Permit •
1
BUILDING PERMIT
CITY TIGARD PERMIT #: BUP2002 -00553
*491/A DEVELOPMENT r SERVICES O ) 639 -4171 DATE ISSUED: 1/9/03
SITE ADDRESS: 12442 S W SCHOLLS FERRY RD * * ** PARCEL: 1S1346C -00401
SUBDIVISION: ZONING: C -N
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: UNK : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 1,500.00
Remarks: Addition to fire alarm.
Owner: Contractor: .
SISTERS OF PROVIDENCE IN OR ACTION TECHNOLOGY SYSTEMS
BY STEVE FOSTER DBA TELEPHONE & ALARM SUPPLY
PO BOX 13993 835 SE 17TH AVE
PORTLAND, OR 97213 PORTLAND, OR 97214 -2630
Phone:
Phone: 503 - 231 -1992
Reg #: MET 7 2 0 8 00 3 02909
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Fire Alarm lnsp
[FLS] FLS Phi Rv 12/27/02 $25.00 Final Inspection
[BUILD] Permit Fee 12/27/02 $62.50
[TAX] 8% State Tax 12/27/02 $5.00
Total $92.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 00a- 0ff1 OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin (503) 246 -66 • or 1- 800 - 332 -2344.
. 4 _ /� �i J
Permittee
Issue By: `/,; _, z A ♦ L ./
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S I L
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Call 639 -4175 by 7 p.m. for an inspection the next business day
, .
. A Building Permit Application
' 1VED Date received: /2/27 v?�Permitngt{,(P.2 - Q Q,s$t3
- City of Tiga t ECt
X1,1 __ Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard O 223 — -
Phone: (503) 639 - 4171 DEC 2''1 Date issued: By: 25,17tReceipt no.:
Fax: (503) 598 -1960 ■ CITY OF TIGARD Case file no.: Payment type:
Land use approval: BUll DING DIVISIO l &2 family: Simple Complex:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O New construction ❑ Demolition
O Addition /alteration/replacement g1'enant improvement Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: l 24' 2 l.to _ _ r - #Yt42. .vcttio Bldg. no.: Suite no.: /o / E'.20
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: IL • .� AL-t-, lia.-4.- 4. • 1 4 2
Description and location of work on premises/special conditions: Pc-f,/, TO Pte+— Pr 1.."4.4* '
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -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: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerclal/industriaUmulti- family:
CONTRACTOR Valuation of work $ ' S00 , 07)
Existing bldg. area (sq. ft.)
Business name: ► `„. 7 _ „If W '.., s1?r 4
Address: 35 -sir- i -vre, New bldg. area (sq. ft.)
ESP NI •� _ Statep� ZIP: oj�12 i it Number of stories
Phone: 231 —i 12_ f OS►! E -mail:
Type of construction
CCB no.: t '3 Occupancy group(s): Existing:
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHIT CT7UESIGNER 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: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $ 9.2 • SO
Phone: Fax: 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 infomauion.
attached checklist. All provisions of laws and ordinances governing this o Visa o MasterCard
work will be comply , whether r" ified herein or not. Credit card number: /Expires
Authorized signature: e• IA- i' . Date: a- Name of cardholder as shown on credit card
$
Print name: - L _,_ 4 • •;" WC 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 (6I00/COM)
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 or B as applicable):
A.) Sprinkler Wet ❑ Dry LI
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Fire Alarm i vow tITP s cam- rte � w►v.- s-r .
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $ I , o' pO
Project Valuation Subtotal (A & B): $ G , 5
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $ , r )
TOTAL: $
•
is \dsts \forms \FPSchecklist.doc 10/04/00
CITY OF TIGARD 24 -Hour _ - , -
BUILDING Inspection=L i re: 0003) 639 -4175
a),
INSPECTION DIVISION Business Line: (503 • . • • 1 MST
BUP - _ d SS
Received f Date Requested g-- g-- ' M 1 l • I, BUP
Location / 2 /`' 7 -- / / /- X Suite MEC
Contact Person Ph ( ) a' 3 l — / ff PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner i � i1 L .�-' / . _-.„;L., ELC
Footing
Foundation ELC
Access: l » , 1 / 6e#4 j„�s?� / )064,_ ELR
Ftg Drain �p lS- G
Crawl Drain
Slab Inspection Not e sB O I — _ O SIT
`J •
Post & Beam I
Shear Anchors ) •
Ext Sheath/Shear al Vy
• Z(Z 6 s V-
Int Sheath/Shear /� � ,(L < a
Framing / / a-r e
Insulation WI / P6 T /
Drywall Nailing D �� �p • Q S �"'-
Firewall V 7 .)-7 (� ? . 0 ? e-7
Fire Se • kler v
Susp'd Ceiling
Roof C\1' a � /
r �� ..
Other
7
n I
PASS RT FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service ,fii ifr. s i.
Sanitary Sewer
Rain Drains •
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
1
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line , „ ,
ADA �' ( / 3 'IV/( t
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL