Permit CITY OF T I GA R D BUILDING PERMIT
PERMIT #: BUP2003 -00669
I, DEVELOPMENT SERVICES DATE ISSUED: 12/1/03
Ali SW Hall Blvd., Tigard, OR 97 (503) 639 -4171
SITE ADDRESS: 10220 SW GREENBURG RD 610 PARCEL: 1 S135AB 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: 2FR : 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: Relocate (1) fire sprinkler head.
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 4 000 0 0 1 1179
FEES LIC REQUQIED INSPECTIONS
Description Date Amount Sprinkler Rough -
[BUILD] Permit Fee 12/1/03 $62.50 Sprinkler Final
[TAX] 8% State Surchart 12/1/03 $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 13) 246 -..'! or 1- 800 - 332 -2344.
_ ,
� ata2A-A--/
Issue • By: tl
Perm tee /
Signature:
- .11( '
OP':
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building Permit Application OFFICE USE ONLY
. f i{ City of Tigard Date received: /. �03 Permit no.: , P,. /, / , o f
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Project/appl. no.: ,� date:
City of Tigard Date issued: B 1/ °Recei t no.:
Phone: (503) 639 -4171 Y� ;� p
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration /replacement ❑ Tenant improvement 14Fire sprinkler /alarm ❑ Other:
. . JOB SITE INFORMATION
Job address: IOZZD 5lA) 69.E6 - km , ,,, Rl. Sl.) e (0 4 • Bldg. no.: Suite no.: C II Q
Lot: Block: Subdivision: 0 L . C-01—k) Tax map /tax lot /account no.:
Project name: W,() LIIPJC,CAL ,SV lTE G IC:7
Description and location of work on premises /special conditions: L.00ATE: (1 ) Fitatg APP- Ny...1a -j
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity; solar,etc.) 1
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -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: McZln1s n C-0 Covered porch area (sq. ft.)
Mailing address: — •i tie LoW/Iftg QLV Deck area (sq. ft.)
City: p, LAN° State: 0/2 ZIP:4 7 :`_ k Other structure area (sq. ft.)
Phone: 'B'3Q,015 Fax: 3N1 E -mail: Commercial /industrial /multi- family:
. CONTRACTOR Valuation of work $ ( a9 Lb
Business name: �6_L1� &rit.Y c_• New bldg. . re a(sq (sq. .)
Address: ft.)
New bldg. area (sq. ft.)
• • I t < R� " Number of stories
r ZIP:972 , Type of construction
Phone: 3g /, O2.34/ Fax: 3 3/,(,90 E -mail:
CCB no.: t 09: Occupancy group(s): Existing:
New:
City/metro lie. no. r7 , Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER 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 • OFFICE USE, ONLY
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -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 ❑ MasterCard
work will be complied ith, w ether s.ecified herein or not. Credit card number: / /
/, ���� Expires
Authorized signature: �..�- � -�.' Date: Name of cardholder as shown on credit card
Print name: ` ./1 4- ' _ - ' Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. ado - 46t3 (6t00/COM)
1999
SAVE - HISTORICAL INFORMATION
BUILDINGS) NAME CHANGE
PER KIT CHURCH, ENGINEERING
10220 GREENBURG RD, LINCOLN II NORTH
CHANGED TO 10220 GREENBURG RD, LINCOLN III
10220 GREENBURG RD, LINCOLN II SOUTH
CHANGED TO 10220 GREENBURG *RD, LINCOLN II
CITY OF TIGARD 24 -Hour
1:0111.1G Inspection Line: (503) 639 -4175
*0
INSPECfiOIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested I2. - 2.3 AM PM BUP 3 -00669
Location / Daa-O G-,re � Suite Co 1 0 MEC
Contact Person r Ph ( ) 5L4 -- 0 S PLM
Contractor _ Ph ( ) SWR
BUILDING Tenant/Owner ELC
Fo ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fi rewal I •
Fire . prinkler
Fire Alarm
Susp'd Ceiling
Roof
O.- •
I
PART FAIL
PLUMBING
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 ii 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 L
ADA Date /07
Inspector Ext
Approach /Sidewalk
/ z3
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL