Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00516
A l �� ,
DEVELOPMENT r SERVICES , 639 -4171 DATE ISSUED: 11/10/2004
- 13125 SITE ADDRESS: 13125 SW HALL BLVD PARCEL: 2S102DA 00401
SUBDIVISION: ZONING: CBD
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: 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: $ 1,000.00
Remarks: Fire alarm system.
Owner: Contractor:
TIGARD, CITY OF LIMITED ENERGY ELECTRICIANS
13125 SW HALL 4020 SE 1ST PL
TIGARD, OR 97223 GRESHAM, OR 97080
Phone:
Phone: 503 - 519 -4496
Reg #: LIC 136699
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 11/10/2004 $62.50 Final Inspection
[TAX] 8% State Surchan 11/10/2004 $5.00
[FLS] FLS Pln Rv 11/10/2004 $25.00
Total $92.50
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
callin• 13) 24. or 1- 800 - 332 -.344.
Issu B
Permittee
Signature: g 2 p
Call 639 -4175 by 7 p.m. for an inspection the next business day
r 1 (Z5 » w H41-t-
,, " Fire Protection System
Building Permit ft Ec x � it i/ V FOR OFFICE USE ONLY /
City of Tigard Da teBea _ ,/� A /
oL ,// PePermit No.: / 7
13125 SW Hall Blvd., Tigard, OR 9312 2 p 2004 Plan Review
Phone: 503.639.4171 Fax: 503.598 O A\ i , t DateB : •- ' -' 4 L3 Other Permit:
Inspection Line: 503.639.4175 CITY OF TI X71 I
��� Date Ready/By: 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
BUILDING DIVISION -
!i •:5 ': G �",.tt `, kSSI6 -- �.' «2M` # 43b�8 4 .'hi Y °dz:'J " ' � Io .. t. i ' ' ' :.,, .. N l i. `:.:�a ` ih;.wi'x4��x, -
y =�� �;r:: ,.. -•, pi . .. TYPE 0 OF W( ^ t-, ti t s t ; 1
t e RE. 1»AND 2 FAMTI;1'«D
a>'�3ca�•',�w��">e`.`�.'.�'ku s�.'. ' a,xx�`w�e r.�`m »,. »A # ° " "...S S�.�',��:..?:•F'.. ...«, �if� ,:,'?s-...`:'•>1'�cr.*`3,�,�`� r�i, u: �'» ka.: Q "4`w'S;�.P.�.sr„�?"r`:w.lx �.,. `?: :':''• +�•...., .. ..
[2 New construction El Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
El Addition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the
•ffi;.., .Te nn '2 cv- :a.21f; ;: " i n:; : ". li + :2 3� : •. r 'r ' : • Ft > w ;r?,7•Y ;•1:' � "• FP . 4
����� &° ,'�' � �t.CAT .OF G N TR � �_ � �' •�:- �1 �,,. ° ;�;�, work indicated on this application.
„ .kt:- apt,, ¢ O S : IJ.CTI �._•. „;...:; u ::4-:.,..
:,.>��..�i: x.. x�' r �`�T.'�+:u'e= :i#-r�:'•:3UNr:�; >�.�":k� ; a�?. �':,' #'.�'Aa.;- °a °3sha::."�::�� �,ic,�d:�::es: K:» ":`: "
El 1- and 2- family dwelling Commercial /industrial Valuation: $
El Accessory building 11 Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
; , .�rs,„:��,,- T.#k';�' -. �Z =.1F;: ' " =.^:w»:"�� »% v,:'.#T°,Ei,�.'k!.a..• :a +l.m x , EV:;.c
; ,, n „ • �' ; Rla L`� INF®RMATION AN➢ .M AT'ION , !V4W. ti Total number of floors:
4 , ..-., '- . �'�.'� ., s.,.. a<: a, fig � ...� -Y:» .���� rse� �.,rla� =..,�i�w.�. "w�:.�
Job site address: /3 /f 561) f'4/ / / 'j/d New dwelling area: square feet
City/State/ZIP: „.� 9777 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Via &Mil Covered porch area: square feet
Cross street/directions to job site: V / /���� Deck area: square feet
Other structure area: square feet
- '...a'.'s ' ° t. * �.�': °�`: '. 4t*»;3� 4a� , ty�iz^s •• > ar y ,.,:�r.�:� :C Cr:. ` s..,
lalg 2 r D 1TA ;GO1VI aER C I:AI, ` US E dgei IST:
. a'r:.'�., ^.,».k:w;a :.7 '. xe; :.'i'ow ,. a::a.: ac:,: v . ::k72.,wc ,,x, .'4
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
equipment, materials, labor, overhead, and the profit for the
r , • ; el a'` 2Z w :: t"F9::ebr .,.. "aa 44 • y:=t;�:e,.;�, t r,.�4,"<..n - 'l". ' ' ' IM �`�
mac` -'��D' } ORKt : ,, work indicated on tins application.
/ail- pm 6 ” vci Valuation: $
I 4
_EA-// Existing building area: square feet
•
New building area: square feet
M I 'P,ROPEli 5W471 ' ` " � 'rf- iW - �� T NAN t ttP ." , Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
•
Phone: ( ) Fax: ( ) New:
`r " `*acv - r , :c — t�r.q t' , i l f ... f:; r; a u a :>�=., -; s :jSg: . r,.r,
;° .' o ; '`' - ICA'' —1 ` '''Orr"-"'',44 „il ” , 4 •CO N TACT 'PERSON ': l' � 1`..' , ;» :.,r I ;-.�;. ._..''''"•: °':'
, w �:: M < i 4 e; x; A - ,, , ° , - ;d . !N ea* c *r^e.. .t € ^ >:;%,n•: aig,: -. d M - '. M ,t,*.' t ; ,,, , , , E t z Og<
Business name: /1/ ; / 7 r"[ .� L dr �� (' / 5 a ; <. nt tors and sub - : z. - : -: .,« :.. contractors are required to be
. t
qjj y/ � All c
Contact name: licensed with the Oregon Construction Contractors Board
�- YtS '71 .Jr under ORS 701 and may be required to be licensed in the
Address: 51 S� / sI pG jurisdiction in which work is being performed. If the
City/State/ZIP:� S -4 �i' 97oro applicant is exempt from licensing, the following reasons
`` SW- 7 ,
apply:
• Phone: ) / S/ //!f / Fax:: t 3) $4 —
E-mail: C lit• I' / S o f9/,1-7,41i1 t/1/ '04 ✓`2.Gi Ll. /M (4
_ ,�, ,L . �" : - "CO TRACTO Sri a t `
/ ) s r P
CA�tr7 =r� K
�
Business name: �Y� f�u{� _lc wt � „y i �:r�°�, •
; � w ,,;�,_;.M.
, . h 1 ,t RMIT F EES; ;
Address: Vo/7 5-z-- /..-41,,7L n... ar � , _,..�.,, : a _�w.:s , •
Please refer to fee schedule.
City/State/ZIP: Q,..,,,...., Vf 9706 Fees due upon application
Phone: f 3 9 - 7 7 7c, Fax: 3) 7aZ - l 9/2
Amount received
CCB lic.: /36,67 ,/ , 1_____ -_ ,. e.-s<:,f 9 --- pi -- ,03
Date received:
Authorized signatur / - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: C4 `iS. 6 �� DateJg./ r /O% * Fee methodology set by Tri-County Building Industry
�f '''f Service Board.
i:\ Bui lding\Permits\FPS- PemutApp.doc 12/03 440- 4613T(11/02 /COM/WEB)
•
A•
I) r. rr 31,J ' 'L
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work; °tobe,done _,.e ..',:x , ...
1.) .f New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of # (Q nplete A; =B wCor D as applicable):, ...
Ai)'Commercaal prwkler� �` :� ; f k ` q
❑ Wet ❑ Dryl ...
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
�,
*) 'I Yp;e .I Hoo_ d F ...h `°
Hood Project Valuation: $
:3fz..0 - 'd{a�! �v�,:., .� . ...,w*., ; 'S+' � ^2.R p}•y. ;.`�i'(' "'�. = "4: •;' k. }1.". '>+,`.'t'':1 Y;f x.. fro:, :.«✓��.:x'k°s- ^<..�L. :M [,r,
,C�),FireAlar ate* s '`-o�v">�a'i e 9B , z .Z. ^,:n,, .
Submittal shall Battery Calculations ,Q. Yes
include: Individual Component 71 Yes
Cut Sheets
Fire Alarm Project Valuation: $ f
'F:.�;": "?"'•- u�. ".'a: "�`�.E*::.�n`": ::'::: a:�c:`.$" . ,sr?.�°'R.•__'�'.- Tt'- �',� ;':r.. "?"is �a�.' ^ �°'',-� ^','o� *•`'- .<ex,:.,,:.� z�: " <�,, -r
Square Footage: Permit Fee:
0 to 2,000 $187.50 , r
2,001 to 3,600 $232.50 4Mitt 4.2P:607-4
3,601 to 7,200 $292.50
7,201 and greater $381.50''_
Sprinkler Project Square Footage:_ sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
Plan review requires a completed application and.3 sets of plans at submittal. 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" technicians.
i:\Building\Forms\FPS Checklist.doc 12/29/03
12/01/2004 10:18 FAX 5036847297 City of Tigard [Z1002 /005
'I
12-01-2004 09:10am From- CENTREX CONSTRUTION 5036206692 T -819 P.002/005 F -617
Nov 29 04 10:47a Russ James 360 B44 -S ?31 Ip.
11/23/2884 14 :49 5415640281 FRONTIER SYSTEMS PAGE fly
1 AIV Cr° 5 / (a
FIRE ALARM srsrn:M
• RIECORO OP COMPLETIO .
Name of protected property: 11 e air' ..r. a I: r4 u I A � It
Adagyee, v.% � • .' �Y . ! .• - I C f �.
Representative of p rohn tad worm (ostoolp a):
Authority having jurihdiedorl:
Addeoae/tetopbot3a numbeir, -
1. "IIIP40) of System or Sault s
v JJ NPPA 72, Chapter 3 -- Load y
if at:inn is trap sruittod to lomtien(s) off promisee, Au. where ewtdved: r )O.Ir� ' . [ t . -
NFPA 72, Chaplet 3 — Emarscsty Vhakr /Marco Sovv os
Qu■ntity of uoladaluria Cbannehe , Single, Adulelp)e: _
Quantity of speakers Saddled: , _ Quantity of woke( mast;
S;Aity of tolephanos or telephone jacks included in axs+n' _ - -
f NFPA 72, Chapter 6 -- Aa siPary
Indicate type of cc uct g :
Local QAetdy Shunt Panelled telephone
1.00stina of telephone nueaher fbr reaoipt of silgorla:
NFPA 72, COaptet d -^ Remote Station
Alarm:
Supervisory
NFPA 72, Chapter 6 — Proprietary
X1 elonoa am retransmitted to public fire aetvice arminurti dorm ceatare or Abaft. indicate leeeti® end
telephone nubmore of the onternisation reciting dam: —
Indioste has al=to b retransmitted:
NPPA 72.chsptar b •- Cadre! Stadion
Prime 000unsrtorl
Con tntl Maass location; _
Moon of transude don of cognate from the protected prenumss to the control statiwi:
IIKcCullop Multiples Ons-rrry radio
Digital slams corn munfert ar _ _ 'lurosway radio - — Other"
Mears of transtui.*ian of aw to the public fire service cammuoiest6oua calltcP
(b) -
System leadion:
P ?M R.coo or ComiLloon : el of
•
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0
12/01/2004 10:18 FAX 5036847297 City of Tigard 2003/005
12'01- 2004 09:11am From - CENTREX CONSTRUTION 5036206692 T -B15 P.003/005 F- 17
,1ti/Y a.7' V-r AU; I. fa muss .lames 360 -944 -6731
• p. 3
11/23/2004 14:48 54156402731 FRENT SYSTEMS PAGE
pane! sew
>� 4ve n
Installer (': )9•(.,E` -7y z Y� use �t r'S )6►y duels
•
8.�op]:ar r
Service orgenieqtlan SheilC
Location of nerd tewhitiitl drawings. C c F.), C Tic . 61 rvl F AA I act_
Lnerir;len sunsets manual* ,
Locdttoa of teat repose :. 1 t tt Ot a
A sentrest, doted Al A , far tape and inepottion in neoonisaae with Rim smulardio)
Noir). _ ,dated . - . ,is in effect.
Z. ll.vord ar system IMlatohatian
pan e odor leatjUadioo 1. complete and w:rivg checked for open., Omani. ground faults. and improper
gran but prior to cpndectiog a crania nl aocr ytance taste,)
This eyemm Ma been installed la th the NFPA, tM idoda as shown beket wan teopeetiad
by e- on I( ' t , inel.daa du dwises atoms Won, and less bean in service
since
N7PA 72, hastens 1 2. 3 4 5 8 7 (cii k all {hole BMW
_ NPPA 7O,Natio.ial Eiterriaal Code, Amick, 700
_L MRnulhatum' instruction
• other
Signed: pate: 4//?y,/17_
Organ :latish:
3. Racoon 01 8yatvap Operation /
All aparational fastness and remolieas oldies syetota were WSW by t e ma // L .
• and Ibue4 in be oparsting pruparI in aomwdanm with the requirements el'
1■67A 72. Clamour. 1 2 9 4 5 5 7 Wale on that apply)
FPA TO, National lrlactrioal Cods.Attbcle754 •
,1164Dotufactinalie inatrsmtioao •
Other (*ROOM:
Sigllod• Date: _
Organization:
1, Alann.lnitiathis Deviant and Circuits
Quantity and Glean of iaitiaGag device circuits (me .NMrx'.A 72. 7bble $ -51 Qt w,t 1 y: Style; , Cina
MANUAL"
(a) Lf Manual stations Itroewaaed,aativet4a s 'I1romemittara Ceded
(b) Combination tamed Are alarm and gaunt■ ten.: ceded station*
AUTOMATIC
Coverage: Complain
Par.isk
(a) i. f Srealsn t Ian *i'bete
tb) Duet data:lore -, lop ,,1 Photo
CO Heat detectet. Zrr s$ mot ii0
(Navel mews ei Cvn0+6.7 M A)
•
12/01/2004 10:19 FAX 5036847297 City of Tigard ( j004 /005
. 1241-2004— 09:11am From- CENTREX CONSTRUTION 5036206692 T -819 P.004 /005 F -917
No ES 04 10:47a Russ James 3S0- 944 -6731 p,4
11/23/2004 i4:01 541554 ®281 FRONTIER SYSTEMS PAGE 83
(d) .l Sprinkler watorllaur seriatim: 14ansa:itlere Nmtcsdsd. acbi.ui ug Coded
(o) , Other (1Gs0)e . _
• S. Supefvisety Sisnai•lnislat1na tandoso rind Circuits boa blanks to indicate quantity d cli lCOa)
GUARD'S TOYS
(a) Coded seattons
(h) - Nonevded stations, setrvekiag _ _ trenrmitsere
(o) Compel ley SUM Ie,r @Piano eo prllsed of trsnamiuor *liana sod
fearerssedioto ■tesicen
Note: Combiossion devices are lvostded under 4(b) end 6(a).
SPI4TNKLER SYSTEM
(e) L Coded valve wpeavisory aig)iNig attathmenla
Value supoxvisory switches, activesing b haec enter^
(b) Building tesnyefntosopanto
(e) Sher water temperature palate
(d) Sits water supply level paints
Elanrric pomp:
co) Piro pump power
(() Arc pump vuanzag •
(R) Plume reversal
linaipie- driven fire pump:
(hl _ , Selector in auto waiting..
(i) _ Engine or coon-el panel crouhlt
(j) Fire pump running
Engine—driven waiter:
(k) Selector iii seta puoit -ao
(1) Control panel trouble
cm) - ,,,,._ 9emmbrswiorbes
(n) Engine running
Other eupervioory fneeeien(s) (epocUS):
S. Abram Notification Applinsav end GlrcWle
° • Queasily and WAND (sae NFPA 72, Tble 3•7I utoatifiasion epp a oecuia esmueetad cp tan symWW: F
Typo and quantities of neti}ieetioo appliaaca8 brawled: Quantity :. 7 Style_ 7 Close:
(a) . Dolls inch
(bl Speakers
(e) Same
(a) �— Oth
Sp(ru Rested 01Co'eptdlon s DV I)
•
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12/01/2004 10:19 FAX 5036847297 City of Tigard a005/005
12 01 - 20U4 - 09 :11am From - CENTREX CONSTRUTION 5036206692 T - 819 P.005/005 F - B 7
�,uv ca u-r iu; v i+a KusS .Jrne5 360 - S44 -5731 p 5
11/23/2004 14:4E1 54156482B1 FRONT/ER SYSTEMS PAGE en
(n ..! .7,— Visaed signals Ty 4 S
with audibl. ✓ Wlo 'nubble
•
(g) Local mpnunciataw
7, Signaling Una Circuits
quantity soul clue tees NFPA 12. Table 3 -6) of etl¢ulieg lino circuits coed t cream
Quantity: / Slyly- - Cuss.:
b. Systwn Poster Sappil*a
(a) Primary (mein). I SG> inw 1 vaksgo: / Current maw Ant
(Tvercarrentproo Typo: f currettt ratinit.
(e) Soee f (standby):
- Storage hammy Amp•hottr raqug^
Calculated capacity to drive system- in boon: _ 24
Engine- drivnu gouerator ded;uc4b.d to fire alarm system:
Location aTfael itonago; Alit
(s) rraorgeugr or itandbY eyawae vaod es b.dlcup to primary tower eupply, iaetad of using 4 Secondary
peens uappl)r:
Emergency .sateen desetled in NFPA 70. Ariicis 700
!Aga* regtdr ed eteadby *yam demand ii NFPA 70. Ariirle 701
- Agnate' ntnodby mum daemibed in NFPA 70,,Artiehr 702, ninth alia menu etc performance
requittdeneate of Article 700 as 701
L Syst.m Software
(a) Oparatiiaz tyetero .outwore revision p t�eJ hrf
(iv) App)icuiion software Teviaiole loser(
(cl Revision oomplatod by:
1 {firm l
10 . Corttmenb: ,
reh
ingsga) far atria shim mania. ®p■ny artotraNttth.awetfatedni ppl {rillo ate)
Pi quoncy ar ' taste and tptpeeamo, if otha rtt}att in aootsdesse. with the ref rtana.d P ataadatd(a):
Syeta a dcviatioerp from Lion reFekm+abd NVPA atandmd(.) lace
falyoa9) for ammo etatwe ar 414r41 service camt+.nsor ioataauvian tonwar T /oUpplisr ! (title) aloto)
• Uvula armpladowa ortin eyettua(r) eatteihexry seer(.) wiwawed CO required by the aarharity hnvity¢ ,Ntritidictinnt
(.!Ravel rey,wacnmt.o of the a+ap.ney ho.iarlu.iadlwoA {rids) I I Issas)
(NFfM Rana of cuepooirn 4 a e)
‘z 72; •
CITY OF TIGARD
Journal Entry Form JE # 133
)00. G/L # 5 JE Date: 11/10/2004
Description: Payment f Permit Center Remodel Fees
See Attached
BUP2004-00516
Month Ending: 11/30/2004 Reviewed By:
Entered By: alb Date Entered: 11/10/2004
Debit( +) Additional
Ln# Account # Credit( -) Amount Information Trn#
1 100 - 0000 - 101000 + 5.00 Cash & Investments 1
2 100- 0000 - 207020 - 5.00 8% State Surcharge 2
3
4 245 - 0000 - 101000 + 87.50 Cash & Investments 3
5 245 - 0000 - 432000 - 62.50 Building Permit Fee 4
6 245 - 0000 - 433020 - 25.00 FLS Plan Review 5
7
8 300 - 6100 - 750043 + 92.50 Old Library/City Hall Remodel 6
9 300 - 0000 - 101000 - 92.50 Cash & Investments 7
10
11
12 + 185.00
13 - 185.00
14 = 0.00
15
16
17
18
19
20
21
22
23
24
25
26 I: \FIN \Financial Operations \EXCEL \JOURNALS \04 -05 FY\[2004- 11.xIs]05JE #133
27
28
29
30
Fees Associated With (.2 _,..„,_ { ( < : 45 r, :4
6PM
4 ::4
I _ Case #: BUP2004 -00516 � Q- �-t ( -r- C E 2 P>tiH°b E. Q L.
City of Tigard
ca' - ., "' s ^s "'� 's z.--:4 �* � ,£ i4. -3`, a s 'F ; x'! ''� R'. - _ - , e
.. Fee�:.� Starf� :4 - u' :;,�� �s.� '� �. `€ ���- 4 a� _. �3 =� - '�.�-
�,,, ,�._�,� E d. � � - .. ��. , . �:��� ; Revenu � reat' ° � �= ° � � ��
. a. ti,2a,,, &:• z 5 ,r. .41/',.3 t; :� - f. �.�, s g:'�F- - a S =- „. „:- '. , G -^` � ''�=
- •. ,5 'De t . Lion = ,t om _ _ y- 1,: B -- . . j_. �, z �`'
^ Type, . Date , _ _ d .. . _ ... , .,� .. ., " _ . Date Ariount. U. r Dau!;.-
�,� ,. ,� � � : � a �,.: ��: �` :Account Numbers. = � � : � � -0, � �3.� . , �h� ., � °: >�
PRMT 1/1/1990 12/31/2005 [BUILD] Permit Fee 245- 0000 - 432000 BSB 11/9/2004 62.50 62.50
5PCT 1/1/1990 12/31/2005 [TAX] 8% State Surcharge 100- 0000 - 207020 BSB 11/9/2004 5.00 5.00
FIRE 1/1/1990 12/31/2005 [FLS] FLS Pln Rv 245- 0000 - 433020 BSB 11/9/2004 25.00 25.00
Total: $92.50
/ / / %i/
' - P /4 . ;, ) — . ., _
7 4f■ahie•e}4- d/e °2-44-1— ta
ti
( 3, Ov - &/ao -7So0 V3 (ii-12-A Lio Ill- . .=,
i pl ,_4_„,.esL__ .........14.1.4_, et •C_.-4-la—(-6,- C.)
CS
/A
1 / -4 / 61 i .
--- J24
•
Page 1 of 1 CaseFees..rpt
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2004 -00510
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/10/2004
Phone: (503) 639 -4171 ��' A,4 0\ I��I�iiipil
Inspection Requests (24 Hrs.): (503) 639 -4175 _� :_...
INSPECTION WORKSHEET FOR DATE: 3/29/2005 TIME: 7 :11AM PAGE: 3
SITE ADDRESS: 13125 SW HALL BLVD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: CITY OF TIGARD PERMIT CENTER
DESCRIPTION: Fire alarm system.
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: LIMITED ENERGY ELECTRICIANS PHONE #: 503- 519 -4496
Inspection Request Scheduled For: Date: 3/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 003115-01 503-793-2673 N
Corrections /Comments/ Instructions:
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`PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL . ❑ CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector PO _ Date: - O ()' Phone #: (503) 718-
.