Permit BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00605
DEVELOPMENT SERVICES DATE ISSUED: 12/29/2004
44- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10220 SW GREENBURG RD 125 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: UNK : 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: $ 300.00
Remarks: Add (2) pendent sprinklers.
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST AFP SYSTEMS INC
ONE SW COLUMBIA ST #300 19435 SW 129TH
PORTLAND, OR 97258 TUALATIN, OR 97062
Phone:
Phone: FAX - 692 -1186
•
Reg #: MO692- 9
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 12/29/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchan 12/29/2004 $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:
Permittee
Signature: _ �-� s),T
Call 639 -4175 by 7 p.m. for an inspection the next business day
DEC-28-04 05:03PM FROM—Automatic Fire Protection 5036921186 T-778 P.003/005 F-621
. • J3iiiidina Permit APE ______
FOR OFFICE USE ONLY
City of Tigard Received
13 125 SW Hall 131vd., Tigard, OR 97223 N 1 DEC '
447,,,,,,,,ti , Dateisy: 62-,zq -I "?6::
Flan Review Permit N.:OLATV
Phone: 503.639.4171 Fax 503.598,196
2 2004
Date/13 : Other permit:
Inspection Line: 503.639.4175 iY .
■17, ..■., Dare Ready/By: Iuris: g See Page 2 tor
ln zemet: www,ci.Ligard.or,us CITY OF TIGARD NotiBed/Medied:
1 Sooplcmerical Informati
. ..-V- 1....1., . 7. '& :41.1 : ! : 7 * n re -1,1 ' .; : 7 -1(1■Cia - -' 7'.: :;:r: , 7 . ...ii!`-.;- :, Z......";:i— ..,•..!5',. ' ` pc,',,W0):Fca.:9.3.eoltieT2trAwirryDNKEE.--mp
0 New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
t31 Adding' taterariplacement 0 Other equipment, materials, labor, overhead, and the profit for thi
•'...: work indicated en this application.
'•:!‘'q .45gEs '...17 NL: a .1;!;•••:. • ' - : na :i• . 21..40.r
CI 1- and 2-family dwelling a Commercial/industria1 Valuation: $
--....
El Accessory building 1=I Multi-family Number of bedrooms:
_ ____
0 Master builder CJ Other: Number of bathrooms:
_
1.•::q'. "-:1 pkaliA,glie `"'' Total number of floor •
:a74::-.4;4 " '"' af•r ...1t"..0•C,H4.! -'-=' '. J ija.c„-..,i --_______.
Job site address: tsm ommirdi New dwelling area: square feel.
-
--______
City/State/ r: ...'"Z ih. C ITZSI Garage/carport area: square feet
• •
illalta Idglapt no.: r&S" Project name: L - 12 I,N a vc.o cmcru . Covered porch area: square feet
Cross street/directions to job site: - — • . -T15 Li 1C4-i4L-4-1. Deck area: square feet
-..
— Other structure area: square feet
i,7T,
— C CMIST
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
7 "-" ,, ,..., - ..; , ,.t:::4::*• ; :sTc,1,1 , 4.704R..4,1 .$'.; 1.. .... P4P. '". • '•-•••-"'"- . _i" ' ._-,au,.-t,S),, :v ,. .., , .4, , ,
itVAcygi.56: ' , ' Vain." ,..17 work indicated on this application.
.,---,
_ _ Valuation: $ SM
—
IS Existing building area; A tti square feet
— -__
New building area: .--- square feet
•ti 17 Number of stories: C
Name! L ,C. - Type of construction:
Address:
Occupancy groups: IS
City/State/ZIP:
Existing:
--
4.ii.v•.:•,;!tac..,.2.n;;44;,•:43.7. Fax: ( ) -.A • • , " , t'•' '' •,:•.,::',.1.7.:F":7::'O New: * ) .". '4 . 1 '{‘ ,"`=;:;..7r VP•17. . 7.. - 1 ' '•:'. : '
I :f,:le.,'.rv4,7).;,17-42:r..AM'illAR. 44. C .. . - ... ... .
Business name: 1
— All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
— under ORS 701 and may be required to be licensed in the
Address: ' 4ST Sw t?9" -
jurisdiction in which work is being performed. If the
City/State/ZIP: IL Do _ Q 91 7. .
applicant is exempt from licensin th
g, e following reasons
a-(SL0 apply:
—
Phone: ( 9N-s) (97 C3 Fax: 7 (S711 ) GI -z 11 3G,
_
E-mail:
1
c - 0 Aii r t,.. , .. --
•• % i": - :: ......, -. .',:.
Business name: q ,srEcr. 11-14.... ..:;‘. '.. ,..•- .•/-Acrxtx*O;PRtaim ittEs''
Acic."4_..._....._-) Please refer to fee schedule_
City/State/ZI.1 i.y.07... ___
Fees due upon application Col
Phone: ( 9A ) caz_92.(84 Fax: (Stil ) ‘Ca . 1 t
Amount received
—
CCB lie.: C 4
Date received:
Authoriaed signature:
IC\41 This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: L 1 a %,...) L ot.... Date: iz.. z - Fee methodology set by Tr -County Building Industry
— Service Board.
nBuilchne■Permits\FPS.PerrnicApp.doc 12/C13 440-46131111i Dl/COM/WREs)
CITY' OF TIGARD 24 -Hour;
BUILDING Inspection Line: (503) 639 - 4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 AM PM BUP ;Z (96 6
Location o � ` - V _ `A �s Suite / o � 5- MEC
Contact Person R(L Ph ( ) Z . � �� ��� t PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ( i r ELC
Footing ELC
Foundation Access:
Ftg Drain 206 -00(0 05 r/ ELR
Crawl Drain
Slab Inspection Notes: 9 ; SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
ire Sprinkler � •
ire Alarm
Susp'd Ceiling — ;.� %�,� –' •,
Roof �eJllir ` M • I I I
*ASS PART FAIL
PLUS - ING'
•st & Beam r ,i
Under Slab iff
Rough In y Pti MO A —
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 all for reinspection RE: Unable to inspect – no access
Fire Supply Line 4,441
ADA Approach/Sidewalk Date ./ Inspect lbw
Ext
Other:
Final DO NOT REMOVE this inspe Ion record from the job site.
PASS PART FAIL