Permit •
-- BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2002 -00059
;alit DEVELOPMENT SERVICES
o
SERV IICES 639 -4171 DATE ISSUED: 6/11/02
- 13125 SW
SITE ADDRESS: 08770 SW SCOFFINS ST PARCEL: 2S102AA -02800
SUBDIVISION: TIGARD HIGHWAY TRACTS ZONING: CBD
BLOCK: LOT: 026 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: I�0 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: 0.00 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 : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 32,541.60
Remarks: 12,516 SQFT Fire Sprinklers Addition
Owner: Contractor:
TUALATIN VALLEY MENTAL HEALTH AMERICAN SPRINKLERS INC
8770 SW SCOFFINS RD 10818 NW ST HELENS HWY
TIGARD, OR 97223 PORTLAND, OR 97231
Phone: Phone:
Reg #: uc 64890
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
5PCT CTR 2/20/02 $16.52 27200200000 Sprinkler Rough -In
PRMT CTR 2/20/02 $206.50 27200200000 Sprinkler Rough -In
Sprinkler Final
FIRE CTR 2/20/02 $82.60 27200200000 Sprinkler Final
5PCT CTR 6/11/02 $10.94 27200200000
(additional fees not listed here)
Total $508.08
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 -81 a 332 -2344.
Perm ittee '� !
Signature: . _�� ,/ /�
1 ,_ ......
Issued By: 1 / i -.../ _ //. . Nib
Call 639 -4175 by 7 p.m. for an inspection the next business day
01/29/2002 13:19 FAX 50 35981960
CITY OF TI 7 / G,
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..7. .�,_ Cit of d ;- eermiran.: p
aver Address: 13125 SW Hall Blvd, Pro orappl.na: P ,41; .. - 64 J
Vie: (S03) 6394171 � 0� �cpite
Pam (sacs) 598-1960 �Y OF '1iCiAIiD Due a s no.:
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Land use appr DIV ��` Pay�ttype: •
1&2 family:
Simple ample:: ! N
family f\ PE Of. PI 121111
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01 &2 aamssoty
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0 AddilioNaloaationheplaoement p Tenant Commercial/industrial 0
Fl sprinkler/alarm 0 New o Other ypn 0 olifloa
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n spafdedalarttr Off
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Yoh address
.1011 SITE I N IT/ I1 N I A �I 10 \ ' iiiii Lot subdivision Suite no.:
' • 'ect name: • Tax , • iCOOUat era:
locatio„�of work on puueisespj bona: a n — .. J
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OR MIA .11_ i oioi:\T1f \ I:s (11LC kit f
IMIIMINIPEIM MIW I talliaill (FIuo (A it, .
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` ZIP: . I & 2 family l •.. .
Phone: � Valuation of " .,,.,� b g .6
B�rail: ...
Owaei"s Na of • . _,, • .
. Phone: , Total urrmber of floors ... ....., ... .
// r 1 L I �. - f New dwrWag ana (sq. R.) .....4... ....... - .......
.F I . .t ,� area (sq.1L) • ............
addce.5s: C overed porch area (sq. ft.) .._.........,
�� .� Deck area (sq. tt) ...... .................._...__
Phone.: P E '?- ZIP: - ? other �e�s a zea ' ..
z • . — �: - --
CO \'11i Olt �'
Business Vahatclon of work.- ___.- ._.... -,.- � '
usiness mare' - -... L..0 ;-- w - � S area (sq. R) _ 3
Address: ....- .- ............
. New bldg. area (sq. R) - .........- _............
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Phone: State ZIP: Number of a> •- -^- .•-.•-- •-- .............e....
City/mete, lie. era: �°pp(ax E'u
I t I I I I . . ' I ► c, I t , I I t Modem All ammo= and suboonhnecoes are fired to be
Names licensed with the Oregon Cambodian COMMONS Board under
provisions of ORS . 701 and may be required to be licensed in the
Comer person: ZIP:
j lice applicant is
Plan no.:
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L \4r \1.1 It
' Name:
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Address: Ca • - .• Pees due upon application - ....... .„ • —. $ /� � . 96 •
a . Date eeoelvod:
s ty z� • Phone: • Amount recei ed W..uuu..W.u.......0 WMM.
Pal. PLUM refer to tee scheduler
I hereby mai& I have read and esuunined this boa and the ma
anacbedmet Ofyawssadaldoee 01441 a�..e,ws�w�4ul.e erw�mam
week will bo complied g thi o iNea' ' p. —
d herein or oat. Qrnfs eve me , • Dare+L- f/ ate,
Print aamele -- e w a •
Maim: This Pmt appllmtioa empires if a permit is eat whhin ISO days idler it has hem ec pted co computer. a n
. 440:011 01010260
01/29/2002 13:19 FAX 5035981900
CITY OF TIC,ARD
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Fire Protection Permit Check List
A. a New • Addition • Alte . , •
B.) Modification to sprinkler heads only: n CI Re •air
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review
required.
•
Number of sprinkler heads: 3 yr
Additional description of work:
•
•;71 b ,.,. =,q. -r' L' ,��'
• Stand••• �s D
Additional Hazard Orou •
Information Dens'
Desi , n Area c0
K. Factor
B. T • - I - Hood Fire Su • • cession S tern
Hood Pro ect Valuation $
Submittal shall Batte Calculations i
include: Individual Component Yes O
Cut Sheets
Fire Alarm P • _ t Valuation: $
ro
Permit fee based on valuation see
8% State Surcha • e: Eallilltrezumm
FLS Plan Review 40% of Permit: • - o
TOTAL: .
Plan review requires a completed application and 3 sets of plans at submittal.
Plan review fees are required at submittal.
New' fire proteotion.systems require that plans bear the original seal of an Oregon
,:.
licensed firie, suppression engin r, or NICET
. , .;. . _ . _ • ... •: -- ... ®e level . :3 1 ' tedinicrans.. . •,
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Req ested ( AM PM BUP ��a - 660 57
Location 8 7 - 16 1 � Suite 'NEC
Contact Person Ph ( ) PLM
Contractor --�, Ph ( ) SWR
BUILDING Tenant/Owner / ,/ - TYLP/j2 ELC
Footing
Foundation ELC
Ft Drain Access: � G ELR
Crawl Drain S /T�DO /- 0DOO � li f- P���-�
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
yl �
101SDIM RT FAIL
•inr= G %
Post & Beam ,
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole /
Storm Drain
Shower Pan
Other:
Final
PASS PART F L
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL -
ELECTRICAL
Service
Rough -In
UG/Slab
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 i/� Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL