Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00310
� i� l DEVELOPMENT SERVICES DATE ISSUED: 6/29/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10250 SW GREENBURG RD 200 PARCEL: 1S135AB -04500
SUBDIVISION: LINCOLN BUILDING PP1991 -055 ZONING: C -P
BLOCK: LOT: 001 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: 2 -1 HR : 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: $ oo • 0
Remarks: Modify 10 sprinkler heads for TI.
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST MCKINSTRY COMPANY
10260 SW GREENBURG RD #100 5400 NE COLUMBIA BLVD
TIGARD, OR 97223 PORTLAND, OR 97218
Phone:
Phone: 331 -0234
Reg #: MET 4 0000 00 01 1 179
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/29/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchari 6/29/2004 $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 4. -•699 or 1- 800 - 332 -2344.
Issue By: _ 4 - d
Permit tee
Signature:
Call 639 -4175 by 7 p. . for an inspection the next business day
Fire Protection System
'Buil1ing Permit Application , - FOR OFFICE USE ONLY •
City of Tigard Date /B d ea A I� Permit No.: I a/„, .�/ 5/0
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 . , I M° Other Permit:
-
'< � � � D ate /By:
Inspection Line: 503.639.4175 L! Date Ready /By: 1 ... .,,..) 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: I ' Supplemental Information
s :V , , , PE, O F WORK .? , k REQUIRED „DATA, : - ,_ : D * , , , - , '. D _"W ELLING. ', ''''if ,
,_- _- ,'`;`�.� _�, _, . _ r o_ . fir,, ...< , . ... a ._,_, -„,, �1. ',. -' ''5i , � � ,_. „ -, �, _ , , � ... ..... ..... 8°a - _ '_ _ - K.ss�.- � ,_ ,i.,, ,E ��
❑ 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
°_ TEGORR iF°a x t , O ; - IO x°
N , 1'4 , ,-7 work indicated on this application.
v
°: F C CA O ,;:
❑ 1- and " 2 - family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
_ & ° B SITE INFOR N `ANDrL , j?:':`: .:";. ,,,
- t' =,� =" � ;' JO O A TIO_ OCATION�.: =. =_” . =�� -� � Total number of floors:
Job site address: 10250 SW GREENBURG New dwelling area: square feet
City/State /ZIP: Portland, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: 200 Project name: Forest City Suite #200 Covered porch area: square feet
Cross street/directions to job site: Lincoln Four Building Deck area: square feet
• Other structure area: square feet
",: REQUIRED _'DATA:COMMERCIAL- U SECHECKLIST
, , . %,.-.0. - -.T _ - _ >. > - , - ; .
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
profit for the
F
Ste`, ' =:DESCRIPTION OF WORK '% �- . equipment, materials, labor, overhead, and the pro
:. work indicated on this application.
., p
,
�,� ��i . - t�i�+��E,:•� f.af:?<. _ - W�t,S�r:wga�; , ,,ft � e - _.._ .. , ° " P
Modify 10 sprinkler heads in tenant improvement Valuation: $$800.00
Existing building area: square feet
New building area: square feet
z,i`wa 3 3 >..5 a.:, i „y n• � ,�. EY'a,
;ka iii7. PROPERTYs OWNER ,,,= a ' "®R_TEN Number of stories:
Name: • Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
rsa,. -
APPLICANT -�,_ ,., CONTACT"P.-ERSON _: -
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: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 331 -0234 Fax: : (503) 331-6906
E -mail: richardg @mckinstry.com
Via' ,��,�� >, >: �;��r �.�:: �: �,.
CONTRACTOR `i.,•
?�,,., , � _ . , _, = � ,__ , -� ..- -� ,_, -..- •,.,,,,. . ; ���. �- _ „��; _ ._ ._ _ ..� =,.� n � .cam,.- Y_ .. . , � ���,�, -
Business name: McKinstry Co � ° 3 , �r .^
_„ 'BUIISDIIVG - PERMIT EEE g _:
Address: 5400 NE Columbia
Please refer to fee schedule
City/State /ZIP: Portland, OR 97218
Fees due upon application
Phone: (503) 331 -0234 Fax: (503)331 -6906
CCB lic.: 6 t Amount received 4 6 7. sr)
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 Gordon Date: 6 -29 -04 * Fee methodology set by Tri- County Building Industry
Service Board.
is \ Building \Permits\FPS - PermitApp.doc 12/03 440-461 3T( l 1 /02 /COM /WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPEG`?IION DIVISION Business Line: (503) 639 -4171 MST
( /� BUP . — �s " o 3 % O
Received � D. - _ AM PM BUP
Location d� --- iri �_ -.
�t_ / MEC
L ' uite
Contact Person % -- Ph ( ) PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner < , ELC
Footing r
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Q � SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd•Ceiling
Roof
t I - .
ART FAIL
NG
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 •me,
UG /Slab �' f' �r' _ � . a
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL