Permit •
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 00569
�11i DEVELOPMENT SERVICES DATE ISSUED: 10/1/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AA
SITE ADDRESS: 10215 SW HALL BLVD
SUBDIVISION: METZGER ACRE TRACTS ZONING: C -
i
BLOCK: LOT: 037 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: 48 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: $ 1,400.00
Remarks: Fire alarm
Owner: Contractor:
INTEGUMEND LLC BY SCOTT COLLINS MD PERFORMANCE SYSTEMS INTEGRATION COR
& MARIA ROSS MD 7759 SW CIRRUS DRIVE
9495 SW LOCUST STREET BEAVERTON, OR 97008
PORTLAND, OR 97223
Phone:
Phone: 503 - 641 -2222
Reg #: LIC 150747 •
FEES REQUIRED INSPECTIONS
Description Date Amount Electrical Permit Required
[BUILD] Permit Fee 9/19/03 $62.50 Fire Alarm Insp
[TAX] 8% State Tax 9/19/03 $5.00 Final Inspection
[FLS] FLS Pln Rv 9/19/03 $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 -00 : • I • • .h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli . (503) 246 -66 or 1- 800 - 332 -2344.
Issue By: 2 2 d_14._it
Pe rm ittee
Signature: ��<___ _ iti—k >
Call 639 -4175 by 7 p.m. for an inspection the next business day
099 18 /2003 11:09 FAX 5035981960 CITY OF TIGARD 1 001
p 2IS S Protection SSystem a .
/NT6GUrl
Bu Permit Application R eceived FOR OFFICE USE ONLY
Building
RECEIVED Date/B : ' - ' - • 1 °A- Permit No.: " — 0057 •
Planning Approval Other
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Revme Q Other
Tigard, Oregon 97223 SEP ! 201 0 Date/By: - 'Lq.O 03. PermitNo.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960
,: ''r ' P ost- R ev i ew Land Use
s i Ca se No
_i e
Internet www.ci.tigard.or.us CITY 0 : --� "- - ' natality: luris.: e..1 See Page 2 for
24 -hour Inspection Request: 503-639i-41715m
- DumuING DIVISION Name/Method: �S(� Supplemental Information
u! x•:lltr �r� .I Irr l., )•. t , ,:, I; _Ak::..:::.•... :, , •,- ,- ,• �� r' :•
4,
:0.': .. ''t' k,:. , ••L "'I :'i ii, '.rl �' -1•�• I .W ; , ,:,o :
1 • ,. .. I �..... u 0 1:11.. ' ,•..
Demolition i.;. '' _ l ..
Et
ewconstn�ctlon � `,.'. .,,,. �,:;:�� ..... illA` ,>':: �:::�:
• Addition /alteration/replacement ❑ Other:
y:ad °'...; ?F� iU!.- ',,..!,;; • m:..I , . Q , ; ', 01040111t§ (1f1il iy ',i' ;; I , ; ' .,,:; ,: Note: Permit fees' are based on the total value of the work performed. Indicate
■ 1 & 2- Family dwellin : v. Commercial/Industrial the value (rounded to die nearest dollar) of all equipment. materials, labor,
overhead and profit for the work indicated on this application.
[l Accessory Euilding ■ Multi- Family _ $ /
El Master Builder • Other: Valuation
! ] K! t a Yi e' I.9P 1 16T •, ::^ i : Ci `'j;;; No. of bedrooins: No. of baths:
;�; ; ;;!,lilL t Y Vt_ Total number of floors
Job site address: • 2.1 W U1. ' e • New dwelling area (sq_ ft.)
Suite #: Bldg. /Apt. - : _ Garage/carport area (sq. ft)
Project Name: (►JTE ij i I? I.... • 1 - • C.. Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.) . •
Other structure area (sq. ft.)
• q; "' t ' :NL , . . y. I. „ . . ; q ., , I ` '•': ,,.�.y i
•` : -: I: L r�� F r JyS n,l P1 11 ..! G . Ip 1,L'i , } '
`.�,, I' t. r `- c ^r•'t! yL a!� 1 ! 'i 1 ' :��:: i
_ .. .. , a1 1
6�'0 � ` y 6 l i J t f �! "'F ;.F
Subdivision: 1 Lot #: �.it• ll , J
: ,
Tax ma :i M arcel #: Note: Permit fees' arc based on the total value of the work performed. Indicate
r' ; c: i t • , IT , e . '' i-'-:' °I:' '.: >;; ' ! :' > -;`1" the value (ttwnded to for the neaicst d°lla of all equry materials, labor,
:'. �,.. • - i � F�li„ overhead and profit the wor indic en this application.
Valuation
— — Existing building area (sq. ft.)
- New building area (sq. ft.)
, Number of stories
1�1' {;' ta1]'�:{ (I'ip,C�,`,'d1, 19!li,, 3 •, 4 4i ' ti. .:; . 1 S a_. �S.,r ..., .} Type of construction
Occupancy group(s): Existing:
Naive: New:
Address: -
City /State/Zip:
NOTICE: All contractors and subcontractors are required to be
Phone Fax licensed with the Oregon Construction Contractors Board under
lq l X91 i'i l:ry'' �' EL7 t� ; ce t' `�" d ,t ; ` , provisions of ORS 701 and may be required to be licensed in•the
Business Name: PERor, to acs St 5A' M} /"hater'° / jurisdiction where work is being performed. If the applicant is exempt
Contact Name: 5bWarD Gt- 1ioN4, , Co l. from licensing, the following reason applies:
- ,
Address: }451 Sw Cirrus Dr-
^ City /State/Zii: L . - „ a ' 1.,o : �
Phone 6'i 1...2.2.22. ax 6'i l - IL( a 4 ,n,„ r ti , � Itiii! i
y ` ,i i ,. 1 7 1 1 q lI ` j d , M ` , It a
E-mail: E r '. l r , i 11, ti 4 f
. -_ 6 e. fij ._.�` , Q lie . l i . —L li ; Fe.
�C1Y; g� 1 i rUU�
.. 1. F°t,„ t�' �: II. n kC I��OR�LP. 0tid11� ?�i9�.�.�lti nj�: 1•; �tr y� ;!� >k. .16 M _...3L. ,l _._
Business Name: Fees due upon application.. $
Address:
City /State /Zip: . Amount received $
Phone: Fax' Date received:
CCB Lic. #: /5'0 7`/ 7 ;//.c/e) f -
AuthciriZed r Notice: Ibis permit application expires If a permit is not obtained within
signature: Date: 7/11 6. 3 180 days after It bas been accepted as complete.
Eb,uiA rb. Crtt` o rJ 6 *Fee methodology set by Trt- County Building Industry service hoard.
(Please print name)
i :uDUs\Pettrdt FortreslBIdgPcmutApp.doc 01/01
V
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line:' (503) 639 -4171 / U MST
(/ AlCrap
Received / 25 ?Date Requested l Z/2 -- AM � rr � 7— O U
Location /0 2,_/S S sue(- P P ! Suite MEC
Contact Person C' P Ph ( - a 6 Z cz0Z_CpLM
Contractor °/10.1 -46( \477".40 Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: j� ' SIT
Post & Beam C CQ D . � -PIL
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire ,
11-M1111•1
Susp'd Ceiling
Roof
• s- •
'ASS PART FAIL
NG .. „
Pos -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: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date / 2 : 2 63Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL