Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00351
- DEVELOPMENT SERVICES DATE ISSUED: 8/26/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111AC -02700
SITE ADDRESS: 14650 SW 97TH AVE
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5
BLOCK: LOT: 037 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: 5 -1 HR : 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: $ 529.00
Remarks: Installation of fire suppression system for Type I hood.
Owner: Contractor:
TIGARD TUALATIN SCHOOL DISTRICT SIMPLEXGRINNELL LP
6960 SW SANDBURG ST 6305 SW ROSEWOOD ST
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
Phone:
Phone: 503 - 683 -9000
Reg #: LIC 149921
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 7/21/2004 $62.50
[TAX] 8% State Surchari 7/21/2004 $5.00
[FLS] FLS Pln Rv 7/21/2004 $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.
Issued By: T77, i r
Permittee
Signature: / , / �Lq / `P
Call 639 -4175 by 7 p.m. for an inspection the next business day
02/27/2004 13:27 FAX 5035981960 CITY OF TIGARD x]001
r i t6 5 o .5/4) 77- • TTY,
Fire Protection System
-r FOI OFFIf t t SE O\1:1
Buildins er m�t A�;ttcatib Q V • i ,k
u u rived A� r . 'j - 1A . 1
City of Tigard , 200 Datert3 /
13125 SW Hall Blvd., Tigard, OR 97223 ' ` 11 Review / OtherPrnnit
Phone: 503.639.417 Fax: 503.598.196 I' l i D ' a U -0 /5 aie 6�1 Sae rags 2 for
R D ' °' `- Data ReedyBy Fa see rags 2 InformationInternet
Inspection gard 9.41 5 T1GA Nodded/method:
Internet www.ci.tigard.or.us Q✓1TY O F $1 01`1
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' :,.:. Permit fees` are b
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aced on the value of the work
7 ;`lew construction ❑ Demolition Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteratiOnreplucement ❑ Other: ! equipment, o anon. the profit for the
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work indicated on this
t!I..uld;til:.:.., • ,.�<`,:!: ;. ; ; ;:. V alua t ion: 19
❑ 1- and 2- family dwelling ET6ommcrcial/industriai
Number of bedrooms;
❑ Accessory building ❑ Multi - family
❑ O� � Number of bathrooms:
El Master bui lder
��.
� , g�!;� J o • r:::...:: " : Total number of floors:
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lob site address: Il.l 8c0 (�..� I //v •
Garage/carport arca: square feet
City/5tate/ZI1': .6 4 c �.A r 9 ?--2- J
1 n t d() / 7a ��I Covered porch area: square feet
��t� i
Suite/bldg./apt no.; ProJ ect name: /
Crasseet/directians to job site:
Deck area: square feet
Other structure area: square fat
I REE:) DI r'ATA`I.LbMMF.R. ;CiA% 1SE CIi CXLIST'',.
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Subdivision: I Lot no.: Permit fees' are based on the value of ibe work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: the p ofit the
{ application.
cquipmettt, materials, labor, overhead, and e r for
. �.�. a: ��:.��:. ., • :I - ., r:, '�: I':Irr.�l work indicated on this
-
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Existing Existin building area: square feet
New building arca: square feet
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;I ,. . �,: ,•,,.,':,. ., . :. :• ..; , ;: � ,� ,,.';. ,;.� : ':. . Number of stories:
:
qr QP ' 1 (' 11V:1YIE .,: I ' k . •r..,:.... • '.a:,, '1 : •'i
Name: Type of construction:
Address: Occupancy groups:
City /State/ZIP: _ Existing: —
Phone: ( ) Fax ( New:
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Business name: ; ,,/2 of C, "; ;/ / j All contractors and subcontractors are required
n p f licensed with the Oregon Construction Contractors Board
�Coatact name: ,b L >�c�5 � l.� - under ORS 701 and may be required to be licensed in the
� � �. . jurisdiction in which work is being performed. i . the
Address: f 5 s7'd t"' applicant is exempt front licensing, the following reasons
City /State/ZIP: .... (94, ,. )e , 5 ,-.• i, q) apply: .
Phone: (z;.> ) ,Kee 7 O ( Fax::(
)
E-mail:
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Business name. : • ii L)ii.OING!'PE11t' -
Address: Please refer to fee schedule.
City/State/ZIP: Fees due upon application •
Phone: ( ) Fax ( ) Amount received
CCB lie.: Jc 9? L/ pate received:
Authorized signature.. This permit application expires If a permit is not obtained
/ within 180 days after it has been accepted as complete.
Print nay Date: - 1G_O 1 e Fee methodology set by Tri- County Building Industry
I � !/ l�" ��� Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPEeTION`1DIVISION Business Line: (503) 639 -4171 MST
BUP ®O
Received Date Requested ii AM PM BUP
Location 1'<p j n 1 Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Cr awl Drain Dr ain S (C ELR
Cr
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 ANA
't, .'Y
_______
Fri t
•ART FAIL � ' V
• • 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 Blvd.
PASS PART FAIL
SITE El Please call f• reinspec on RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL