Permit R
�,r CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00462
*Atli DEVELOPMENT SERVICES DATE ISSUED: 10/22/02
- 13125 SW Hall Blvd.. Tigard, O R 97223 (503) 639 -4171
SITE ADDRESS: 09635 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: WASHINGTON SQUARE 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: M 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: $ 1,990.00
Remarks: Modification of 10 fire sprinkler heads.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC FIRE SYSTEMS WEST INC
P.O.BOX 21545 600 SE MARITIME AVE #300
SEATTLE, WA 98111 VANCOUVER, WA 98661
Phone: 360- 693 -9906
Phone: 360- 693 -9906
Reg #: LIC 49732
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 10/22/02 $62.50 Sprinkler Final
[TAX] 8% State Tax 10/22/02 $5.00
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 fo low the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 10 throug OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin (503) 246 -6699 0 1- 800 - 332 -2344.
e
Issue y: ' kk it. • 6. d: 1 4
Pe rm ittee
Signature: X ---"---i"- Cro../2-- .
Call 639 -4175 by 7 p.m. for an inspection the next business day
t
Building Permit Application .
A _,--
. Date received: /O1, 9-/O- Permit no.: 4.42 -
11+� a ti ii �i City of Tigard
- Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE -OF PERMIT
0 1 & 2 family dwelling or accessory 12 Commercial/industrial 0 Multi-family 0 New construction 0 Demolition
1 • Addition/alteration/replacement A Tenant improvement Ait Fire sprinkler /alarm 0 Other.
JOB SITE INFORMATION
Job address: 7 g S ,. t „, As ji l NA, f—ty..( SO • I A?.{:. `��� Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: Tax map /tax lot/account no.:
Project name: S c i w Al'
Description and location of work on premises/special conditions: A171) R id / 7 7 _4 -i s- PR 1'uK LGti
It-fo /L/ ! #17u /l) at /' hie4
OWNER FOR SP ECIAL INFORMATION, USE CHECKLIST
Name .7AYa CAN!'1 I-J6L -/-. Cam/ ST17 (Floodplain,septic capacity, solar, etc.)
Mailing address: l'. --- t=%=• , -,e I, 1 4S 1 & 2 family dwelling:
City: C.Ar.CP StteOR- I ZIP:c("7107 Valuation of work - $
Phone:T* /< ,4j oil Fax: E-mail: I No. of bedrooms/baths
Owner's representative: IPPI\IX Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: t t J T Covered porch area (sq. ft.)
r ¢� ����� � D eck area (s
Mailing address: (,oc Se tN►ARtT3hil-' 14Yv � (sq. ft.)
City: VAnle) Livery— I Statet,./w I ZIP: 9$6G / Other structure area (sq. ft.)
Phones. G 97- 990 6 Fax: E -mail: Commerciallindustrial/multi- family: p F
CONTRACTOR Valuation of work $
Business name: s i.../15 Existing bldg. area (sq. ft )
f t I�-t. SYiT�"r S New bldg. area (sq. ft.)
Address:
City: State: I ZIP:
Number of stories
Phone: I Fax: I E-mail: Type of construction
Occupancy group(s): Existing: 42# .,t/901
CCB no.: Al 731_ New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI IITE(T /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: '-pc\Z 1a Ir-Lf1 l 1 •.J C, provisions of ORS 701 and may be required to be licensed in the
Address: 34 /,J , I S i Pr/ s $ U ri 7i Z�� jurisdiction where work is being performed. If the applicant is
City: QZed∎Sp I State: eR-- I ZIP: 9 7• 9 exempt from licensing, the following reason applies:
Contact person: G L K Plan no.:
Phone5ti 2,2.. , "ax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdicdom accept credit cards. please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
■_ work will be complied with, whether specified herein or not. Credit card number: pyre
Authorized signature"... -- pw•rf / Date:/e5 • / S L Name of cardholder as shown on credit card $
Print name: __) A5=, SA/YiQ5 h! 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 (6/00/COM)
CITY OF TIGARD 24 -Hour
3UILDiNG Inspection Line: (503) 639 -4175 di-m---ii-
INSPEatION DIVISION Business Line: (503) 639 -4171 •
Received Date Requested ��'' / 7 AM PM / / UP
Location 0 635'5 w GJ05L- Sg. Suite C" s MEC
Contact Person C su 6 to 4 W c - A -5", • Ph (36' 0 ) 6 3 -1
PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ---M ) SIT
Post & Beam
Shear Anchors / 3 . -
Ext Sheath/Shear -en- •
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall r
(
ire Sprinkle � /, in ``
Fire Alarm 2 ? V___, r
Susp'd Ceiling
Roof
•. -•
i PART FAIL
• LUMBING
• • - : 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
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 El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA 1�j ^ \
Approach/Sidewalk Date `� ` / Inspector Y Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL