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Permit
CITY OF TI GARD BUILDING PERMIT PERMIT #: BUP2004 -00578 ,...., ,��4 DEVELOPMENT SERVICES DATE ISSUED: 12/13/2004 13125 SW Hall Blvd., Tigard, OR 97223 (5031 639 -4171 SITE ADDRESS: 10200 SW GREENBURG RD 110 PARCEL: 1S135AB -00900 SUBDIVISION: FIVE LINCOLN ZONING: C -P 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: 2FR : 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: #/aDO' DU Remarks: Relocate (10) fire sprinkler heads for TI. Owner: Contractor: EQUITY OFFICE PROPERTIES TRUST MCKINSTRY COMPANY ONE SW COLUMBIA ST #300 5400 NE COLUMBIA BLVD PORTLAND, OR 97258 PORTLAND, OR 97218 Phone: Phone: 331 -0234 Reg #: MET 00001179 FEES LIC REQUIRE INSPECTIONS Description Date Amount Sprinkler Rough -In [BUILD] Permit Fee 12/13/2004 $62.50 Sprinkler Final [TAX] 8% State Surcharl 12/13/2004 $5.00 Total $67.50 • 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 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 ( e 46-6." or 1 -800 -3 -2344. Issu By: AL - . `(' GQ - r(4k) Permitte- P Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day '`Fire ,i on System Building Permit Application FOR OFFICE USE ONLY ` City of Tigard Date /B : ,.Aro 4/ / j PemutNo.:� �� —466 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 / � 4N 4P Date/B : Other Perm t Inspection Line: 503.639.4175 E!1l Date Ready/By: MI H See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information F :. - - " '4;x ' i '?' - ffi::°%� ss.;:i '_ > S+s: ::.. s. ..m*` 5. - 3r, #. - - s =fie »i"" -d "°u".�'t g ^c `,-A;, -^u ^a�' 3e aye e'ST s- >'- 'sw. &. "7.. �^� i;�a; _, > ur, t .� . -, w - ., : ;,, t : ; ._ : , „ - :. 4 , TYPE O A, WUR .. , ,;.. . . w .. �- x �2EQU D AT =A. 1 AND-:ZIF 1VII • • .w�v «..�. rr,� A.a�. .mss. �';�;�'- , =.u�.:',�`"R`arre �°<w.:�c.emr:,x... %�en1, : "sxcc >. �sd.k.,.. s . us.. aniaC:tia', ::e`�°`i:.S El New construction El Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of :' /T Addition/alteration /replacement El Other: equipment, materials, labor, overhead, and the pro t for the i„, .. � ' 5 s?; ,- .far a; r»*;< < n :IV . *aw'.' +;.' .Vx*;t°.,} ex;" -w j a"".; .^^,'sx, "':' • > +,, ^ .�*: �; �,r'� eai��,�r„.���>�',°'��'.'"-���. i `�; "°�- �, ;5,:�- . ^ "-,� ;- '` =° = ,;��,�,d work indicated on this application ' ~ ;.4t:,;,t= ,LATE ORY, OF :GONSTI2UCTIQN;; : ° 74 �;:.-4 _,::; - �,��- .x�.���a�� ;.......f. w`� <.a- �ta%:`s�.?�i'�, ^spa" ^�.� ev�:'�.,..M+;.: Ana. �- x�°.::; s+ ci. �sE..... . � °,; :�:;d.. >x =.,�, < `. � ,. -+ Valuation: $ / El 1- and 2- family dwelling XJ Commercial /industrial CI Accessory building Cl Multi-family Number of bedrooms: El Master builder El Other: Number of bathrooms: a:" :,� +.'• - ; s� ' �.�., . «fir.:'.:'- ; , ,'.�%';: ' .i :;s'""�P.n¢r�?'.'�tY a w� .r ., <.k •N., ,r7,'.'.4-'''?". �,..�. �` � ,� � R- dB rSI F� Total number of floor . Job site address: K UmLa CjJ New dwelling ar• .: square feet City/State/ZIP: )0 '.620 6 > W C-xte(!_Nf211i Q�� leir fl O � Garage /carp: area: square feet Suite/bldg. /apt. no.: 1 0 Project name: Fi p �L-) _ � � 77 1jfl° >77-r Co. • Covered .orch area: square feet Cross street/directions to job site: Deck ea: square feet Other structure area: square feet :rah �, -..�,. � z..��- >.., ��;.�,., gs�.��. vb r;, ��m.w .... - ,,,.:. .tI2E " 'Ali DATt1: GOrMERC I E C I{LIST' . ` t< ;.s.+.: ✓ �`: m n , - 4.A.W`! f&;%t,AW, : -.,b: rB�k, n3'.,.« a•u°a^.,' ' 1x:1 Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all " n K equipment, materials, labor, overhead, and the profit for the ° ..t a ` � ` .. r,.. WO " �'�;,.E� i'' z ,, - .,, � application. DESCRII'I ION OFD work indicated on this a Valuation: $ 1 ZA, c cow j C -F. --. Existing building area: ,jil square feet New building area: Nl/k square feet t PROP OWNER f ®TENAN• ` 4 Number of stories: N1A Name: Q) 1"r% o4 7( 9 '. ES . Type of construction: PE Tr _ rg Address: Occupancy groups: City/State /ZIP: Existing: L Phone: ( ) Fax: ( ) New: mm ''i fix'? : "` :: .;a';� w".�. .s r�,'� „';,' �� �'; ;v.: �„«,��r� e ";�. a::�,',11w 'ie�','a"�- �:; "„ad - - - - .n_ X t °r + - . * i'?f„'s 'i ^' « r, :':1 � 'k*:. i ' T ''''' ,"v `'''' -'.4 i' :^, .. • $' ':' V . &! °.A'PPL -ANT x,. 5 .:. ' 'GO T4G�T. . '':" ,' . S� =+>. , _ .�..sy %.. - a , C .x.. F•''". - .. � .„. .�. � =v,. _ s� «,,$,.a- ice,' �� ., < �.�: s� m � ,?�' �"x� " : • Business name: jij L 16.1 1 0 5- 1' C pM Pp I - All contractors and subcontractors are required to be Contact name: rJ rn /JV� licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 5-7 t 0 itie COWM&A e,1LD jurisdiction in which work is being performed. If the n applicant is exempt from licensing, the following reasons City/State /ZIP: .pD1V1 �{ , O R • '' 1 Z1 C7 apply: Phone: (503) 3'31 , 0'23 r ) —7 I Fax:: (5;3 ) .54 . 6,e1O E- mail:..) E N1 e. M t L J 5 -17Z --; e 0U,,, _ . k i, ., tote - A Mac .b� € ,,,, 2;" •s $ " b« _ _ . ter . a . Business name: r %e ' > r t; keil . "' ''BU'ILDI,IG;,PERMIT�EES'` « `,�r _ �: ���" ���. �,,.: ���.,,_ ��_ .�.,�,.._.. <..y...::w,�. „;... . Address: Lj r 'T oo %� �� [.UM6 ill pi (....1/0 Please refer to fee schedule. City/State/ZIP: )90 gl 0 O(L . 6i1 -1-i' 0 - f Fees due upon application Phone: (505 ) 33) • 0 r2,. Fax: (Q)..5) 3' ���� I �' ,� � 7z./.c, v Amount receive CCB lic.: �, Se)--- Z23 — d I ( Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: c - ! j /1 1° V.'. Date: it , 13.04 * Fee methodology set by Tri-County Building Industry Service Board. i:\Building\Permits \FPS - PermitApp.doc 12/03 440 4613T(1 I /02 /COM/WEB) 1 � • City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Descra<be work,to be,done ,:: `:' x *.:: . 1.) ❑ N,ew 2.) Modification to sprinkler heads only: ❑ Addition ,- 1 -10 heads: No plan review required. Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Fe (`fo' S S' Fib ''lLIJ�1 iL �S Fa, e J Tom. Teype; { ofSystem g (Complete,B, CorD`asappl><cawble) „ ,,,., ..,,.,, , , . : ' ,�s� � ;u &'s`�3's p S .'��� ,-"* -�T e r x�.:3� � ry`, �,�'`� � � ��.s �, ��� ^ f � � s 4,),�,C©mercaa11S tnl ler , _ .��s. s .._: .._.__ �._�,.._�_�k �.. s 2 Wet ❑ Dry Additional Standpipes 1■7 /A- Information: Hazard Group (,,l 1:7147" ; • Density 4 Design Area 1S K. Factor ((�„ Sprinkler Project Valuation: $ j Zoo °.% . ^ . ;Y".r� - � , ..% - g "..5«= ,a'�u«'t�•;'� r< "#';&iv ":,,°,a,_t� �_.a�- .;c }?;q,"^g::: Wit„: `` >':,:a• B) Type, ®oodxFlre S'u =ppresslop Syst r m ct Valuation: $ ._.., .� . ;; `.;.. ....o. Hood P oje 'on: //P r' "Y :?; ., ^rg° „y.;}`ae�”. }% emu Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ Pi R a rg rint r� Stand Alone;:S� ,stem w :, = g r A. - - ; °`_ :. ,.. ,.,���)��.. e s>< r dent i ..�nR,�._w.,.._!�„(� � .,� .w ,r .e .�.,y .� H� ): x�� �.�° ����� �� � � �-� � _ Square Footage: Permit Fee:' _ 0 to 2,000 $187.50 2,001 to 3,600 $ 9 t 232.50 � � � � tt" 3,601 to 7,200 $292.50 : vas '`': 7,201 and greater $381.50.,`''. Es.; "c en'` ' :_:: Sprinkler Project Square Footage: ) /I sq. ft. _ p .j q g N/ Project Valuation Subtotal (A, B & C): $ I Zo I ✓ Permit fee based on valuation (see attached chart): $ Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ FLS Plan Review 40% of Permit Fee: $ 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. i:\Building\Forms\FPS Checklist.doc 12/29/03 , CITY OF TIGARD 24 -Hour BUILDING Inspection Line:503) 6 175 INSPECTION DIVISION Business Line:' (50 - 71 MST BUP '&ovy - a)578 Received . Date Requested o a 5 AM PM BUP Location -7--O Z CD Suite /7 (') MEC j Contact Person � � u O_ Ph (• ) 6576 3 PLM Contractor . Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation - Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall m aggrilMr Fire Alarm Susp'd Ceiling C k\ Roof Other: • PART FAIL . r Post & Beam Under Slab - Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole : Mr 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 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line - 7c/10 ADA Approach /Sidewalk Dat Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL