Permit BUILDING PERMIT
C ITY OF T I GA R D PERMIT #: BUP2002 -00162
I =' D EVELOPMENT SERVICES D ATE ISSUED: 5/23/02
,�- �' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15900 SW 116TH AVE PARCEL: 2S110CD -00105
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: JURISDICTION: KIN
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: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 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: $ 1,800.00
Remarks: TYPE 1 HOOD WITH UL 300 SYSTEM
Owner: Contractor:
UNITED STATES NATIONAL BANK FIRE EXTINGUISHER SERVICE CTR
REAL ESTATE MGMT DIV -T3 PO BOX 1391
PO BOX 8837 gz BEAVERTON, OR 97075
P9h-one RA A 79 -1-0 Phone: 643 -3309
Reg #: LIC 00069384
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical lnsp
PRMT CTR 5/23/02 $62.50 27200200000 Final Inspection
5PCT CTR 5/23/02 $5.00 27200200000
FIRE CTR 5/23/02 $25.00 27200200000
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee ---
Signature: f 31 S /
Issued By: __Q.-.741 l azZ_
Call 639 -4175 by 7 p.m. for an inspection the next business day
0
Building Perm A t •
D ate received Permit n,
I 1 p2 Ufa — /(�Y
-/y Cit of Tigard --- -
- Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By` Receipt no.:
Fax: (503) 598 -1960 Clll Y Of likiAND Case file no.: Payment type:
Land use approval: INIIMODMVPM 1 &2 family: Simple Complex: -
TYPE OF PERMIT
CI 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi- family ❑ New construction CI Demolition \
❑ Addition/alteration/replacement tKTenant improvement ❑ Fire sprinkler /alarm ❑ Other: tV
JOB SITE INFORMATION
Job address: QQ - ���s_.�� Bldg. no.: Suite no.:
Lot: Block: 'Subdivision: Tax map /tax lot/account no.:
ss�s9.r ; - . '� -
Project name: lr //.:e. L ! 0 't: I
Description and location of work on premises /special conditions: - -t — I-) O D '575' tom
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.) \`
Mailing address: 1 & 2 family dwelling:
City: (State: (ZIP: Valuation of work $ i \
Phone: (Fax: (E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors v
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage /carport area (sq. ft.) 4
Name: rd to et, t// C P c r Covered porch area (sq. ft.)
Mailing address: 9(06 L.ci p7 Q eck area (sq. ft.)
City: 'State: (ZIP: Other structure area (sq. ft.) V
Phone: 6 :_?,..?j,••• Fax: E -mail: Commercial/industrial /multi - family: _
CONTRACTOR Valuation of work $ / l t�dd f O k.
Existing bldg. area (sq. ft.)
Business name: l ee- r . , 6e✓ . CA. -
Address: 544(,0 ` 0061-pi New bldg. area (sq. ft.)
y (eN --ter/ ( ( '1 - 2 t90 Number of stories
City: Statt�Z ZIP:
Phone'563.(d'f3.3 q (Fax: (Email: Type of construction
Occupancy group(s): Existing:
CCB no.: 69 3g
New:
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER 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: I State: ( ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
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 ❑ Visa O MasterCard
work will be complied with, w = r s d rein or not. credit card number. Expires
Authorized signature: . _ _4(Art j 1 Date: Name of cardholder as shown on credit card
Print name: /t7 I- e' , .e "4 z et Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/ 3/CO t)
Fire Protection Permit Check List
A.) ❑ New ❑ Addition ❑ Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:_
Additional description of work:
Type of System (Complete A, B or C as applicable):
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $ j 9 c
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $ 1 qv
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
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.
is \dsts\forms \FPSchecklist.doc 11/21/01
CITY U Dff IL G R D y
Inspection Line: (503) 639 -4175 -
ST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP ?-61° i I I
Received Date Requested 2,6 AM PM BUP
Location / 5100 //& k 4-0,2_____ Suite MEC
Contact Person Ph ( ) - 2O j PLM
Contractor Ph ( ) // SWR
BUILDING Tenant/Owner _MQ.Sk tv f_ -ifv Va' ELC
Footing
Foundation ELC
Ftg Drain ELR
Crawl Drain
Slab Inspect' n N • SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear j _ 1. Y3-7. 1- t ‘‘ T- if C i f
a mi I
Insulation /114.60 �Q -_ 0 f- C ,.- Q�'2d>
Drywall Nailing ,,/
Firewall �i J9C p a - c/o/3/ ( Typig z ',Lod 4- make-210 a -:- 1 -- ) Fire Sprinkler
Fire Alarm ,6/ c -Od '
-- d c) J 4 7 1 3 ( 1 '4 - c j ' ow I I.u%G-
Susp'd Ceiling n / D / & - / 1 - ! - Lc - Q
Roof l ��.Q (,t�,.QG — 0 f c , h
Other: / Q , /
Final /.1-2 , e_ ,i2/V7 C/� S t-� e1i �,?� (A -,,. ,
PASS PART 0 1 f f
PLUMBING 0)) ' A l ,A--�\ fly/' - - S . �, � ' � S
Post & Beam /1 J e >�O - '0/6, Z. ! P/ 3 �4 3d0 S.n
Under Slab !� l
Rough -In f�-2 -- CJ ht 901- % V S S
Water Service Y _
Sanitary Sewer "' - ii( / S � / ) •
Rain Drains
Catch Basin / Manhole 3) N� ( LI o .4 r. �� 4 � ' e.- .
Storm Drain
Shower Pan 4 J /)e)-) - 7 4i ft ' ti 1 / h fi--f e kr F
Other:
Final 00 ) (AL/ C-i- of •
PASS PART FAIL
MECHANICAL S•) l P S v14-1-.44 G G-e /� / c2J ? e�A
Post &Beam /, 4 /- Q
Rough -In (0 / 6��T !� )-1/L ��Q.(! S�� � �-
Gas Line C ,Q�t 4c_... "7/ 6.-: lif-A' �z./
Smoke Dampers
Final
PASS PART FAIL L , / °�- w � v \
ELECTRICAL V V6-i • 1 -4,2in -c {�`�/J _-,,.___-0 --1 /2._ gv-e
Service
Rough -In -� /I/1 C j S C.v/ '�'� -4/-f &•/- �-2- - 64_2 .
UG/Slab J ff /
Low Voltage 9 L a 3 7 C��!!� r�rk-C k D / �� e-�C-
Fire Alarm 9 /7 Ox_e s I -.-- ,1- _ - 2-y � y /� _ 4et A -/z), -
Final PART FAIL Reinspection fee of $ required before next inspection. Pay at Cify Hall, 13125 SW Halle. `
SITE 111 Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA �'f
Approach/Sidewalk Date 5/2/� �� Inspector `� - Ext / /
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY --OF TIGARD 24- Hour ,,
BUILDING Inspection Line: (503) 639 -4175 �j
INSPECTION DIVISION Business Line: (503) 639 -4171 ill/ � MST !l
`il+'
Zo-vC - ao 11
Received R quested 7 -5-6 v /
AM '1/4/ PM BUP _
Location /3 UD .5(A) I r Av-e /1 Suite MEC
Contact Person Ph 7(25 S (1 7 PLM
Contractor Y 1 A l Ph ( ) SWR
Y 17) ,_BUILD N Tenant/Owner r Y/ � ' 1 C V■ 1 Q.( na- ELC
noting
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 4 1/1 -� o
Framing 1'`�'
Insulation .S
Firewall IA 2_ C-0 // Z /' ti • . W U 1 - 30 O Drywall Nailing / CD �� J
� —�j ' A5�� 6 /3 0 1 d k Fire Sprinkler
Fire Alarm /1 XMet 24.1417- 24.1417- _ 00 /' / (l l -- 4.-.. //--1,s._6
0
Y. Susp'd Ceiling ,U�' /�
Roof C�7 As- s. -C-d � ji `l
, /U -2- Crz-e) — d 4.c___--
er: l _
F p Lk 1,662_- 6 0/ L 3 ( 7 -
ASS PART L -'-
PLUMBING
Post & Beam „ n (, ; L c 2, a 2 - v d 15# T=
Under Slab ((.�� l� p S
Rough -In i C5 -/� -7 /34) 2 (F C ) d 1 -' --
Water Service
Sanitary Sewer 4/5 )(g'j�, D - a ' - 0 Q / 7 s ( i. d)
Rain Drains �w _ `C
Catch Basin / Manhole �� As5,A CC / /3 /6 Z 6%2") d
Storm Drain 1
Shower Pan 1r1 Cc c�'� Cal 7� 5' Z � Cc.
/� —
Other: (� (.� `^'
Final ■ j., •'
- -,,
PASS PART FAIL �/
MECHANICAL &I-4 .fp S S
Post & Beam
e �/ 1l /1 /.�, jL`. S (7
Rough -In /"� , '
C (1
Gas Line A) c` �, _ _ _ / _ ,x 4 Smoke Dampers ��� �V
Final h.) a rZ ‘3- dal - c
PASS PART FAIL r
ELECTRICAL (2) h i 4 ..m r ate' �Q■r -- a.10:7,..c................■---
Service a Rough -In ` ) G,- e
Low olt Q, ) y �c,
Low Voltage
Fire Alarm ) (N ( 4- L 1 / 72) S ► 'Lk-
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line Z
ADA Approach/Sidewalk Date
V S a Inspector E xt 2y
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL / /^ -7----
CITY OF TIGARD 24 -Hour
. BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST _
BUP
Received Date Requested AM PM _ BUP
Location Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear v L
Int Sheath/Shear y.) (, QQ f' _ e s ; s A..rl. 6, I k � f
Framing V
Insulation !../G •
Drywall Nailing
Firewall k.) / / G-e. , 6 _: , ( ..4. :; pi r " e
Fire Sprinkler
Fire Alarm / „ S r G_wl Y2.-- /f,
Susp'd Ceiling w
Roof �1 j-e� ■ � ■ �/
Other: _ /��
Final - \ S Z�� C. - ��� LJ (d"C-,� f /f �L./
PASS PART FAIL C L ,/� ,,-,
PLUMBING (P (� i ni /
Post & Beam .� i 51--t-,r .C__-) Slab Je 1 t/I ., � - '
�
Water S
Water Service / � C�
Sanitary Sewer C 1 lz - j J
Rain Drains / � v
Catch Basin / Manhole ..4 t p . `LN�
J
Storm Drain ^ "� "
Shower Pan G iNf----e im-Lr . -Q--4._)-(--f-
Other: 4
Final
PASS PART FAIL 1 �� <<
MECHANICAL ` J � \ fit s --o � ?� (
Post &Beam ��N 1
Rough-In �./d-''^. e___51.—
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 0 Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 7 /</c i- Inspector Ext �
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
-?.- i-- ----