Permit CITY OF-TIGARD BUILDING PERMIT
• ',...
PERMIT #: BUP2003 -00565
Alk, , DEVELOPMENT SERVICES DATE ISSUED: 9/17/03
'�J 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10220 SW GREENBURG RD 501 PARCEL: 1S135A6 01004
SUBDIVISION: TWO LINCOLN - TOWN OF METZGER 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: : 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: $ 956.00
Remarks: Add or relocate (10) sprinkler heads.
Owner: Contractor:
EOP LINCOLN, LLC MCKINSTRY COMPANY
10260 SW GREENBURG RD 5400 NE COLUMBIA BLVD
SUITE 100 PORTLAND, OR 97218
PORTLAND, OR 97223
Phone:
Phone: 331 - 0234
Reg #: MET 0 04 0 01
00
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 9/17/03 $62.50 Sprinkler Final
[TAX] 8% State Tax 9/17/03 $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.
4
Issued By: Z .2 -4- c &..e--)
Perm e n n
Signature: , c,( r /�/ \fil{ -i (x/
Call 639 -4175 by 7 p . for an inspection the next business day
.'
Buil - ding Permit Ajpli
I Y 1 ®Iss.l L . ; 1 V IG Li Date received. i ' a 3 Permit no.:B /J e , _ � .5�
�" �� � > ,y,''. City of Tigard
Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard g:197223•1 2003
Phone: (503) 639 -4171 Date issued: By: z.P Receipt no.:
Fax: (503) 598-1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval: BUILDING DIVISION 1 &2 family: Simple Complex: -
• . TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction Cl Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement gFire sprinkler /alarm ❑ Other:
• - • JOB SITE INFORMATION
Job address: I O 2.2.0 SW G N taesz RA . Bldg. no.: 3 Suite no.: go t
Lot: 'Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: Vc/ E1.1.5 F432 1 o t - A Ge._
Description and location of work on premises/special conditions: 4-At7 (NZ- 2E1 -0 ("Tic' 16) 5Q9.4 NJ 44.0 R-
(7S Fe) (2— — CE..ni AN T -t.1 E-t•1 T
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling: '
City: (State: (ZIP: Valuation of work $
Phone: 'Fax: 1E-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: . Fax: E -mail: New dwelling area (sq. ft.)
• - APPLICANT Garage /carport area (sq. ft.)
Name: H L k 1 NSTQ -1 c . Covered porch area (sq. ft.)
Mailing address: 5'.QO N. coLUMBIA t51.al Deck area (sq. ft.)
City: IDO2T LA N D 'State: qR 'ZIP: 9 - zA E, Other structure area (sq. ft.)
Phone: 331 0234 Fax: 1(ci E -mail: Commercial/industriallmulti- family: •
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: M kt1451Ry c , .
Address: 540 AV- Co L-i. '1 E,IA 131.v r;)
New bldg. area (sq. ft.)
Number of stories
City: PO LAIC{ C 7 'State: 0 R I ZIP: 91Z I R Type of construction
Phone: 33t 0 i 4 I Fax: 531 cog c E -mail:
Occupancy group(s): Existing:
CCB no.:
40' l New:
City /metro lic. no.: It 1 01 Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGN licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: 'ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: 1E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the 'Not all jurisdictions accept credit cards, please call jurisdiction for more information
attached checklist. All provisions of laws and ordinances governing this ❑ Visa 0 MasterCard
work will be complies ith he er cified herein or not. Credit card number: / /
Expires
Authorized signatu _ 4 a _ „ Date: 9 ` 4 1 - 0 5 Name of cardholder as shown on credit card
Print name: 4l _.L Ft- (.- S6C( /AT $
` Cardholder signature ' Amount J
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM)
•
• .
Fire Protection Permit Check List .
A:) D New 1:11 Addition Li Alteration 1:11 Repair'
epair
• B.) Modification to sprinkler heads only
Describe work to 1. 1-10 heads:f o plan review required)
be done: 2. 11+ heads:' Plan review reqUired. .
Number of sprinkler heads: 10
Additional description of work: gEL (to)
Tiiiie)0sY,ofteKtCbtri
A.) Sprinkler Wet. Dry U.
Standpipes /WA
• Additional Hazard Group (--1, 6er )--6
Information Density 1 Pfr1
Design Area. 1 50
K. Factor
Sprinkler Project Valuation: $ s(,
B.) Type I- Hood Fire Suppression System A • • Hood Project.Valuation •$
. .
C.) Fire Alarm
Submittal shall Battery Calculations Yes. 1:11 /j/A--
include: Individual Component Yes ID
Cut Sheets
— Fire Alarm Project Valuation: $
•
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see chart): $ 5 -0 . • •
8% State Surcharge: $
FLS Plan Review, 40% of Permit: $
- . $
Plan review requires a completed application and 3 sets of plans at:slibmittal.
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"
„,, •
i:\dsts\forms\FPSchecklist.doc 11/21/01
I
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
Received W° Date Requeste "/ AM PM BUP
Location /D2 o Suite _ ' MEC
Contact Person !' Ph ( 3 3 3/ 00-3V PLM
Contractor e/ / Ph ( ) SWR
BUILDING Tenant/Owner (�i'V 1 ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain , /i�
Slab Inspection Notes: �G�` ��` A ' # , €74 SIT
Post & Beam
Shear Anchors a/ 4 , `� -63
Ext Sheath /Shear Y `7
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
ctf e pin r
Fire Alarm
Susp'd Ceiling
Roof
Other
PASS ART FAIL
ING -
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 fo reinspection RE: L Unable to inspect — no access
Fire Supply Line �j 1
A
3
pproach/Sidewalk Date �/ / U Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL