Permit irr CITY OF TI BUILDING PERMIT
PERMIT #: BUP2004 -00370
DEVELOPMENT SERVICES DATE ISSUED: 8/3/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 350 PARCEL: 1S1266C -01506
SUBDIVISION: ZONING: C -G
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: : sf N: S: E: W:
OCCUPANCY GRP: B 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: $ 250.00
Remarks: Alter 2 sprinkler heads.
Owner: Contractor:
WYSE INVESTMENT SERVICES CO. AFP SYSTEMS INC
111 SW 5TH AVE. STE. 1100 19435 SW 129TH
PORTLAND, OR 97204 TUALATIN, OR 97062
Phone: 503 - 294 -0400
Phone: FAX- 692 -1186
Reg #: MEF692- 9
FEES LIC REQUIR INSPECTIONS
Description Date Amount Sprinkler Rough -In
[TAX] 8% State Surchaq 8/3/2004 $5.00 Sprinkler Final
[BUILD] Permit Fee 8/3/2004 $62.50
Total $67.50
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-se : - - • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
call' • (503) 246 -669• •r 1- 800 - 332 -2344.
/ /
sued By: i
Per ' --
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
AUG - '2:56PM FROM- Automatic Fire Protection 5036921186 T -865 P.003 /010 F -182
melding Permit•.A.pplication
AI, „ Da<ereceived: 5 11 04 tv Permit no.: % 1 / ..d(} 370
City of Tigard . Project/appl, no.: Expire date:
City of Tigard Address: 13125 SW Hall f k i ti •., -4 Ri m
Phone: (503) 639 -4171 Date issued: By Receipt no_:
i Fax: (503) 598 -1960 AUG 0 2 2004_ Case file no.: Payment Type:
Land use approval: 1 &2 family: Simple Complex
GI TY OF TIG; ; •
1 OF I'LRMIT
Cl 1 & 2 f. ' d elling or accessory 17 Commerce 'industrial ' ❑ ulti- family ❑ New construction ❑ Demolition
9S.Additio . • teratio placement a; Tenant improvement ire s rinklcr arm CI Other.
JOB SITE INFORMATION
Job address: c 1(NZQ 4a-s4,,..)(, i bia. a. Bldg. no.: Suite no.: M
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: S G - . _ _
Description and location of work on premises/special conditions: "1”: - Ilk • e. e► • — let."11 - -
I '• a MEMMEW
OWNER FOR SPECIAL IN7:ORMIATION, USE CHECKLIST
(Floodplain, septic c ip :4city. solar, etc.)
Mailing address: It t .<'ri L i E. .1.c. t i oo 1& 2 family dwelling:
City: .Cr' � ; - r: State: p‘ 'ZIP: ctriZot4 Valuation of work $ -
Phone: L C Fax: I E -mail: No. of bedrooms/baths. .. ,
Owner's representative: yfl,,1C\ 4.\Ikt.-4‘E5 Total number of floors
Phone: . Fax: E-mail: New dwelling area (sq. ft)
APPLICANT Garage carport area (sq. ft.)
Name: 1 a �x Covered porch area (sq. ft.)
Mailing address: t • I Deck area (sq. fr.)
City: 'T , . State: 6t ZIP:' 10(4 0th • ,• cure area (s .. ft)
Phone: St1S - (o Z • .a Fax: (a47• : B-reall: r i J " dustriallmult5 family:
CON URACTOR Valuation of work $ 72
Existing bldg. area (sq. ft.) '49i)Z.
Business name: r t t QC_ _ - New bldg. area (sq. ft) --
Address: �C 43S ��a1 fit= Number of stories S -
tate:ISt Z P :91Na
ry Type of construction ......... _.___ "T iZ
r
Phone: c2 .92N, Fax: OZ. 1( . E -mail:
CCB no_: �n1
Occupancy group(s): ` is Existing:
New:
City/metro lie_ no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: Z , N.' 1 a LV0, Zt T provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed- If the applicant is
City: (°� • aC re - exempt from licensing, the following reason applies:
City: a, I Stare: I ZIP: 9 cl
Contact person: Plan no.:
Phone: 583 n Fax: E - mail:
ENGINEER
Name: — Contact person: Fees due upon application $ (DI . SC
Address: Date received:
City: IState; JZIP: Amount received $
Phone: . 'Fax: IE -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not nil jurisdictions accept eadic catde, please col[ jurisdiction for more information.
attached checklist. All tovisions • f laws and ordinances governing this ❑ visa cl MasterCard
work will be complied r whe) , r specified herein or not credit card =be s C
xoi
Authorized signature. a 41 Dare: S-Z- S Name or eacdbolaer as silo= cal treat taro
$
�� _
Print name: V \�, i�n1 L�D►J Cadholder signature AMOS= .,
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 444.4613 (elootcoM)
CITY OF TIGARD 24 -Hour
BL,'ING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP�&_ Q� ?
Received Date Requested b AM PM BUP
Location 9 Z - 1 4 j / 56? Suites 3S MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) D�a 9a1 R SWR
- BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
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 (1k-L,
Ro•f '
- ASS PART FAIL
P = 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 dirdr
Rough In � . ` it i /I i iii iV/
Low Voltage � •
Fire Alarm -
Final 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: 0 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