Permit y
N. BUILDING PERMIT
CITY OF T
PERMIT #: BUP2004 -00489
_Vjy;� DEVELOPMENT SERVICES DATE ISSUED: 10/8/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112DC -00500
SITE ADDRESS: 15883 SW 72ND AVE BLDG -B
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
BLOCK: LOT: 040 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: 5N . 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: $ 1,294.00
Remarks: Relocate (5) fire sprinkler heads and add (1) new.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: .
Phone: 620 -4020
Reg #: LIC 64174
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 10/8/2004 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 10/8/2004 $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 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -001 Q.through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (5 ) 246-. or 1- 800 - 332 - _ , .
Issued 1 !ti` ` , d..d IL L
Permittee `.
Signature: ,�G� ..)
Cali 639 -4175 by 7 p.m. for an inspection the next business day
Buildinti Permit Application FOR OFFICE USE ONLY
City of Tigard DateBy:: i ld V et Perrot No.: f --t:19 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 A , 1) l , Date/By: Other Permit:
Inspection Line: 503.639.4175 ;.. f Date Ready /By: 1 ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified /Method: / ( Nit Supplemental lnformadon
• _ - � L l - s ) d _ ,.. _ ., a Ksu �7 xd'-.� U. � h[ _
E OF�WQIii - ♦ g D
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
�T.. 4ddition/alteration/replacement ❑Other: Indicate the value (rounded to the nearest dollar) of all
equipment, materials. labor, overhead. and the profit for the
.•Li „ v - 42;.- =v. ' z,•: ” • work indicated on this application.
:EATEGORY.QI�TONSTItUGTION. - • * �- .
❑ I- and 2- family dwelling I M '.mmercia i• dustrial Valuation: $
❑ Accessory building ❑ Multi- family _ Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
...:a. „` -
'.: ,.<z S +z' ,�NFO
1 �t _ r �`9.- ;t x : i .. r Total number of floors:
� BI . O RM +L - � ,�`. - :`�r�x S.
Job site address: / sg 8 3 M 7� 7<��. New dwelling area: square feet
��—
City/State/ZIP: � / C 7 9 - � Garage/carport area: square feet
Suite/bldgJapt. no. FL Project name: )/h , iS k q Covered porch area: . square feet
Cross street/directions to job site: ' "'� C / �' � _ ( �\J Deck area: square feet
Other structure area: square feet
Subdivision: I Lot no.: Permit fees' are based on the value of the work performed.
Tax map/parcel no.: Indicate the value (rounded to the nearest dollar) of all
'y10�' equipment, materials, labor, overhead, and the profit for the
�: <; i., t "k.1� V y , ' ry `�_ . ` work indicated on this application
r^ _ - S Valuation: $ / ' f
/ ` Existing building area: square feet
New building area: square feet .
' +... EbR't'*¢ ` r +y , Number of stories:
c
Name: - v a.0 s c 7 L- / f c( Type of construction:
Address: / J On S IJ I V Occupancy groups:
City/State/ZIP: `. A A �R 4 r/� Existing:
L `
Phone: ( ) Fax: ( )
.;_ .. ., 4 �,,.1** , .f : .. .... N, BY New:
"it. !
ly r ' _ .G _ i l..t'- .Vi� ' r AP1ZUC NT = -<<= r �l' �:f, i :; .. �7 [�(���st�' / gyp p O f e:ti t '' • l.wca <:_ t
' i ��'i y ; 0'I. .7 T^' F gyp," $,�� } MW��
Business name: �•'Y•'. w t ,.. ....,. � ,,°:.=-•.• . _ � . . � w� 'n� „Sd:w k'4 +�fAi.twx
- / : All contractors and subcontractors are required to be
` y ^ Contact name: i 4 licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: / 5 ) r a. jurisdiction in which work is being performed. If the
City/State/ZIP: ,:r. r>� J �� � ��0 T ppicant is exempt from licensing, the following reasons
apply:
Phone:gi 5 o - (1C.6 Fax: : ( C9� � /off
E -mail: co �GJ 66
.. .._.. .- .. ,'...... -'',.1 _ .. _ ., `�. • e.•-. r r�' �- r.r -:A� _k.:, ✓.. :!`�•..t - ; t "' }: .
Business name ei____.?C. ITC/.. _ ..61".i -'S :'. 9:2' igittt ��lie.. ,; .,-+» : , k ba r .
/ 7 9 S SGJ . >_
Address: e
/StateiZlP a
Please refer to fee schedule
Cit
y (� / �2 ' Fees due upon application G:5-7•• •• .C 2—
Phone: ( ) Fax: ( )
CCB lic.: (i % 7 Amount received •
` Date received:
Authorized signature 771 / This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: / ,, 6 l Date: a r I • Fee methodology set by Tri-County Building Industry
Service Board.
inBuilding■Penmu,BUP- PernutApp doe 11/03 440- $611T(11 /02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST p
BUPROC. —06 Received Date Requested � 1 `_ / d AM PM BUP
v
Location 1 s O �3 �a� �� L) Suite MEC
Contact Person � _ Ph ( ) G a- 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner E VZ4 7 ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
ire Sprink er
Fire Alarm
Susp'd Ceiling a± L_�
Roof
■ MIN ��
,di . f _ •
F
PASS PART FAIL
•LUG =ING
• . & 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 E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please ca or rei pection RE: Unable to inspect — no access
Fire Supply Line -
- ' ,
ADA
Approach/Sidewalk Date ���� ` Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL