Permit BUILDING PERMIT
II
CITY OF T I G , R ® PERMIT #: BUP2008 00027
II ° " COMMUNITY DEVELOPMENT DATE ISSUED: 2/12/2008
:TIGARD ' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135BC -01100
SITE ADDRESS: 11117 SW GREENBURG RD ZONING: 1 -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: MATERIAL FLOW
Project Description: Fire Sprinkler TI for new mezzanine
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,015.00
Owner: Contractor:
ROBINSON, E LEE + EVELYN L SIMPLEXGRINNELL LP
PO BOX 91305 6305 SW ROSEWOOD ST
PORTLAND, OR 97291 LAKE OSWEGO, OR 97035
Phone:
Contact #: PRI 503 - 683 -9000
FAX 503 - 675 -6521
Reg #: LIC 149921
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/31/2008 $83.95
[TAX] 12% State Surch 1/31/2008 $10.07
[FLS] FLS Pln Rv 1/31/2008 $33.58
Total $127.60
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 503.246.6699 or 1.800.332.2344.
Issued By: _/ 2 ,G�.4_ j �� Permittee Signature: � �
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I LM PST — 11 I t ^CPC — Er►�l
Fire Protection System
Building Permit Application Received FOR O U SE ONLY
�
City of Tigard Date /B : mug � Permit No.: A Da, 7 ,
I II 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review S��
C Ph one: 503.639.4171 Fax: 503.598.1960 Date /B : / Other Permit:
T I CARD Inspection Line: 503.639.4175 Date Ready /By: ,, IBEI 0 See Page 2 for
Internet: www.tigard - or.gov Notified /Metho.: rt 0 Supplemental Information
I
, ,-'; ,:q' a < :,�,.<e_. - :'. <x i'': ,- - ; ,,, it ; 3rd "r
" " "...,"- s y .4 4 , " : : : = );.u% =a 'n =_ , , RE' UIRED. i - : '
- .., . " ;�: , . ., ,�;" y ...: .TYPE O ,_ r
❑ Ne construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
>_° a,<;,,,: ° _: r,..,..z :,:;;r :,� ",:�=, . '-.<.,,,,,:,' ,,.;:-.: , :,,: z': _ c _ : i" work indicated on this application.
a z'. 3 �� G ATEGORI'; . - CONSTRUCTION :;'':,,;�",, " , t' ` : ° : � :. "
. '":', m��<..... >,`�k� �=- <<<y�1'�'�..�A. .¢;n :, .., m.- ....0,00,-- ,"��v' ;., ", is%., ,�; � .:11�r.:_. . ' °: '._. ,�. _. �a•�
Valuation: $
❑ 1- and 2- family dwelling ommercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
;:c'� ; '. -,:, .."�a;..n %are ,ry -> ::�,�-:::;, >��.•3i: =,�'.< '- a�'''.�:� "' Total number of floors:
I2V , "'' :`: M �- _-A;
JOB �°,,,ITE INF.QRMATION�>AL;OGATION?; - ';, -" ,
-
-
Job site address: f' n / St &taw e
. New dwelling area: square feet
City /State /ZIP: "ri GA4`.0 , OK_ ( 7 i 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: t }--{ I- t(,i-L FLO W Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
'REQUIREDJDA.TA 'G"O`1V MERCIAGUSE GHECK1 IST =°
Subdivision: 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
equipment, materials, labor, overhead, and the profit for the
, :g'' 3 i ° ". W y ' ne; ? . :: work indicated on this application.
,z,...,, . - , ," ,', ', ..,•, DESCRIPTIOIV WORK P
~ ." P
h..)51104. (� V.) 4 " l " mil �G2�Z/ Si'i i ple.L+E((L � y(7 &' Valuation: $ I'l d �5
U tJDE� ,..)E•(,/ Wt � 22.44iU ( , p o ._ Se-HADUIse Existing building area: square feet
'f P
— l a x ���� � S � � area: s 7 "- F 4 New building rea. q ua re feet
l _�
_ : -
=.` Number of stories:
: i . ❑ "PROPERTYu.OW ` < f- ' ❑` " TENAI , , , " ' , ,,,, 41 • •..,.r< ..., <., v,;< y , _,- sst.: ;a`. -. _ ^.Vx "; a�.I a rte .< . _... -. .;a� "� _3wt�,; x: Lea, . , `;,_� � a.'a
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
r�,
,
APPLICANT ,, , CONTACT: PERSON- =fit ° " •' ' .'•' , t,, a
. -, �, .,.� .�: -:: may,. ,,., . ,, ,,:: o ,..,, ':,. :;,.;5,
.s I� I . "� ... <., : "�3':)a�t:: - -,, »v s'k" "c ., .ltt'G�, �1. . �,��,. , :4 "rA :.
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
v
- NTRA TR , . ; '"' :1 .2 : :, : ;er..
,., CO C O
.. . -z. • <^ _. -� ��s, BUIGDIIVG�P.ERiViIT:FEES
< ... . ., , k '' _: t a i# ' e hed ,e
/ ,D��� d
" ?' - ( re� ro J ce.r ched u le}: .,.,, - ' `, 0' :,: i ,,
Business name: SO4444
63+"^ Permit fee: to � St) WzgewOO S'r ( Z �
Address:
State surcharge (8% of permit fee):
City/State /ZIP: ( g.- 0C a w_ £!•Zo3--
FLS plan review (40% of permit fee):
Phone: ( ) ( — aco Fax: i5a (o7s („: ( (Due upon application.)
CCB sic.:
? /a •. , �/� Total permit fees: ■< 7
r
Authorized signature: 7 Amount received: .eeA4-4/ T his permit application expires if a permit is not obtained
Print name: 0,,e /ce L p7 • ' / s- Date: (�"jt 8 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
t:\ Buildin0\Permits \ FPS - PermitApp.doc 03/23/06 440- 4613T( Il /02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION " PERMIT #: BtJP20()3.00097
13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED: 2112/2008
Phone: (503) 639 -4171 i40'll�i�
Inspection Requests (24 Hrs.): (503) 639 -4175 .
INSPECTION WORKSHEET FOR DATE: 2/15/2008 TIME: 7 :00AM PAGE: 34
SITE ADDRESS: 11117 SW GREENBURC (,(D CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE: 1
PROJECT NAME: MATERIAL FLOW
DESCRIPTION: Firs: Sprinkler TI for new mezzanine
OWNER: ROBINSON, E LEE 4- EV`ELYN L, PHONE #:
CONTRACTOR: S1MPL{ XGRINNELL LP PHONE #: 603-683-9000
Inspection Request Scheduled For: Date: 2/15,:0013 (J Pour Time:
Code # Inspection Description Confirm # Contact # Mes .:ge /
910 Sprinkler rough -in /test 065077 -01 503- 793 -5500 e
� c td.
Corrections/Comm reectons /Co mats /Ins o tns L per'
1.1 .4e: ki 0 2,__to w, ',A C-77,(z_ " IQ tAA) \iy\e416..,A,.-1---e . .
,:„.-7..2./ , _ Z--- ____
_...,- l A -.414ri
//3 1 Te..s -----.
/ua, ., (4,-)
,„_ , . . el' J .
0* 62_6,4 ft-Az_ Lk.. ,--, t;,, c.-1- ,:_42--,,,,‘ .
tA V ‘L'H
j' I
a
7
'PASS ❑ PARTIAL APPROVAL El CANCEL I I NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�— S t (--Phone 2_1( z .\.4).
Inspector: Date: #: (503) 718-