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Permit
AI! OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00200 ��� DEVELOPMENT SERVICES DATE ISSUED: 5/24/2004 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171 PARCEL: 1 S135AB -00100 SITE ADDRESS: 10350 SW LINCOLN ST SUBDIVISION: TOWN OF METZGER ZONING: R -4.5 BLOCK: LOT: 005 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 -1HR : sf N: S: E: W: OCCUPANCY GRP: El 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: $ 519.00 Remarks: Hood ansul R102 Owner: Contractor: WASHINGTON CLACKAMAS CO SIMPLEXGRINNELL LP SCHOOL DIST 23J 6305 SW ROSEWOOD ST 6960 SW SANDBURG STREET LAKE OSWEGO, OR 97035 TIGARD OR 97223 one Phone: 503 -683 -9000 Reg #: LIC 149921 FEES REQUIRED INSPECTIONS Description Date Amount Final Inspection [BUILD] Permit Fee 5/4/2004 $62.50 [TAX] 8% State Surchari 5/4/2004 $5.00 [FLS] FLS Pln Rv 5/4/2004 $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 calling (50 : • •9 or 1- 800 - 332 -2344. AlIP Issue. By: I , l A ,.4 _ /i A . _! i -...m.7, Permitte = � ' Signature: ,r Call 639 -4175 by 7 p.m. for an inspection the next business day 1 _ Ilk ! o SO SW L.iNCo� 11 /27/2004 13:27 FAX 5035981960 CITY OF TIGARD X1001 nen6 -ea- 4 - Fire Protection System ��,� E vv ED OR $uildiBuilding Permit Apl�litl$illl F OFFI( I: ( SE ONLY City of Tigard i y 4 2p p 13eeeiwea '' ...so permit Na. p. __ // - O O odd 13125 SW Hall Blvd., 'Tigard, OR. 97223 Sr Permit: Phone: 503.639.4171 Fax 503598.1960 of 1 '' i::' ilij'' f ' „21 �5 Other Inspection Line: 503.639.4175 CI1Y ; '` ~- - Dan Re Read /By: Internet wwwci.tigard.or.us BUILDING r ; .. 'I."• •:.:iE• Ikl i. :.:: -I.a .: 7b::'� ti:' .:. ,,. HiI1�iQ�t�r�� �' }'�• ����� /� . cal• 1•'y,,. WIEL':LIN.fd :'j`.' ;: :, .. :.,. ,."..... !: 1 ' RI! .;: w t4; ?!: :.s•:i'I...Jo..1.- ....::. ?•'t: '' :'r • _ r .. 111 1' . ,1 ' B Y D, r . , . I;:I:� :; . r ,j; i;: a... ,. Q. .:,.:.. ;', r ... N Permit fees. : • ti • .. , the work performed '•'''' ''�� °� ~' • �.:::!'I, :.:• .' , .•..'• "� °'� are based on the value of O'New construction ❑ Demolition Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteradodreplacem at ❑ O ::.11:;.::::-..: ,. indicated e i this labor, overhead, the profit for the Other: equipment, e • : ., ,,;.. :•11;lC9 ,• 'CORIi01&' +C(f»S. - .., .: - i Valuation: $ ❑ 1- and 2- family dwelling fomtncrcial/industrial Number of bedrooms: ❑ Accessory building ❑ Multi - family O Number of bathrooms: ❑ Master builder Men �,'. , 1 •. : Total number of floors: • i:•o ' `.�pfi'K: !• s f�.. . t�.�� ,.. ' .'" 1 . � (1�P'u�►14!:1�'QC►T[ rl•i; „I:c, `� �i: � : :.. • ; ,•;:j ` _,.�;,i.l• ; � J lob site address: / i) ?7/ S 'ALcc, l • New dwelling area: square feet 77 ,f) City/State/ZIP: � 4 4 is c., 7 z 3 Garage/carport area: square feet no.: Suite/bldg. /apt 1 Project name: ,1i jz ppz j/t. rr , Covered porch area: square feet . Cross street/directions to job site: Deck area: sly feet Other structure area: square feet R I - 40440 . M1VIE8 1 CI 'DS4;C , I CId iS'I' Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map/parcel no.: equipment, materials, labor, overhead, and the profit for the .. . ©- , :r. ,,,.. •. , , .[ l e:ii ^.Ir'i” I� Jj welt indicated on this application. .. °p�:i. :�: .. .. -.I~'u I I':' ... ��, ,^_, ,,� •:I::'ill'Ylr l!•r'� . •I 1.� .y S • ;:`• . � Valuation: $ ] ; ,._ 7 I J1 F1112_ S y `''+W M Existing building area: square feet New building area: square feet !_ 0::;I.I .uin ` it'G;i.: '7 : .J1'!:F' I q i:a ;j'ENI�iN;T;.`•i 'a6: '' Number of stories: Name: Me .1..2 9 ep El Q tyl oA $i 1, ,.,4 Type of construction: Address: ,1 1 o3 r S i Om rol/V 7r Occupancy groups: C ti w Cit /State/ZIP: -73 / oe. (17 223 Existing: Phone: ( ) Fax: ( ) New: ,°:I _ • r . L 1 i �.�,. ,,,� :' 1. • • - u :il t+ErAr .§. � : ,.I is 1 SI': : � ' _' 4! E.: n .• .::I; 1�:: �I" If�118. `r' ;.�:,.•., :.:• � •�)�.:• 4.:,.QN: 1 :�:. i:'�h,l II.��' �' /•`'� TLC :':1• °I',t��j:�ai,:i:li:y . " -a L1::1'i I r.l�'k�.F :>' ~... . ''•li .. . C � :err,..: •Ji:': . L':::. : "I . � ' A.: ! .•.: ' . :13`.1 '. '• . Business names c ti ... •• •. (-jr,'N1Jp // All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name ��, y �� _ under ORS 701 and may be required to be licensed in the Address: 6 ..?6) 5 J ' �.t jurisdiction in which work is being performed. If the )�� V �•� �/� �1 applicant is exempt from licensing, the following reasons G�ty/State/ZZ>P: Late. �3 G. J t? p o be % apply: Phone: (.>3 ) (5((j -(9 (XYV 1 Fax: : ( ) E -mail: •, 1 7 'ru,'•11.,•�rl.u^ •r ;x dL :1 :r x ,• . -a. -..•. 1' tIF: �•1. i lit I i: ... ,,, I ,',i'• I4» I•` :.nl.l{ �1 ' •r •.i�'= ''' "�i �'' :`:.it ,j.,: , R.Iiifili a :1.r. ... i. 41:00.1V'! • '�'f"'f' 11*.ki•i,..ii;:., . ; :•1L;:'.)1. :. i4 ,.:.. .:1 Business name: i 1 f' i1::.: I• • 'B jI INQ r'RHBS'' • Address: Please refer so fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) F ( ) - Amount received q L 5 CCB lie.: _ Date received: Authorized signature: This permit application expires if a permit is not obtained _ within 180 days after it has been accepted as complete. f Print name: gob , kuj LDate : 11 — o( j " Fee methodology set by Tri-County Building industry Service Board. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 417 MST BUP 4'2°C)(1 O� Received Date Re uested 7 ✓ ( AM PM BUP o C e° — GCO3.4tr Location / 6 3 57) cy Suite II1E6 $? 6O $ --/ , - 7 Contact Person R-01 Ph ( ) o9 FSS7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation a..1 Drywall Nailing - row �� Firewall Emu Fire Sprinkler Fire Alarm Susp'd Ceiling Rod L7 A I M PART FAIL ING 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 '�I Rough -In 4�tl•��Vir , % \ . _ ,41ii>♦ UG /Slab 11WIIYk-11111-� _ _ Low Voltage Fire Alarm Final 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 ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL