Permit } CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00563
• JAIK DEVELOP Tigard, o
SERVICES 639 -4171 DATE ISSUED: 12/2/2004
Hall
SITE ADDRESS: 10260 SW GREENBURG RD 1180 PARCEL: 1S135AB 03400
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 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: 2FR : 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: $ 600.00
Remarks: Alteration of (5) fire sprinkler heads for TI.
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST MCKINSTRY COMPANY
ONE SW COLUMBIA ST #300 5400 NE COLUMBIA BLVD
PORTLAND, OR 97258 PORTLAND, OR 97218
Phone: 503 - 412 -4800
Phone: 331 -0234
Reg #: MET 4 0 � 0 g 0 g 0 1 1179
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 12/2/2004 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 12/2/2004 $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 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ( • - • .99 or 1- 800 - 332 -2344.
Issue. :y: �� J ' ;, • (
Pe rm ittee
Signature: I
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
, .. _FOR OFFICE USE ONLY. . .
Buit'cliiig Permit Application Received (D Building
Date/By: a" de( Permit City of Tigard
Ai A Planning Approval
Date/By: Other
Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503-639-4171 Fax 503-598-1960 —Will— Post-Review Land Use
Internet: www.ci.tigard.or.us ei i I Date/By: Case No.
Contact Juri_ ,,.. [2] See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method: —nC, Supplemental Information
.
'-: •'; • %-:: :!...•' ii--•- '.; IriNTt-70E-VORK: .•-.:::: '.. • ..,-"., :•,i, . . . .
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...
D New construction 0 Demolition .' ' r ' .•1!•& 2 -F81VIIL:A.:OWEt( . :ii.,.: 11$0:: ':-.,'.-:.:.! • . -:' '”:
,- ,1=: -,, -.-:-.•. , .a:-. -,,,! --:. - .: • ."
gi Addition/alteration/replacement El Other: 2 :::1
..: ... - •:' • .. - C-ATEQORVopeortsTRUCTION-:
. . , Note: Permit fees* are based on the total value of the work performed. Indicate
„
El 1 & 2-Family dwelling El Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
0 Accessory Building El Multi-Family
li] Master Builder El Other: Valuation 5
40B:SITEIINE!ORMATION4iid:&OCATION'.'L .:,:.,„':::':',,-:::: - No of bedrooms: No of baths:
Total number of floors
Job site address: len,6c, 5() 6,,xes4 Ey (14 r.
New dwelling area (sq. ft.)
Suite #: ) i eio Bldg./Apt.#: LiAco 44 TotAla- Garage/carport area (sq. ft.)
Project Name: HAf-R-oweit_ .R0,..v.)-e..1,1-1— Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
.' 7''':•',':'''',41;M;',.'''':-. iiiiaiiii6401VVi.:0-P_:,4,-Kln:671=
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Subdivision: Lot #:
Tax map/parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
P3iiiiiE5ckikirloN'OELWORK:;.; . .'::$6: ..7-:,'.V;-:"::' the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
' -.
F-e1- (s) ssp P_ ;ii-o.w.t_t&I-s io 0-0
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.) /J44
Number of stories AVA
1Z1::';till.cikEliTYCOONEWWW1g kg 4ErN Type of construction -- r - qt - - -TC-
Occupancy group(s): Existing: 13
Name: Li;L.9r-re Plevi . New: iS
Address:
City/State/Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: Fax , licensed with the Oregon Construction Contractors Board under
ARr-AVATCOTAX;e:4
) El ''-'0:Nrkett4US1:110i1:2E;: provisions of ORS 701 and may be required to be licensed in the
Business Name: An C . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: - Mer--vo.g. from licensing, the following reason applies:
Address: '5 A..)e Couini&A XL....al)
City/State/Zip: 'RAZ-ID j Of, •°11z..1 o
Phone: 331. o Fax: 33 I ....-.:
,kke %-
E-mail re INTric C
: ..1-c-c e Aur.,,,tb 4: : g '::,'',=;*"-'` 4tiz,z43% tOt3rii
OW * 147
i i:Ika;;Stila.:11. : 00:10itA:croRI.,:::::: :•i .''(<-- .:0:v.mA.lv . :-.1. - .1 ".^e4P.M4RIW':
Business Name: M r..4 1 -1:vrg-Y 6, , Fees due upon application $
Address: 5Y-r, a 14e Cot puil) &1 .
City/State/Zip: c l , -D(Z-7L-A-r-ID j t:712 . c").-7va Amount received $
Phone: - 331. c 2:34- F x: 331 6, Date received:
CCB Lic. ,: . go ffs/
Authorized
....._, Notice: This permit application expires if a permit is not obtained within
Signature: Date: 11, , 0 Z_ 0 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 •
Fire Protection Permit Check List
A.) New lj Addition , D 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: Iz
4
:Type 0 SYStertQCorni3lete
A.) Sprinkler Wet ja Dry LI
Standpipes /Pr
Additional Hazard Group 1-464-1-r '
Information Density 1
Design Area 1Coo
K. Factor 5.cp
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $
C.) Fire Alarm
Submittal shall Battery Calculations Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $
Permit fee fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
Plan review requires a completed application and 3 sets of plans at submittal.
• Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon
licensed fire suppression engineer, or NICET level "3" technicians.
iAdsts\formsTPSchecklistdoc 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INS EGOIt N :IVISION Business Line: (503) 639 -4171
MST
BUP U`� - ooS�
Received Date Requested / — — 7 AM PM BUP
Location I.C) - 2- Co u/ Suite I / 6 MEC
Contact Person � Ph ( )3 J O S� L PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain j�_rn f j c ELR
Crawl Drain 1
Slab Inspection Notes: SIT
Post & Beam r���.1
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing j ,� l 6��n
Insulation U `e- <CO / ski: �=-K-t
Drywall Nailing �
Firewall _ �� /�. •
( -Fire Spfinkl
Fire Alarm
Susp'd Ceiling
Roof /
Other:
I
• S PART Al
` PLU BING _ _ A�� __:
P.:
& Beam ' .��
I� � a
Under Slab I
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 f: - of $ required bef• re next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please c- I f• reins r ection RE: ' � Unable to inspect - no access
Fire Supply Line O
ADA
Approach /Sidewalk Date Inspector Ent
Other:
Final , 0 N • T REMOVE this inspection record from the Job site.
PASS PART FAIL