
City: / . Ag.D EMI ZIP: 9 �d �.' Number of stories
Type of construction
Phone., y 0 3 to Fax371 mo ',MOIL _ a - rAAA).larv1/4 Occupancy group(s): Existing:
CCB no.: '
New:
City/metro lic. no.: C . ; Notice: All contractors and subcontractors are required to be
ARCIII7 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 provisions of laws and ordinances governing this o Visa l] MasterCard
work will be compli- : ith, ether sp i - d herein or not. Credit card number: / /
Expires
Authorized signa _/ . I r U_ ate: la h( � 1
Name of cardholder as shown on credit card
Print name: T (7, � � Cardholder signature Amount
N This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. $
440 -4613 (6/00/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST _
INSPECTION DIVISION Business Line: (503) 639 -4171 BUP 6o 5133
Received or v 1 —D to Requested 1 1- 1 AM PM BUP
Location / a . 7 S - 0 6 0 ' Suite MEC
Contact Person Ph ( ) 5 j�0 — 373 02. PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
o•
ELC
Foun•a ion
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: V'7J SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear \. ■74
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
re Al
Susp'd Ceiling
Roof
Other:
PART FAIL
41.411 = ING
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 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA /,/ Approach/Sidewalk Date /U Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL