Permit ` ® BUILDING PERMIT
'= CITY OF TIGAR
PERMIT #: BUP2002 -00194
*,1�' DEVELOPMENT SERVICES DATE ISSUED: 5/21/02
k- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135AB 01002
SITE ADDRESS: 10220 SW GREENBURG RD 551
SUBDIVISION: THREE LINCOLN -TOWN OF METZGER ZONING: R -12
BLOCK: LOT: 009 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B 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: $ 1,200.00
Remarks: Tenant Improvement - adding a door
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST LEASE CRUTCHER LEWIS
10260 SW GREENBURG RD 921 SW WASHINGTON #150
•
SUITE 100 PORTLAND, OR 97205
TI n A on l i - e. q0 g4 p57 Phone: 503 - 223 -0500
Reg #: uC 92919
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT CTR 5/21/02 $62.50 27200200000 Gyp Board Insp
Final Inspection
PLCK CTR 5/21/02 $40.63 27200200000
5PCT CTR 5/21/02 $5.00 27200200000
FIRE CTR 5/21/02 $25.00 27200200000
Total $133.13
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 -6699 or 1- 800 - 332 -2344.
Penn ittee ,
Signature:
____
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
(0/C-
j; Building Permit Application •
Date received: fj A a 1— Permit ialA E j,;2 - 00/1
;,t 1 11 City Tigard
ty of
Project/appl. no.: Expire date:
City ofTigard 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
❑ 1 & 2 family dwelling or accessory commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
. ' - JOB SITE INFORMATION
Job address: / 02 - D G .AL VOW �:. .. 1, a - LA - ! Sr Bldg. no.: Suite no.: '
Lot: Block: Subdivisio . Tax map /tax lot/account no.:
Project name: S , v `Ovc. .
Description and location of work on premises /special conditions: I i .:__-rt
- OWNER - ' - FOR SPECIAL INFORMATION, USE CHECKLIST
Name: SJj.,rlouc(cs 4 - qp. (Flood plain, septic; capacity, solar, etc.)
Mailing address: /0230 w t, pee i bo.: ► "1,Pet kit , 5vr 1 & 2 family dwelling:
City: - d , e -! State: o . ZIP: et 2.2. Valuation of work $
Phone: , s m Fax: 42- 5 1 E - mail: No. of bedrooms/baths
Owner's representative: 1„ - 1 - ;Q, 'LA Total number of floors
Phone: Eall E -mail: New dwelling area (sq. ft.)
- APPLICANT Garage /carport area (sq. ft.)
Name: (�► Lrs v u Covered porch area (sq. ft.)
'Q Mailing address: - sw 49, hi , o ; SC, Deck area (sq. ft.)
, - ' ZIP: ,r Other structure area (sq. ft.)
Phone: )13 p g'Ca Fax: 2 1.3- A5 7 4 EIMMMEIME Commercial/industrial /multi - family:
(" CONTRACTOR Valuation of work $ OU .00
Existing bldg. area (sq. ft.)
Business name: _ ,_, d,„ ;5
Address: • 2 __ LA), , , so, e .! 5� New bldg. area (sq. ft.)
RM. Apt .1 State:0 s ZIP: - /.4, Number of stories
Phone: _, E -mail: Type of construction
CCB no.: • Occupancy group(s): Existing:
' 1 ' New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: , 4- 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: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
EMI III 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 all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MastetCard
work will be complied ith, 46 / �they specified herein or not. Credit card number:
Expires
Authorized signature: ‘ ' # Lti Evil Date: ' ". /5/0 Name of cardholder as shown on credit card
•
Print name: d... 1' : . ' 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)
Commercial Plan Submittal
Requirement Matrix
City of Tigard
x� ' ' TYPEfOF�SUBMITT tV E' ` ', # of Plans
t(I el New,4ddlt ons„orAAIter Reyuire�d�at
ss Subm ittal , uPta
Site Work 4
(must include location of all accessible parking)
Plumbing -.Site Utilities 2
•
• ,
Building 1*
Fire Protection System • • • i3 ** • . ,
Mechanical 2
Plumbing - Building Fixtures 2
•
•
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans . for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue). -
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 B U P
BUP
Received Date Re•uested /;2- AM PM BUP
Location 1 ✓ Suite S15 MEC
Contact Person Ph ) C ( 7 PLM
Contractor Ph ( ) 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
D wall Nailin �' = r % e",/400F
ry g
Firewall
Fire Sprinkler
Fire Alarm
7
Susp'd Ceiling L
Roof
Other: a
PART FAIL
PLUMBING
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
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA Approach /Sidewalk Date Z - Inspector Ext
Other:
Final DO NOT REMOVE this insp ction record from the Job site.
PASS PART FAIL