Permit c . CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00604
I& DEVELOPMENT SERVICES DATE ISSUED: 12/28/2004
��' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
•
SITE ADDRESS: 10215 SW HALL BLVD SITE 1S135AA -01400
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -N
BLOCK: LOT: 037 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: r T J FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N : 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: $ 2,500.00
Remarks: Add (2) heads and relocate (7).
Owner: Contractor:
INTEGUMEND DELTA FIRE INC
10215 SW HALL BLVD 14795 SW 72ND AVE
TIGARD, OR 97223 PORTLAND, OR 97224
Phone: 503 - 245 -2415
Phone: 620 -4020
Reg #: LIC 64174
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Final
[BUILD] Permit Fee 12/28/2004 $72.10
[TAX] 8% State Surchaq 12/28/2004 $5.77
Total $77.87
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 By: LL /1 /i>'ia.,/,d___ .
Permittee
Signature: X /
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protect' s.. , - I 20
Mr BuN1dhn? Pe °� �'il • h o i FOR OFFICE USE ONLY
' /,
City of Tigard iI n(�r[r(� el Date d t I (, ��oy ?}�
Permit > l, ' Po 00 4 _a0�0�/
13125 SW Hall Blvd., Tigard J&497n38 2004 Plan Review 1 III / „ A , Phone: 503.639.4171 Fax: 503.598.1960 . Date /By:
Other Permit:
Inspection Line: 503.6� „,,,...44I I. - Date Ready/By: s ® See Page 2 for
Internet: www.ci.tigard`6t OF TIGAIZD Notified/Method: //G Supplemental Information
BUILDING DIVISION
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❑ 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
;< '; „: _: ' ":: ,,P -z,7 - ,, work indicated on this application.
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``° ”' Valuation: $
❑ 1- and 2- family dwelling A Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
,f., *( � "' s
30S;�SIT»�dN�Ci' � �'IO >AN D;`IOCATI(1 . - ^ -; Total number of floor
Job site address: IQ l s S VV 14 pti, 13 LOD New dwelling area: square feet
City /State /ZIP: ¶1 6.1A- D 1 012_ 011 g.4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 1 Ofe,67 U AA D L 3- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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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
t4
"o mN ° " equipment, materials, labor, overhead, and the profit for the
r•' , p ` I %`h-,- e . work indicated on this a
`DESG'1, t�lF"iiW RAC f`' --b ;- application.
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r�.
R n IU WO S (J {�, ` mo o Valuation: ~$ �5W4OD
� r i v 91 Existing building area: square feet
New building area: square feet
e9YNETi` ik ri:.M% __ ,1:0.-44117E-4,',.: ; -` Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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- APPL)C�. N: ❑ >C(7NTAC S N"
' . ..;;:.: ,: "may
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Business name: Dp,1. - - 1I rz, 1 ' 06 All contractors and subcontractors are required to be
I Contact name: AA ,/ ( f v licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14-10, s � J 7 - nor f jurisdiction in which work is being performed. If the
City /State /ZIP: I 6/peep ,
F ' ax:: (� I/ ) All (1 l �Sd /' g 4 applicant is exempt from licensing, the following reasons
�/� (�g� � `,fin apply
Phone: (503) L0- 40W J�y 7. io
E -mail: 77
�r�u� � fi`.. � p �;"(�lnv` �•��. ':t., ��z; \. :x .gSfv.:1:w:�:: ,::.,
Business name: LI /,l �., >, ":: r >N -;, ;:. ,= a :i'
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Address: 1 `i l 9 c f,0 -7 2 0 el Please f f
ee schedule
P lease re er to e.
Cit /State /ZIP: Grigg-4
r� � • � I � I / Fees due upon application
Phone: (503) - L�GV _ Fax: ( 1e �.D
`. Amount received
CCB lic.: (
Date received:
Authorized signature: a i L � �_ This permit application expires if a permit is not obtained
_ ,<fD • • within 180 days after it has been accepted as complete.
Print name: Date: 9-- S * Fee methodology set by Tri- County Building Industry
Service Board.
i \Building \Permits \FPS- PermitAppdec 12/03 440- 4613T(11 /02(COM/WEB)
CITY OF TIGARD
BUILDING' DIVISION PERMIT #: �()F 0060A--;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 1 1 111 �iip� %��1l
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: (6 Z( �`"� tt—� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: (li-T ea 01/k PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
� •,11
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL fI CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CII-Y ( 0F TIGARD 24 -Hour
BUILDING... Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST !/
BUP Received Date Requested °? • AM PM BUP
Location /0 -1 Suite MEC
•
Contact Person Ph ( ) J �� PLM
Contractor Ph ( )(O ■ A49 SWR
BUILDING Tenant/Owner _ I '.'����IiL =.�_/ ELC
Footing
Foundation ELC
Ft Access: c 2
g Drain -0'0 61 L c _' ` E L R
Crawl Drain
Slab Inspection Notes: /rid / SIT
Post & Beam •
Shear Anchors �2 / � i
Ext Sheath/Shear J /
Int Sheath
/Shear
Framing
Insulation •
Drywall Nailing ,^
Firewall
Fire Alarm J �l D' Lo t> u
• Susp'd Ceiling —
Roof
Other: �, �
Final �/ PE F - V" \ S
PASS PAR 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 Reinspection fee of $ requ' •e • re next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
ari—
SITE � 111 Please c- 'for re* spection RE: ` II► � Unable to inspect - no access
Fire Supply Line 11110
ADA
Approach /Sidewalk Date - Inspecto lirMhY Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175 MST
INSPECTION I VISION Business Line: (503) 639 -4171 BUP c 71 - 00 Cf — Do ‘O T
Received Date Reques ed ` AM PM BUP
Location /v a—( Suite MEC
Contact Person Ph ( ) 4' o r PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner . .I_�� � ' ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation P l al ' M Pi E Drywall Nailing
Firewall
((ire Sprinkle
Firelarm —° i t I , I __�
Susp'd Ceiling
Roof � r s :7 ����
Other: -
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab i �.
Rough -In r ra WM.
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 befo next inspectio . Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ` _ Please ca I or rei - pection R -. 4 ' Unable to inspect - no access
Fire Supply Line / .� i .
ADA V vim/
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITYF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -417 MST
INSPECTION DIVISION Business Line: (503) 639 -4171 .,poz — 00027
Received Date Requested AM PM 0 --
Location / . _I 5 / / ar v"o( / .2 P ?e MEC
Contact Person Ph ( ) — 2-57 PLM
C on actor Ph ( ) SWR
BUILDING Tenant/Owner f--A/ 7G L! e 17 4 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain Y
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ` �/ �1�1 ��,L ei�L
Drywall Nailing �s
Firewall . 1� `.Er I•.t.
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling
Roof
O r: Fi v'
final •
PASS 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 Reinspection fee of $ require. • • re ne.' inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL rr
SITE . ❑ Please call or reinspe• ion RE: I� :_ El Unable to inspect – no access
Fire Supply Line
ADA / / r ,/ � �'� I /
Approach/Sidewalk Date Inspector Oct _
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
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Delta Fire, itia:.. 10 - ' '- 2 -12-F 2E-- L Mot�E I- ci sscr -5.12A
14795 S.W. 72nd Ave. 4— - 't _ -__' 2 ►=10 SF - 1 /1.-51 - =L =U. HS_yd.__ 132p,5
• Portland, OR 97214 1 1
CCB# 64174 i .