Permit •
BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2005 -00618
- eillk DEVEL O C �639 -4171 DATE ISSUED: 11/29/2005
PARCEL: 2 S 102AA -00906
SITE ADDRESS: 12080 SW MAIN ST ZONING: CBD
SUBDIVISION: PAYLESS SHOPPING CENTER LOT: 002 JURISDICTION: TIG
Project Description: Fire alarm repair and alteration.
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: M 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: $ 2,278.00
Owner: Contractor:
MONTCO ASSOCIATES DIVERSIFIED ELECTRONICS INC
BY THRIFTY /PAYLESS INC #5354 875 WILSON ST UNIT C
PO q BOX 8431 EUGENE, OR 97402
IPhRRISBURG, PA 17105
Phone: 541 - 484 -9078
FEES Reg #: LIC 144685
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/29/200: $72.10
[TAX] 8% State Surchari 11/29/200E $5.77
[FLS] FLS Pln Rv 11/29/200° $28.84
Total $106.71
•
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 • ! -' s 1 • ough OAR 952- 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
ca ng 503-246-6••9 • 1j:00-332-2344.
�,��
I - ued By: „ S Permittee Signature: r
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
e Fire Protection System
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Received Q9 PemitNo.: A �
13125 SW Hall Blvd., Tigard, OR 97223 Dale/3 : II r
a,7 a / � /� �� 47/g
g P Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 iil' Date /By:
Inspection Line: 503.639.4175 __. el l Date Ready /By: mr El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: I i Supplemental Information
TYPE OF WORK REQUIRED DATA: I- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
I J Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I X080 SW -- Mai". Srt. New dwelling area: square feet
City /State /ZIP: 19ah0 0 k 9 a a 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
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
DESCRIPTION OF WORK work indicated on this application. J
Valuation: $ app -7g 17
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: A T—ii_ Type of construction:
Address: Occupancy groups:
City /State /ZIP: 44-62 Z26 / /4 Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT c , ❑ CONTACT PERSON NOTICE
Business name: :J rsi.1 C�.t_C. rov% t;GS "c. All contractors and subcontractors are required to be
Contact name: Q(, - (��� � licensed with the Oregon Cbnstruction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: B75 W; (•,Strn St / u e- jurisdiction in which work is being performed. If the
c � — applicant is exempt from licensing, the following reasons
City /State /ZIP:
�.C.� C„e_ / 0 (L QZt{•OZ apply:
Phone: (54( ) 421 + — 90?$ Fax:: (vi ( ) 30z_g4, 02.
E- mail: Ct,,l.ldn CD ol.tJerS• 6(icd aim-to-mad r (LS
CONTRACTOR
Business name: "•f JP.I tbti p ....14.e...,41Arv 1 ay .,G *
BUILDING PERMIT FEES
Address: g15 („L)' Lsev. S•t (-r1 r€ C.
c L. Please refer to fee schedule.
City/State /ZIP: C�Ll�i1e / 01 9-7(4.0 a Fees due upon application
Phone: 6L{ 1) L( pm._ Cio 7 e Fax: ($t(( ) 3oz- q � 4Z Amount received
CCB lie.: ( L�.Lk SS /45/6 8
Date received:
Authorized signature: c2 / 7 1/611�.� �(L,(�) � This permit application expires if a permit is not obtained
(�- L(/ /f'� within 180 days after it has been accepted as complete.
Print name: alifin t W OOS Date: L.t /Z3/2.co5 • Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Permits \FPS - PermitApp.doc 12/03 440- 4613T(II /02/COM/WEB)
CITY OF TIGARD - 4)
BUILDING DIVISION PERMIT #0 = 006 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
itttIll Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /� . /� Q g I � 1 ete-4,( CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: /] Q
DESCRIPTION:
Ct2 — 62 -CMG'
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -IS- - D 0 8.'0
Code # Inspection Description Confir - Con act # Message
4
Corrections /Comments /Instructions: 5 3 g
1, A jv
gh, ., ...1 - wl i
rii .;4 - yin
r PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F•R INSPECTION ❑ ADDITIONAL FEES ASSESSED
j 064A v ,
Inspector: Mara Date: . 1 e, Phone #: (503) 718 - Z-t��
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CITY OFTIGARD 8u P
BUILDING DIVISION PERMIT #: o idos - _ 60 6 I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �i j �j
Inspection Requests (24 Hrs.): (503) 639 -4175 'IL.
INSPECTION WORKSHEET FOR DATE: TIME: __ PAGE:
SITE ADDRESS: (Z 0 FO at,it CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3-- 7 -0 , • . / l/ - 3 0
Code # Inspection Description r Confirm # Contact # Message
g ii2.4Aini g-uricS _cyf - zgs g
Corrections /Comme nstructions:
5;:1 c 4 LOW : _ 7 .
-.- Oe_ip TO - 1 - F - 1 - . ft-OT-0)7V1/(Pee-)
licOb -
, . r f QS .- - 70 l' ___6.12._
To c
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL I. . ALL FO' NSPECTION ❑ ADDITIO . AL FEES ASSESSED
Oaf p 7 ®� c ) Ins ector: Date: Phone #: 503 718- 4242Z3