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Permit CITY OF TIGARD . BUILDING PERMIT P ERMIT #: BUP2001 -00309 42-00,1 DEVELOPMENT SERVICES DATE ISSUED: 8/31/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12325 SW KATHERINE ST PARCEL: 1S134CC -01700 SUBDIVISION: MARY WOODARD SCHOOL ZONING: R -4.5 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: El TOTAL AREA: 0.00 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 : Y HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,606.00 Remarks: Fire Alarm Owner: Contractor: SCHOOL DISTRICT #23 JT ATLAS ELECTRICAL CONTRACTORS 13137 SW PACIFIC HWY 4403 SE ROETHE RD TIGARD, OR 97223 MILWAUKIE, OR 96267 Phone: Phone: 659 -2212 Reg #: SUP 2581S LIC 1532 ELE 3 -2C FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Electrical Permit Required PRMT CTR 8/29/01 $26.99 27200100000 Fire Alarm Insp Final Inspection FIRE CTR 8/29/01 $28.84 27200100000 PRM2 CTR 8/31/01 $48.11 27200100000 5PCT CTR 8/31/01 $5.77 27200100000 Total $109.71 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -6699 or 1-810-332- 344. Perm ittee Signature: V Issued By: , , 4.dt, Call 639 -4175 by 7 p.m. for an inspection the next business day /( grd d Building Permit Application Date received: 19 � Permitno.�Up i' . co 309 lj ° " ;1y'r" City of Tigard Project/appl.no.: Expire date: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 - 4171 Date issued: By:Mil Receipt no.: Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: l &2 family: Simple Complex: - t TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement AFire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: r1.k \„j, , \t,, ry ,, \ Bldg. no.: Suite no.: t o Lot: I Block: Subdivision: \..a'_ SO .l NIE I Tax map /tax lot/account no.: Project name: isk ‘ ,,, 0 4„, t EV y .. \ `� Description and location of work on premises/special conditions: Qwu Z.4 Cf A. .o, - Ytc 4 OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: at t \ io \ Ja�0�� (-VC d \ �, (Floodplain, septic capacity, solar, etc.) Mailing address: \ c31 0.61 ; ,$G A wy 1 & 2 family dwelling: City : ‘ ; c,,. - I State: e'er I ZIP: T y' Z3 Valuation of work $ Phone: JJ IFax: IE -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: / r , Covered porch area (sq. ft.) Mailing address: Deck area (sq. ft.) , City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commerciallindustriallmulti- family: CONTRACTOR Valuation of work $ Business name: '� > t ky«\ Existing bldg. area (sq. ft.) � `w3 ss � a C \ New bldg. area (sq. ft.) Address: Number of stories City: iti,,, V,.jt I State: oQ, I ZIP: `1 7 Type of construction Phone: 6,51- 2.23, I Fax: 651 -'(1 r(t(I E -mail: CCB no.: 1532, ) 3 - 2,,L Occupancy group(s): Existing: / New: City /metro lic. no.: 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: I State: I ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: Name: Contact person: Fees due upon application $ Address: Date received: City: 'State: 'ZIP: Amount received $ Phone: I Fax: I 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 1i s ..',4-,Oinances governing this ❑ visa ❑ MasterCard work will be complied with, whe . _ d herein or not. Credit card number: / / ,� ' " � �� u Expires Authorized signa re-, • cwt •,'I Date: Name of cardholder as shown on credit card — t WO. ` $ Print name: ^ 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. 440 -4613 (6/00/COM) FL's f ( E Y• 8 g 'f pttzt s.77 . 4 to 6,11 • Fire Protection Permit Check List A.) ❑ New ❑ Addition ❑ Alteration ❑ Repair B.) Modification to sprinkler heads only: Describe work to 1. 1 -10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: Type of System (Complete A, B or C as applicable): A.) Sprinkler Wet ❑ Dry ❑ Standpipes Additional Hazard Group Information Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation $ X C.) Fire Alarm Submittal shall Battery Calculations Yes ❑ include: Individual Component Yes A Cut Sheets Fire Alarm Project Valuation: $ �, (v06 Project Valuation Subtotal (A, B & C): $ �, (6 0C3 Permit fee based on valuation (see chart): $ 3B 8% State Surcharge: $ ct ' FLS Plan Review 40% of Permit: $ A i,-`� TOTAL: $ �✓ �" is \dsts \forms \FPSchecklist.doc 06/07/01 CITY OF TIGARD BUILDING INSPECTION DIVISION 3ifi jo r 24 -Hour Inspectioi Line: 639 -4175 Business Line: 639 -4171 MST BUP 30? Date Requested 9" i f AM PM BLD Location / Z Z r Si✓ k'G /' e4 Suite MEC Contact Person Ph Gs, -22.01 PLM Contractor Ph / SWR 321)/ " - Tenant/Owner / q CA", 4 j4 * ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear qQp Z1117/ Se gee ( Framing Insulation Drywall Nailing , — 406 fy' Firewall Fire Sprinkler Susp'd Ceiling Roof �J yyam�,, Misc: ��2��'/'/ f�'Ss�� • Fi dip PART FAIL BING F --5u Post & Beam Under Slab Top Out �J /!�/ Water Service /� Sanitary Sewer �� q Rain Drains '5 , 6g q 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 PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA ((/(0( Approach /Sidewalk Date Ins �� Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site • *Val"' ._ - ... "':bin 1. NEW PORTABLE EXISTI PORTABLE A :00911::::::°07nt.. a►�Y a s de �D ....• A. 1' a he* alk P • See k . P 3 -' Katie • 4 y . . Job p, cess: '� 8Y • 0 0 34/ 0 o I my ,s ,5 • . 7 • K1 r ----.), • .•• • Ei r -- r • • MI •••• XI • • • • • Ale. Gf `� •• • • •• � • � • • • • • • • -�!n • • • • •• . ` •• •• •• •• •• FPL f •••• • : 4 • •••• I �� r • • • • • • • •_. r H N- • • • .. • . ,____J I L� .... • •... . • • • • •••• • • - •••• • • • • • a 1.11-PL F MARY WOODARD AND BRYOM PORTABLES 2 6k ! `d FPL INT12124 HORN • © O i 106 WEATHERPROOF BOX © 2089 -9754 PULL STATION AS24MCW -FR C.: r # !S FP L. 75cd HORN STROBE O 4098 - 9601 SMOKE DETECTORS 4098 -9788 BASE Note: Replace existing bell