Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00274
51 i T � 1 D r SERVICES C 639 -4171 DATE ISSUED: 6/11/2004
4514
ITE ADDRESS: 10220 SW GREENBURG RD 111 PARCEL: 1S135AB -01002
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: LOT: 009 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: : 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: $ 600.00
Remarks: (5) sprinkler heads.
Owner: Contractor:
SPIEKER PROPERTIES L.P. MCKINSTRY COMPANY
10260 SW GREENBURG RD 5400 NE COLUMBIA BLVD
SUITE 100 PORTLAND, OR 97218
PORTLA ND, OR 97223
one
Phone: 331 -0234
Reg #: MET 4 0 � 0 g 0 g 0 1 1179
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/11/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchari 6/11/2004 $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 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: ( /' LPL � )
Permittee 9
Signature: A. - 4
Call 639 -4175 by 7 p.m. or an inspection the next business day
Fire Protition System
BuilcT`iui g' Permit Application FOR OFFICE USE ONLY •
/
City of Tigard Received Date /By: Wilt /04 Peril No.: i3 U _ V D 2-711
13125 SW Hall Blvd., Tigard, OR 97223 s Plan Review ! 7
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
Inspection Line: 503.639.4175 ='' , Date Ready /By: )uric: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: r Supplemental Information
,. ,. n ..... .: .: ..::. .< .. r ..., -, .. . ,,r <�';:`; .. - 9'�� - y °jai._
F W .. 1 DATA: l— AN ILY_'rWEI i
...,
r: TYPE` O ORK� � = < RE ` UIRED D�2 =FAM - LING:-
g�� r . -.. -. .�_. - - ., -., .,. <. _ ��€ `s•'�., c> �., `v'z - ` frna " 'ra„€e.n� - �...a,: =�:?��.s
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
-, a, T E: =F: SON *x work indicated on this application.
�. ,; . CATEGURYe ...OF>,CONSTRUCTION;:,,.<;.` .: ' :,' .;;;"> ,,
, a. ,; 9...0_ .- , :�s., =�,-,; ._;-.. ^e'... --. ,a�.1v�. _mss <�.s'`3'`�...i `Y,..,e ✓:i.'"i,•ykck`.:5�'`. �h4. -. .. .d�;'as,�Suc. ,....�
El 1- and 2-family dwelling Valuation: $
y g ®C ommercial /industrial
ID Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
TI 1V`- AND' "u N.
Total number of floors: •
;f<
JOB`' °SITE' INFORIVIA O LU.GATIO
Job site address: 10220 SW Grennburg New dwelling area: square feet
City/State /ZIP: Portland, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: #111 Project name: American Express Covered porch area: square feet
Cross street/directions to job site: Lincoln Three Building Deck area: square feet
Other structure area: square feet
REQUIRED DATA; COMMERCIAL -USE, CHECKLIST
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
, ; ,z`•�D SCR work indicated on this application.
,,,,,E IONrOF�WO
Modify 5 sprinkler heads in tenant improvement Valuation: $$600.00
Existing building area: square feet
New building area: square feet
:'® WPROP,ERTYOWNER ®TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
I CO CT RSON��� �:�
P CANT = NTA
°AP .L
a
Business name: McKinstry Co All contractors and subcontractors are required to be
Contact name: Richard Gordon licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: • jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 331 -0234 Fax: : (503) 331 -6906
E -mail: richardg @mckinstry.com •
: CONTRACTOR °a `' _;,:f �.,,
Business name: McKinstry Co `; ° °r °"` -
BLIILDI11iG _ :°.... •
Address: 5400 NE Columbia
Please refer to fee schedule.
City/State /ZIP: Portland, OR 97218
Fees due upon application
Phone: (503) 331 -0234 Fax: (503) 331 -6906
Amount received
CCB lie.:
Date received:
Authorized signature: I ` AD, This permit application expires if a permit is not obtained
— — within 180 days after it has been accepted as complete.
Print name: Richard Gordon ! late: 6 -11 -04 * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Permits\FPS- PermitApp.doc 12/03 440- 4613T(I1 /02 /COM/WEB)
��. s0
CITY QF TIGARD 24 -Hour
BUILDING Inspection Lines. (5 s r,' -4175
INSPECTION DIVISION Business tine: (51 -• •-4171 MST
BUP ;NaO � 00 7q
ZS
( �'
Received Date Requested 6 — ( AM / PM BUP
Location I f A `K_ I Suite / I I MEC
Contact Person Ph (� 0 ? PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 5) kiL e1. SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation C, Cf._
Drywall Nailing
C .
Firewall
r Fire Alarm
Susp'd Ceiling
Roof
Other:
• PART FAIL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA n (z % _
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the. job site.
PASS PART FAIL