Permit CITY OF TIGARD -� r v BUILDING PERMIT
PERMIT #: BUP2004 -00408
1 'll DEVELOPMENT Blvd., OPMENT Tigard, o
SERVICES 639 -4171 DATE ISSUED: 9/22/2004
13125 SW
SITE ADDRESS: 15750 SW 98TH AVE ADM. BLDG. PARCEL: 2S111CD -00300
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT: 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: $ 1,600.00
Remarks: Sprinkler monitor and alarm.
Owner: Contractor:
TIGARD CHURCH OF GOD DTS SYSTEMS, INC
15670 SW 98TH AVENUE PO BOX 2254
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone:
Phone:
Reg #: LIC 134056
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm lnsp
[BUILD] Permit Fee 8/23/2004 $62.50 Final Inspection
[TAX] 8% State Surcharl 8/23/2004 $5.00
[FLS] FLS Pln Rv 8/23/2004 $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 - 332 -2344. 66
Issued By: rat i :. _
Permittee
Signature: en L P
Call 639 -4175 by 7 p.m. for an inspection the next business day
/567a Sw 98
Fire Protection System
Building Permit pp tii:' b FOR-OFFICE USE ONLY
CI r'of Tigard Received —,QOI/°8
4 � AUG 3 1 I d� Date /By • a - / 0 6C f� Permit N 1 a(�
13125 SW Hall Blvd., Tigard, OR 97223 2004 ' + Plan Revie / W/ , it: _
Phone: 503.639.4171 Fax: 503.598.1960 Date/By 9-41.0y7:65.)3 Other Permit:
Inspection Line: 503.639.4175 , 4 N 1: -. Date Ready/ y: vis. 0 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: / C\ Supplemental Information
BUILDING DIVISION
, r�r. .a
;:r;;r.:_,;.�.,<. .._ � �•:.± t< i'> .:-- YrPE. OF .�Iy-ORit- , >. - += ..: :. , - .r.��.:_ ` �'�1 2� , C zI R EDDaTa�1 - - 3N�D2=" Fr11 'III «L
® New construction ❑ Permit fees* are based on the value of the work performed.
® Other: Sprinkler Monitor /Alarm
Indicate the value (rounded to the nearest dollar) of all
® Addition /alteration/replacement System. equipment, materials, labor, overhead, and the profit for the
work indicated application.
on this i
k'd' this apl
'
..4: ;C -,TEC'ORI OF CONSTRUCTION - - _ . Valuation: $
❑ 1 - and 2 family dwelling ® Commercial /industrial
Number of bedrooms:
❑ Accessory building ❑ Multi- family
Number of bathrooms:
❑ Master builder ❑ Other:
Total number of floors:
:- JOB SITE INFORM4TION. %NA LOC ITIO < " f
Job site address: 15670 Southwest 98th Avenue New dwelling area: square eei
City /State /ZIP: Tigard, OR 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Tigard Church of God Covered porch area: square feet
Cross street/directions to job site: Reference Attached. Deck area: square feet
Other structure area: square feet
= :l E tIRED DATA C'OMMERG1T41. USE:CI-IEC.I L[S'I` :.'
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
.;:,:_:, :•; ::.:.....:......;-- :,:... ,..,. , =-'-',-= ,- 2 , 3"' - ' , '„,...'''''- .-,,, ,-.-., - . e: 1.:=;;O, application.
work indicated on this apph at
_ DEtiC:PTt) OF � (ORI.
. . _ . _ , , .. Valuation: $51,600.00
Provide Monitoring & Alarm of Sprinkler System.
Existing building area: square feet
New building area: square feet
t nes:
Number so
•'(],;PBOPERT -1 OtFNER :- : ; i
-
? `
umber of
® 1 T 4<
Name: Tigard Church of God Type of construction:
Address: 15670 Southwest 98 Avenue Occupancy groups:
City /State /ZIP: Tigard, OR 97223 Existing:
Phone: ( ) Fax: ( ) New:
f E
)T1
-i , i \T� , 'T�y ,-
N N C
PPLIGaNfi. - '. IS � 'O PERSOt
Business name: DTS Systems, Inc. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Dennis Latt 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
applicant is exempt from licensing, the following reasons
City /State /ZIP: Beaverton, OR 97008 apply:
Phone: (503) 643 -3127 Fax: : (503) 643-6194
E-mail: DLATT @DTSSYSTEMSINC.COM
C'OI T121CTOR
Business name: DTS Systems, Inc. ` BUILDIN( 1 ERMIT -4EESh
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
CCB lic.: 134056 \p h
J Date received:
Authorized sign. , This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print na I Date: . 7 * Fee methodology set by Tri- County Building Industry
/ _ ` .� 0 Service Roard.
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP 702
Received _ Date Re uested �— AM PM BUP
Location (157 Suite MEC
Contact Person g Ph ( ) lam` t2 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: < <. ''�
Ftg Drain ELR
Crawl Drain ((
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
ire Alarm )
Susp eiling
Roof
Ot, MIIIMW/ V
, ART FAIL
•. M G
Pos & 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
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 Please call f• reinspe ion RE: �: Unable to inspect — no access
Fire Supply Line
ADA O /I — , FP a � Is
Approach/Sidewalk Date t � Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL