Permit . ?. ,
-F- , BUILDING PERMIT
CIT OF TIGARD PERMIT #: BUP2001 -00057
r, DEVELOPMENT SERVICES DATE ISSUED: 2/21/01
- � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12615 SW 72ND AVE PARCEL: 2S101AC -01900
SUBDIVISION: LOWE'S HIW, INC ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: , t 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: 0.00 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: I ll 1 L _s - Dv
Remarks: Watertlow alarm.
Owner: Contractor:
LOWE'S HIW, INC
HWY 268 EAST
NORTH WILKESBORO, NC 28659
Phone: Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Fire Alarm Insp
PRMT CTR 2/8/01 $121.75 27200100000 Final Inspection
PRM2 CTR 2/16/01 $65.55 27200100000
5PCT CTR 2/16/01 $14.98 27200100000
FIRE CTR 2/16/01 $74.92 27200100000
Total $277.20
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 -1987.
Pennitee AA�, _
Signature: ���� ��
Issued By: <
Call 639 -4175 by 7 p.m. for an inspection the next business day
Sent by: CHRISTENSON ELECTRIC 5032056721; 02/16/01 3:29PM; JetFox #513;Page 1/2
X . E . S. PAGE 04
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A Building Permit Application
Date received: Permitno.:
city of Tigard
Project/appl. no Expire date:
City Address: 13125 SW Hall Blvd, Tigard, OR 97223 . fT
• Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: 598 -1960 • ' Case file no Payment
Land use approval: 1&2 family: Simple Complex:
•
1 OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration/replacement . - 0 Tenant improvement 1 '0 Fire sprinkler/alaist 0 Other.
• JOB SITE INFORMATION
Job address: Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.:
Project name: •
Description and location of work on premises/special conditions: - -
•
O11'NER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floor) plain, 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: 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: Commerciall ndusMal//malti- family:
•
CON7 ItACTOIt Valuation of work $
Business name: Existing bldg. area (sq. ft.)
New bldg. area (sq. ft)
Address:
City: State: �p Number of stories
Type of construction
Phone: Fax: E -mail:
Occupancy group(s): Existing.
CCB no.: New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITE1T /1ESIGNF.R 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: ap 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 $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not an judo:fictiam accept aedit cat+, please can jurisfixxion for more information.
attached checklist. All provisions of laws and ordinances governing this o visa o MasterCard
work will be complied with, whether specified herein or not credit card number.
Expires
Authorized signature: Date: Name of cardholder m shown on credit card
$
Print name:
Cardholder daoacme Amami
Notice: `This permit application expires ifa permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6R06/COM)
•
I d
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 f `Cbmplete A or B` as_Japplicable): • Y.
y
A) Sprinkler . Wet ❑ Dry ❑
Standpipes
•
Additional Hazard Group --
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
• B.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
i:1dsts%formsTPScheddistdoc 10/04/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP 6r91 --- 54
r IW P Date Requested 14 AM PM BLD
Location / o(o1S - SW 1 Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear l �
Framing I V??
Insulation l ,,gym 2I PuL ' /_Q - /S 0
l ai/�'�'' I, �qTl 41/
I
Fire Sprinkler f ('�F >�'Y.
Fire Alarm
Susp'd Ceiling
Roof
Mi
PART FAIL
• BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ 1 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ I Please call for reinspection RE: [ J Unable to inspect - no access
Fire Supply Line
ADA
A /Sidewalk 6./
Other Date Inspector � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
SETTING THE STANDARD FOR SERVICE EXCELLENCE
Facsimile
441 l
To: Curt Bibb
Company: Vector Security
Phone:
Fax: 703 - 369 -6079
From: Robert Poskin, CET, CBO, Senior Plans Examiner
Company: City of Tigard
Phone: (503) 639 -4171 X 392
Fax: (503) 684-7297
Date: 01/16/01
Pages including this page: 1
COMMENTS:
Fill out the submitted application and return to this writer
City of Tigard, 13125 SW Hall Blvd., Tigard, OR 97223
** PLEASE DELIVER THIS FAX IMMEDIATELY **