Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2007 -00339
• COMMUNITY DEVELOPMENT DATE ISSUED: 6/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-01002
SITE ADDRESS: 10220 SW GREENBURG RD 201 ZONING: R -12
SUBDIVISION: LINCOLN CENTER /THREE LINCOLN LOT: 009 JURISDICTION: TIG
PROJECT: INFINITY REHAB
Project Description: Relocate (6) sprinkler heads and add (3).
REISSUE: '105 FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: G 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:$, , 0. oo
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST AFP SYSTEMS INC
ONE SW COLUMBIA ST #300 19435 SW 129TH
PORTLAND, OR 97258 TUALATIN, OR 97062
Contact #: FAX 503 - 692 - 1186
Phone: PRI 503 - 692 -9284
Reg #: LIC 67534
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/28/2007 $62.50
[TAX] 8% State Surcha 6/28/2007 $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 : • . ! // Permittee Signature: ' 4L� 1 (
L •
Call 503.639.4175 by 7:00 a.m. for an inspection that's , siness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
: JUN -27 -2007 WED 03:35 PM AUTOMATIC FIRE PROTECT FAX NO. 5036921186 P. 01
Fire Protecth ml 'System •
Building Permit Application
City of Tigard l�� ' Receivc` � Permit No.. G�`YJ / ��3 '
Iii
a 13125 SW Hall Blvd., Tigard, OR 97223 l U N 2 7 2007 Plan Revi w Other Permit:
Phone; 503.639.4171 Fax: 503 598.196 Datc/B
Ins Line; 503.639.4175 CITY Date Roc dyBy: hula RI See Page 2 for
'I' I i
Inspection i A It 11 P � + ��� Notified/Method: Notified/Method: Supplemental Information
Internet; i t: www_tigard•or,gov
BUILDING p �+ O DIVISION
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Permit fees° arc based on the value of the work performed.
El New construction ❑ Demolition
- - Indicate the value (rounded to the nearest dollar) of all
" Addition /alteration /replacement 0 Other; . equipment, materials. labor, overhead, and the profit for the
:4•':,v ; z s: ; ," k., •A4e a +e. - .w:ya" o i:�"' t Y -'!'x5},' •"a ayr,:,`# work indicated nn this application. -
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El 1- and 2- family dwellingCommcrciul /industrial Valuation:
Number of bedrooms:
D Accessory building ❑ Multi - family -- - ,
[] Master builder 0 Other; Number of bathrooms:
x r � ,- 6. "7 : pA a ., , .., ��y :�H 1' 9 M .. ' N y.,, /:l].L'• 41' k 3.` 7.01P41
ti ; : +: -: , �,' :;c v Total number of floors:
l �i Vim:, "; f . ,,r,�•,'i ' i k M., �}Q ' A IQ �;;4`c"1 1 ....
I +` +:'•''�+�� #:;,61`:V.��M' ?;` y; 7�:, ., i� r1� *... 1,.:'�.��F;k"�1'f�CiC:.i -. �: r;'�'_,, .:r.'���,:U �' �' on,r'. 1�5 -��
Job site address; J b O S New dwelling urea: square feet
City /State/ZIP; '..--- OP C Garage /carport area: square feet
_
Suite/bldg. /apt. no.: w fl Project name: _ 4 — Covered porch area: square feet ,RIPN
Cross street /directions to job site; (n 1\ku , peck area: square feet
J Other structure area: square feet
-- r,t :N 1 ! �' dx' i'' ; t , max. 'w y;
Subdivision: L 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
indicated on this
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I • ' K4 }.f� t2. (0 4 Valuation: ;,
Existing building area: !(' C O Vsquam feet
New building area: 2 000 square feet
, i,gf:J0 , . t • tr,: .: ,, ddr7,, . aror ;. y ' ' + : .'�7° ! 3 m.,;v;/ l F d , ::i''.•.r byliir4 bC Number of stories • ,.n4
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Name: ( Type of construction:
Address; r S �•S��"LL�dd � ```��MM "' . • , `- • - 1 __ . o) Occupancy groups: `�
City /Statc /ZIP: 'Tu . 0 Existing' 7�
Phone: ( ) 3 Fax; ( ) New:
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Business name: A F P J All contractors and subcontractors arc required to be
Contact name; JI In...b,, s,�� licensed with the Oregon Construction Contractors Board
'”` ._�j under ORS 701 and may be required to be licensed in the
Address: I. 4, ' k) (a- v = ,jurisdiction in which work is being performed_ If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: ��u1-A•Tti G'-' � 704 y apply: .
Phone: ( ) L Q12 q�--� ' 9 1 Fax:: ( ) 61 2.-4M3 4
E -mail: b 9.i -t t C b
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IIusinass name: Permit - / "a fee: ( V
Address; '
• State surcharge (8% of permit fee):
City /State/ZIP; FI-S plan review (40% of permit fee):
Phone: ( ) I Fax; ( ) (Due upon application.)
CCB lie.: - 5 -5t--1, Total permit fees: y, d6
Amount received: 61 , 6
Authorized signature: -
This permit application expires Wit permit is not obtained
Print name: , v► . t-v P_ Date: within 180 days after it has been accepted as com plete.
• Fee methodology eel by Tri- County Building Industry
Service Board.
I: U3uilding \ParmileUTS•ParmitApp.dut. 03/23/O4 440 - 4613T(II /a2iCOM/Wet)
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CITY ��'���~N�������� . -
��no n OF wm���mu���
BUILDING DIVISION - .°~,"~~~~""~~° "°"".~~"~~"° PERM|T BUP2007c00339
13125SVV Hall B|vd, Tigard, OR07223 DATE ISSUED: E/28/2007
Phone: (503) 639-4171
Inspection Requo�s(24Hm.):(5O3) 639-4175 �v��
INSPECTION WORKSHEET FOR DATE: 6129/2007 TIME: 7:00Ah0 PAGE: 46
SITE ADDRESS: 10230 SW GREENBURG RD 201 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/THREE LINCOLN LOT #: 009 TYPE OF USE:
PROJECT NAME: INFINITY REHAB
DESCRIPTION: Relocate (6) sprinkler heads and add (3).
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: AFP SYSTEMS INC PHONE #: 503-692-92B4
Inspection Request Scheduled For: Date: 6/2E#2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough-in/test 061177-01 892-9284 N
Corrections/Comments/Instructions:
[K PASS �� PARTIAL APPROVAL �� CANCEL | I NO ��rESG
.~�� �� . / / . . '.~.
U FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
/
.' ^�
Inspector: Oete: ^• ^^ Phone #: K503\ 718- ~~
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