Permit CITY O TI GARD BUILDING PERMIT
PERMIT #: BUP2005 -00352
I DEVELOPMENT o
SERVICES 503-639-4171
DATE ISSUED: 7/26/2005
' 13125 SW Blvd.,
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 420 ZONING: C -P
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT: JURISDICTION: TIG
Project Description: Relocate (1) fire sprinkler head.
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: 5N : 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: $ 1,100.00
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST MCKINSTRY COMPANY
ONE SW COLUMBIA #300 5400 NE COLUMBIA BLVD
PORTLAND, OR 97258 PORTLAND, OR 97218
Phone:
Phone: 331 -0234
FEES Reg #: LIC 40981
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/26/2005 $62.50
[TAX] 8% State Surchari 7/26/2005 $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 -0i -ii i - ough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli r g 503-246-66'9 : 1400-332-2344.
Iss , d By:,. /:�,�� Permittee Signature: �//
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business 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.
Fire Protection System
• Building Permit Ap plicatio n FOR OFFICE USE ONLY
•
City of Tigard Date /B e � ( n � Permit No.: '5, . e°
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I
Phone: 503.639.4171 Fax: 503.598.1960 i I Date /By: Other Permit:
Inspection Line: 503.639.4175 _41 "' - Date Ready /By: Jun 8 See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: •/ (� Supplemental Information
.,- .,.,.._ .._ , . -..:. . �• � .. 2 TXRE�;OF -� WORK : =`':. , -.... =, : RE DATA � 1= =ANA'2� EAMIlY�DWELLING,.��, 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
>>
:;; ;;., work indicated on this application.
El 1- and 2-family dwelling Valuation: $
y g ®C ommercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
Total number of floors:
t�
JOB$SI>TE INFORMATION- :'AND??LOCATION:
Job site address:402(30SW Greenburg road New dwelling area: square feet
City/State /ZIP: Tigard, Or 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: 420 Project name: LA Weight Loss Covered porch area: square feet
Cross street/directions to job site: Lincoln -2 Deck area: square feet
Other structure area: square feet
REQUIRED; DATA:';; COMMERCIAL=USE.0 IECKL.IS'I''°
v.. , 4��,x,"1 - , 8'Sf2..: <:. e .o:.:..S..:t::18"7,Y-„ "-,;= " -=� b*..
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
w ork indicated on this a
DESCRIPTION; =OF:�;WORKa '' PP lication.
relocate l sprinkler head. Valuation: $
Existing building area: square feet
New building area: square feet
,w•, ,.,, „�.” ��=.;; YZ:,�'� ^tea,. =:x:°�..�, =; ",: :,��- „�,`�,.
°.��, ❑:, a
;. ®.PROPE +TY OWNER° Number of stories: ,<�a: TENANT` '\., :” �rz. a �;� -=
Name: Equity Office Properties Trust Type of construction:
Address: 10260 SW Greenburg road #100 Occupancy groups:
City/State /ZIP: Tigard, Or 97223 Existing:
Phone: (503) 892 -2500) Fax: ( ) New:
�
O
, .... NTAC`T PERSON..: y<W -
❑ .
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: 12021 NE Airport Way, Suite -G jurisdiction in which work is being performed. If the
City/State /ZIP: Portland, Or 97220 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 331 -2468 Fax: : (206) 832-8539
E -mail:
:,�,.; •:;;» ., °CON`TRACTORy,: Aa
Business name: McKinstry Co.
�. t �' BUILAING : >I'ERMIT: =FEES* x
Address: 12021 NE Airport Way, Suite -G
Please refer to fee schedule.
City/State /ZIP: Portland, Or 97220
Fees due upon application
Phone: (503) 331 -0234 Fax: (503) 331 -6906
Amount received
CCB lic.: 40981
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: Richard Gord . I Date: 7 -26 -05 * Fee methodology set by Tri-County Building Industry
Service Board.
i:\ Building \Permits\FPS- PermitApp.doc 12/03 440- 4613T(11/02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00352
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/2612005
Phone: (503) 639 -4171 /o nmu� u gpuy��,�pll�(�? �
Inspection Requests (24 Hrs.): (503) 639 -4175 - _..
INSPECTION WORKSHEET FOR DATE: 7/27/2005 TIME: 7:15AM PAGE: 1
SITE ADDRESS: 10220 SW GREENBURG RD 420 CLASS OF WORK:
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER LOT #: TYPE OF USE:
PROJECT NAME: LA WEIGHT LOSS
DESCRIPTION: Relocate (1) fire sprinkler head.
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: MCKINSTRY COMPANY PHONE #: 331 -0234
Inspection Request Scheduled For: Date: 7/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 012246-02 503- 209 -5769 N
Corrections /Comments /Instructions:
•
y PASS ❑ PARTIAL APPR*VAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL fl C i FO INS" CTION ❑ ADDITIONAL FEES ASSESSED
L +i
Inspector: !1 Date: - - 0) 7 ^O Phone #: (503) 718-
vir