Permit C ITY ' OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007
7 1 COMMUNITY DEVELOPMENT DATE SSUED: 5 29 2007 00282
v
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 10 2 C B -02 300
SITE ADDRESS: 13240 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT: 008 JURISDICTION: TIG
PROJECT: PACIFIC MEDICAL
Project Description: Relocate . 4 head, add 4 heads.
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: . /svi Do
Owner: Contractor:
PACIFIC PROPERTIES AFP SYSTEMS INC
BY MARTIN JOHNSON 19435 SW 129TH
13200 SW PACIFIC HWY TUALATIN, OR 97062
TIGARD, OR 97223
•
Phone: Contact #: FAX 503 692 - 1186
PRI 503 692 - 9284
Reg #: LIC , 67534
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/29/2007 $62.50
[TAX] 8% State Surcha 5/29/2007 $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 503.246.6699 or 1.800.332.2344.
Issued By: Ale /i AP �! A Permittee Signature: 7)
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.
MAY- 29 -07. 11:13AM FROM- Automatic Fire Protection 5036921186 T -713 P.002/002 F -241
Buildin Peirmit Application FOR OFFICE USE ONLY
111 11 i City of Tigard p � ���� Received
13115 SW Hell Blvd, Tigard, OR 9722 503.598.196 3 Plan R • view D • � Permit No.•, 4 / 2x07 --
Phone: 503.639,4171 Fax i sxej
T i 6 A r,D Inspection Line: 503.639.4175 MAY 2 9 2007 tr a OthcrPetm,t,
Internet www.tigard-or.gov Notified/Method
tor- 61 Supplemental for
sav
CITY (2;f- + i aA Supplemental Information
..,, :: . ._ . , ..•.,.•.:, :.•'. :....., 4 , ;t•:.':.......? :: R ? •llH p ; 4 wEro lt E , L . .
El New construction . ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the valuer (rounded to the nearest dollar) of all
IgAdditioNalten on/replacement 0 Other
cg materials, overhead, .... : •.�:;.�• te .:. .,,,; . d, and the profit for the
• .. '..,. , r, .. ; • .. ,: ekii OR OF CO .. '. '': : • r :. : : = . t ! ..: on this application.
. ' work e r
❑ 1 - and 2 - fami1y dwelling — 7-5:CommcrcisUtndu,gial Valuation; s ,
• ❑ Accessory building ❑ Multi- family Number of bedrooms:
I: Master builder ❑ Other. Number of bathrooms:
—
STS'.• : ?C wSiYb a
. ►F'OR11 TlfOLi[ DID , . '.• � _ _... .. r :: • : v Total number of floors:
Job site address: • '. - New dwelling area square feet
City /SrateIZJP: l t.Lik QR, Garage/carport area square feet
Suite/bldg. /apt. no.: Project name' ' .. '
__ . a , , ( lour Covered porch area: square feet 4.
Cross street/directions to job site: • - 1
e . L , ' a Deck area square feet
Other structure area: square feet
' REQUUt . ii : : AB'A COMI�it>E�tCW.-USl1'• T=ti 1
Subdivision: • ••••- ••• • •• •• . .... .... . ,. -.,
' Lot no.: Permit feed• are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
a ,. _... :. equipment, materials, labor, overhead, and the profit for the
- DESCRII*ITON :,:01P:tV ,S ; q :
..... ... : „• ...... O>�.1G;:- := �'.;: +� •�,s' .,�•,�:�: ,,- :.�' work indicated on this application.
—•L • . ,� t• III : �, � Valuation: $ `650. °g
..r► A._ ! _/_ .
Existing building area: 1 J, rf square feet
New building arca; 1 00 • square feet
. _ . .Rr <'� s�.:..;. •�� •T� -;- :� °sp ; ' •;' ;+ Number of stories:
Name: R . I Type of construction;
Address: 114. , Occupancy groups:
,..L. .. 71::1 _ •r
City/Statc2IP :r * 0 - Existing; Phone: ( ) per Fax: ( ) '
New:
,. ,. ..:i'_; CONTACT.PERSONi?;y
• "'� ''� " :.:' '� ::i fi r;" • / •� :.. •.... •.:::.,:.,• : . .�.
Business naname: r ' . :.:. ' :. .: . ' : • : `. pcf:�CE�::ji:,. ,.;' •' � `: • , ..
r ( S'mfts, � o e All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
Address: 1 °1 `i3S C q-r� under ORS 701 and may be required to be licensed in the
]� U.F. , Jurisdiction in which work is being performed. If the
City /Statue: - lVoi .1 41 1.
IJIC m A applicant
( ) L 4y91
Phone: is exempt from licensing, the following reason.,
I Fa
4
SPA'
x:: ( ) 6Q� it«
E -mail: J1iv1 L 14-PP stg - CO v'
13UusDIDiG$E�IYII'Y PEES'
Business name: i P S . _ T/" 6
Address: Permit fee:
City /StareiZ1P: State surcharge (8% of permit fee): 0 Phone ( ) 1 Fes: ( ) FLS plan review (40% of permit fee): � .
CCB lie.;O�y I (Due rypo�gPPlltarian) /
permit fees: 6
Authorized signature}. Amount received:
VVVV This permit application expires if a permit Is nor obt fined
Print namc:3 iiii4, R� , , N4_ J Date: 5-.22:7 80 days after it has been accepted as complete.
��'"� • Fee methodology ret by Tri -County Building Industry
11BuildbgWermasIPPS- PrrmitApp.doe 03m,06 44o.a613 �tl Il07JCOhtrw ®) Service Board.
4
......4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00282
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/29/2007
Phone: (503) 639 -4171 h�_�ii
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 6/28/2007 TIME: 7 :01AM PAGE: 89
SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 008 TYPE OF USE:
PROJECT NAME: PACIFIC MEDICAL
DESCRIPTION: Relocate 4 head, add 4 heads.
OWNER: PACIFIC PROPERTIES, PHONE #:
CONTRACTOR: AFP SYSTEMS INC PHONE #: 503- 692 -9284
Inspection Request Scheduled For: Date: 6/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me -
Key Final inspection 051077 -01 971 -67 8-5099
Corrections /Comments /Instructions: i o —IS
00 ,01°.7
PASS r■ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL / 'ALL FOR INSPECTION
El ADDITIONAL FEES ASSESSED
r •
_.........
Inspector: Date: ‘/Z Phone #: (503) 718- L
il
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00282
13125 SW Hall Blvd., Tigard, OR 97223 . ' 'i DATE ISSUED: 5/29/2007
Phone: (503) 639 -4171 g il
Inspection Requests (24 Hrs.): (503) 639 -4175 I .
INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 77
SITE ADDRESS: 13240 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 008 TYPE OF USE:
PROJECT NAME: PACIFIC MEDICAL
DESCRIPTION: Relocate 4 head, add 4 heads.
OWNER: PACIFIC PROPERTIES, PHONE #:
CONTRACTOR: AFP SYSTEMS INC PHONE #: 503 - 6919284
Inspection Request Scheduled For: Date: 6/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /lost 050020.01 503-692-9284 N
Corrections/Comments/Instructions:
I g s fASS I P RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • L OR INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: _ Date: 6 g 6 Phone #: (503) 718- 2 4
gip-