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Permit A BUILDING PERMIT CITY TIGARD PERMIT #: BUP2004 -00104 DEVELOPMENT SERVICES DATE ISSUED: 3/18/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S114A0 01500 SITE ADDRESS: 17005 SW 92ND AVENUE SUBDIVISION: ZONING: R - 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: 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: $ 1,500.00 Remarks: Fire suppression system for Type I hood. Owner: Contractor: TIGARD, CITY OF SANDERSON SAFETY SUPPLY CO. 13125 SW HALL 1101 SE 3RD AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: Phone: 238 -5700 Reg #: LIC 64969 FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Final [BUILD] Permit Fee 3/18/04 $62.50 [TAX] 8% State Surchart 3/18/04 $5.00 [FLS] FLS Pln Rv 3/18/04 $25.00 Total $92.50 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- 0010irough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by callin 3) 246 -66 •r 1 -800- 332 -2344. • Iss d By: . , - "--H Pe rm ittee Signature:, Call 639 -4175 by 7 p.m. for an inspection the next business day 03/10/04 WED 10:38 FAX 503 718 2401 CITY OF TIGARD PW ANNEX Z '-2 Fire Protpct'ion System ' Building Permit ft@r ffl E i lli ED _ TOR OFFIC USL OIVi Y T • City of Tigard 1 2001, fieetivcd �'� �� �rit Na.: nn 13125 SW Hall Blvd., Tigard, OR 97 4 Dste/B : / /�0 u /��i — /D� Phone: 503.639.4171 Fax: 503.598..6 �_ , DatelDy: Plan 1Zevic - /i-otj P. t j Other Permit: Inspection Line:; 503.639.4175 CIT OF T piV IGARD �� j 41I i< � � Date Ready /13y: AV.: '•: I1 See Page 2 fur Internet: www.ci.tigard.or.us BUILDIN ISION I N o till edJNletl!ud: // (� Sup plealenlal Inform:ltlon G ;.'1 ill .l l >Y, �. �� �'� '.1 i �' 1 1 'f' L '1 111' .W: I +111.1., ,`. I. iLtl� '::J k'•i • , Y.1'. I'! , , _.. r'� _. I ..I ' + _lh!.'; li'I � 1 II " 1:1:11 r l l� .�i,I f I Y�E" ...d! .'H' ; . IG';I It ;'e�...1..4i< 4 n.�1 , r I n � L r ', �. ca� x, ,,11 r r,i5'.' J '1. 1;,I I'I �. ■ l i. ,. , '� „�', G�h. p' :, i:'I° .,u., j5;; . a. '4 ; rz: *;.! r. 11: �:.'.., I .'i• lr. 3a } I L.rv'n:, :. ryl .,:a atn: r,...l,. , {I,. 1 : 7 1' i� I Ja,.I.., , rl °jj,,�'' .l 7 - ' u : r ICI I, „i<_. :,:l li t :arl �Cl: �eh ,: -.t + , r l:• v ..', '• {,� :i IL I :• str4 S ,�''....!.:0,.frigt v 4,,„ i , j t, , . i; :•,1„!: '•r.., , . a l l ,. 'A.'� .I. r ,. rfli .1 .1. o . n. III f.. 11, 1 _._ �.. 1 . �F�l., n �� ��11�1�1hll. llll�hll: ':!Lir,:S: �a.�r.7, ?,:. .r, pp. la: >I,'�, ,:.ln'1,a t?'S. :I ;.:1.,,:.':.:,,, ��{� 1, ,,f�a� . �'�' ?.rt��r' LLs�. ; "' I �:Illntt : _p4 .X!Li_� ...r.. b0+�.. ,�., �f;,!,i; .._. '"C1 �':�:,. ;I' .: ���I::: _.�... � ,:'.',I ::.iy'll.l!:.r. :f��S.'Pi'�i . .,: •,.; I ' 1cw construction 1 ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of :!il LI Addition /altcration/replacemeat I ❑ Other: equipment, materials labor, overhead, and the profit for the t:i mkt, :,l'jii ^r';'Sa:PyGli:lii)SU -,li yC,'upc'all ' II�C. Ir., .r "iNNP .UCgn il',�',anp4.r':r;.;,ol. ^t;1:5 15'l'tifi: ". ' ,YI, .,;� .:.; ,.�e..r Q: I 'I( I l+ : - : I' l l ,l >. ,lii6'4k r ,i j4 lli, t..I., r1 sit dll''klrt 11 ,� M, won indicated on this application. t ,10,..,. , E11��,i �dll��i Ji ' 1, i f0..4. ` 1. ; +, + r:.. :z Ar ?t1.., '' ∎, A ?i r4 Ps r.q. *.tr At !! U . 4. 1. ' k. ;,Pp!. n t lt.r a.. I I vl nJ0 I•rW+11�.Py ll)'8 !` I I�, 1� +dCG= .,I:`..`� ThI,e,c.:. �L".1'r. l7�le�l� �. �h 1 -and 2 -famil dwellin Valuation: $ - ❑ y g ❑ Commercial /industrial _ Accessory building Number of bedrooms: 1 CI • t3 8 ❑ Multi-family ...,_ -1 ❑ Master builder ❑ Other: Number of bathrooms: ,.a ] II'b`;t''':;Jlnt:' ie I, h r to,h' I:ra � �l: >rl:. tY.,�n'Ik =.• ! r' '- �j �� III "I'4d0' '4 r N51t Total number of floors: +• l it , f i r .'li it Sl "� .1 ,1 j`�? ', 1 I t' J� Y'irB' !lq�i.;: ;! l�I g ; ��l iii lTt�'Ill �,.i;� l',,.: tl d1f '�l' - AuAiA,a , ►}L, Gt ; .16t. ;�,�'wi I+.' �i �' . . 1.. „ ,� ,all..hl @Ifl9rR f�I, I+ ?' d� ':::.:,,::,rl ,.,I.als1 �1i1'r:an:Pl',Ih'Id . Job site address: /30 0 S 03 32 S 40 e. , New dwelling area: square feet -- City/Slaw/ZIP: T -- A - a_ L f OIL, - 4)72_2-3 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: C P la. o -k. ,nLeS$fa,,.., Covered porch area: square feet Cross street/directions to job site: Deck area: square fret — Other structure area: square feet i f' • ll, rlae." 4-, F' isl7' t° S`:',' i7cI115��r�DiP. 1:' HItI' il''. rTi7gIR^. �1'; r:: nc! n ._,,t_,:`1�Ezf;F1"i�b}{Z'�`„Ix' '�l Subdivision: Lot uo_: Permit fees" arc based on the value the work perfur.ned. i Tax map /parcel no.: _ Indicate the value (rounded to the nearest dollar) of a't l''I !I 'I'tTl6t`, -.. ,., ... ',a::' !�I:, ' ,v .r ., t ".� . ,I:.I . : K f hu,t:l,l;a . ,: r rl I I ,; h I : , .,, r;lcs j . ,. >a .. '::r equipment, materials, labor, overhead, and the profit . the 1 6I. ,,i R ';,'.I6 ; ; s';J�I.I�h; tk,• ,I A III : y .,t._.T' . ; t „ r ,, ,. ha r I I Ill � I i,i 1 ' 1 1' Il +(I' I-p 1191'' ,hA S7!d!.1;i.kf mjull, ... III 1" 0 9 ioL E l; }, o - 1 1 6 .,.;; . `' A.1,1 "` . I 671;!: it i`ol work indicated on this application. I l I ll lt, l �la 411.. I '. f:4.:..dh411� rl, ila,'��,L..:�ud ...51.!I'�t:.u.f:,�. Yl '. I r II!a l ■ m d, il 4 l n l _ .:. L,, naf 'I ��::. � ��I�:r : ::..: c' :31:Iw�.di �krr�u: i,: �f; : �b:•.ati�b� p p — --" -57 y t 1_ Valuation: S / UQ l "--L .� ✓�!�.f Si o.J 7 (�°in r,La be; Existing building area: square feet New building area: square feet 1 • N! r l'I I; . ,t.. rn:pa. .l.u,• In I W -�an Fi•�.u:a P41 711 I h41 I+ it P, :. I . 1 iv ,.:' '�i� � � ll � ' PI � P 'ICj ' k I i'P, 1'i CI ll ; T � , :K:a:ti a:lt llrw:.� l'c r r y_ Irra � , - r ti 1 '.+,411 l i �^�I 1; ,'.I l, I Ilt� / ,.�1. dP, 1 1,pl�, I.,, ' ;l I �``'" Number of • I tItHilili. ��, .: t x ,,: t ' 991,9 � �1, 1 1 tcf 9 A, - A' : , ,ii i!,,,tu�.''. Iu:I N�_Q! ilt.' 4 - Ci ;F� ti lufaT1' f0!41111 f.1 , 1 l 1 stories: .dr D ^.+11,�6.tl.Algl��:��i41,1 � >'fIW Name: / t-i or - 4 /60 r� / . Type of construction: Address: /3 l , 5�' SC A-) J /A_ // ,Q id Occupancy Srou s: P City/State/ZEN / 77' ' 0/6 , ' 72 23 Existing: • Phone: ( t ' - - Y 17 / Fax: (,5 ) 7/8 2Za I • ! i',' I•?ifl�" �'(I; I ; (I r,u �Ir, n I. bl h 'at -"� , ,° hle1Y: I :i,�, i , ty if t�6':jt�•, 1. �� .� I .i I � ,'I "�IIe - II;� ?It " ^. '�tfr.r;rr y ,•o'ni:r, ai!,'s�rlar'sq �nw �. , ✓, r. -- . •i . S ,. . i' 11 l • . � y' Ill11 �t �� _ ,.I, I; . vglii'-CC12NI0-0„/3 � ,� ��(, I ;;c ,, r . . , ,j : ;., ;:c m l hl ; '; . ,.,, ;. 9�r`(t..1:!�n�1 ;,!'I�1�'I: I �Lr i V!. f.:i..,,, .,r� _:11. I. l`, '.r„ �$` mil! hl[IIB: 1, ,.,..'. a: ,a....1: i.:,.t�o� "ILL ..I, III „I�,l,��t�. i'!IV 61.- ,r.,,. ,,ti��,,,:,11:— ,•Ir,:a,=." - -11,,R ..p 1, .., ; ,'' 11,, l:' I 11 k :� I t•;::',.:� ;,!' :; ;!: I, . :. f': ..,,.�1'.`q...*it'Un�3 ...a 1. ull�l I ��I ll� Ill ��i .�1 t.,., . �ill' N; I•I.11:1 q yi:IY�..._I ” . i_ ; :•:4 -. r,::. Business name: C 6 AU contractors and subcontractors are required to be Contact name: 7 - - /72p/zit/ ) licensed with the Oregon Construction Contractors Bc.-cd under ORS 701 and maybe required to be licensed in i.'• c Address: jurisdiction in which work is being performed_ If the City/State/ZIP: applicant is exempt from licensing, the following rear s. s _ / --_ apply � Phone: � ) l; .. • 6 i Fax:: ( ) E - mail: - Te: r� C ( - 67/1 - -©/(.- .. 1JS � S4,1 a; �;: ,a,, °Ft!L:': ' titt,I ' u Irviinhu :111y?I' 41 t TI T :.I 1 �.tl:l Ih: 'il.rry a; � ";a • _. t:Cya. ,'I,,�; !altll ll'y lI �;:!I {: tf;! S' r . "'rv �;dl ru ":7:c'; h;� yl li r 1 ..t., 1.1 1 44 .T'I1M S— `•a',;'.i ?I . I��j 1;l u V �. .,:1 , f,' 'f: �.I � n�ly:' ��. 41h aLri�, IP" v. I, Ni�h> < ,.,. "Il,q'4•s!,1:�su;h,k:�l w., , n�Jr•_! „ : va'JVU�r�n: a!_, i htl d�l, 1 ,tl 'I 7,J• I( � l'' . .+ + Lt;iia•rIGII�,�I�Vki: aid• 6111.' 7: i •; > ; . o [ '�s:'!c'si�'ii�':i.�.':. <h! B B I � usiness name: a.1 , • .e . i ll 1 7 i ; d11 • r I'r e: •i .,_.. : , .. rl1' ..I, . II, Ir. I ..:, I sr tilij4iR.lii "'I�;l' 1?ifl'y,,G','� �:`liiiVliiki:�lis' Address: ced _ ' r »i Please refer ro fee sclute ` city /stag /ern: Ma A. q 7zi"/ 1 se/ .Phone: (� Z3 ' � I Fay: (�J 6� /�f 3' I Fees due upon application q /j / ^ l Amount received ce ,. - B lie.: 7 ('7 `7 i Date received: ____I Authorized signature: ... AO This permit application expires if a permit Is not Ober a :cd within 180 clays after it has been accepted as comp: a - . Print name: r a ,e �/ 1#4U 14 r I Date: ... 0 - 0 * l=ee methodology set by Tri County Building Industry Service Boar& f; ;:\ 3 ui 113 ir2 \Pefmit2\FPS•Permitepp.dec 17/03 4 40.46 13 l uz,comtWE6) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP J0 - / - 601 Lt Received Date Requested g - /V AM PM BUP Location / 7 ©C S _ Tr; 44 Suite MEC Contact Person _ K .C,i'"A _ Ph ( ) X RS-1 sr PLM Contractor // �� Ph ( ) SWR .BUILDING Tenant/Owner C- ek- e►-. -k P G A ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain /� Slab Inspection Notes: -� _ „ az41 p SIT Post & Beam Shear Anchors /1 ,n,, ! ' Ext Sheath/Shear C" .0 / 1 �/ /1/Y) �f�� ` y G2� Int Sheath/Shear )( 9 9 0 f t o Framing O` �� �4/ Insulation Drywall Nailing Asi . , Firewall rar = I/ IF *TM I I Eite Sprlr ( r Fire Alarm Susp'd Ceiling Roof Oth- • ari,... ' F_( ( . .--5 - 7 - . ' , _ .AS PART FAIL - ■ BING Post & Beam Under Slab Rough In ACIF Water Service Sanitary Sewer , ��� WNW 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 • /W km/ 1, n y �_ Low Voltage Fire Alarm . wA!M,�II.`�,�. ' ' Final Li 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 MIIIIIMCw AMIL 1101 S.E. 3RD AVENUE •.PORTLAND, OREGON 97214 • (503) 238 -5700 11111111.11rQPI iWM P 1V 850 CONGER • EUGENE, OREGON 97402 • (541) 683 -9333 11111111SAFETY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300 CERTIFICATION - INSTALLATION /INSPECTION Customer Name C---- 400t._ YO' CA( Address 1 - 406C - 5L c42, V' kso 06 J r SYSTEM i t } Model(s) and serial numbers 1L l d O't` Number of nozzles and Part No. 'VcA.4 1. i leoutvx J cud-rACe Number of detector(s) and degree rating 2 � Energy shut -off devices — type and size Other accessory equipment provided (pull station, electric switches, etc.) O.-11 4.+14 - \° \ • COOKING /VENTILATING EQUIPMENT r , Number of duct(s) and size L P. t G u � 14 {� • Hood size and plenum size l'�bOJ l S 1 ' t'l-{f1 fw' U_ I GA � Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those being protected.) 1 . V•-ifr 7 Y I 1- 4. 2. h1 _ I 2.9 5. 3. 6. FIRE EXTINGUISHER INSPECTION NOTE: ❑ Kitchen ❑ Facility TO BE COMPLETED BY INSTALLER b YES ❑ NO • The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER with the manufacturer's instructions, NFPA Standard 96 and 17 (current issue), and all applicable state and local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO that were observed are noted below. I understand that it is the recommendation of ANSUL Exceptions: _ and of the National Fire Protection Association Standard 96 and 17 that the fire suppression system be inspected and maintained every 6 months to ensure continued efficiency and reliability and that failure to do so may result in failure of the system to operate properly. CUSTOMER NAME AND TITLE YES ❑ NO All electrical work or work provided by others to SIGNATURE complete this system installation has been completed. DATE INSTALLER NAME ACVjt`A (L1,iti�.v�1U}pq SIGNATURE It CP e"''4(•„__.. - . • DISTRIBUTOR 4 )' I,"1..V iSc� 4U+C11 V t \ s ` \ l` (� i ADDRESS f 101 > _ -1i� Ycr C 1R L I L I t -d I�4. k f t�/oti / -� DATE