Permit f0. \` it
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00593
,L� � DEVELOPMENT SERVICES DATE ISSUED: 10/2/03
�
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134BC -00401
SITE ADDRESS: 12442 SW SCHOLLS FERRY RD 100
SUBDIVISION: ZONING: C -N
BLOCK: LOT: 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: 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: $ 4,661.00
Remarks: Fire sprinkler modification for tenant improvement. Add (5) heads, relocate (20) and plug (3).
Owner: Contractor:
SISTERS OF PROVIDENCE IN OR BASIC FIRE PROTECTION INC
BY STEVE FOSTER 8135 NE MARTIN LUTHER KING BLV .
PO BOX 13993 PORTLAND, OR 97211
PORTLAND, OR 97213
Phone:
Phone: 503 - 285 -1855
Reg #: LIC 48641 44��
FEES MET REQUQRSPECTIONS
Description . Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 9/25/03 $91.30 Sprinkler Final
[TAX] 8% State Tax 9/25/03 $7.30
[FLS] FLS Pln Rv 9/25/03 $36.52
Total $135.12
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 ( : 246 -6. • • or 1- 800 - 332 -2344.
Issue. : )j . ∎ , , 0 t • 4 ,
- y.
Pe mr ittee /
Signature: ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
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Building Permit Ap C, OFFICE USE ONLY
•
Date received: 7 A Permit no.: ��
4 0 k ii_ City of .Tigard , •
�'�' "= --" Project/appl. no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard — 4
Phone: g( Date issued: , By: Receipt no.: Fax: (5 Case file no.: Payment type: .
Land use approval I &2 family: Simple Complex:
• TYPE OF PERMIT
) 0 I & 2 family dwelling or accesso ta Commercial /industrial 0 Multi- family 0 New construction 0 Demolition •
g Addition/alteration /replacement ' 1 0 Tenantimprovement %Fire sprinkler /alarm' 0 Other: ' .
• JOB SITE INFORMATION ,
•
Job address: a 4 q Z- 5,(A),. 5 Ho L L 5 F ER R q RD, Bldg. no:: • Suite no.:
.Lot: 0 / Block: Subdivision: Tax map /tax lot/account no.:
Project name: -. 14 G • E DD - i
Description and location ofwork•on premises /special conditions: / ST F[.00 RELOCATE i C - SP - r0 ■ C 17
:. • • o" - N• rin' E., : 05 'ei ZD PLUU •
OWNI R FOR SPECIAL INFORMATION, USE CHECKLIST -
Name: • a 'al L - IN1 ( Floodplain ,septiccapacity,solar,etc.)
M I .. • : .i 1 & 2 family dwelling: H
. City: • p 1 • p State: 0. ZIP: 9 7 2 17 Valuation of work $ •
Phone: 2. 1 5 -e, 5 E -mail: No. of bedrooms/baths '
Owner's representative: t.JA R RE N! Sr 11.4 p5 o A) Total number of floors •
Phone: 21 T-2G 5-2G 92. Fax: 2.15 - GM E -mail: New dwelling area (sq. ft.) I ,
APPLICANT - Garage /carport area (sq. ft.) I ,
Name: 'VAN G R 1 5 N AM ' Covered porch area (sq. ft.)
Mailing address: 5EE COW - • Deck area (sq. ft.) .
City: _ ' _ . State: ZIP: Other structure area (sq. ft) .
• Phone: Fax: E -mail: Commercial/industrial/multi- family:
00 A
• CONTRACTOR Valuation of work $ 4,6 � I. —
Existing bldg. area (sq. ft.) •
Business 'name: ; ATic F. IRE PRO Cr ON Z C '
Address: New bldg. area (sq. ft.)
13 . E. ' v L Tr BLV
City: - , - - N , State: e 1 c ZIP: Number of stories
2 Typc of construction .
Phone: 25- S Fax:2e -6 ?13 E -mail:
CCB no.: 4 g 6,4 Occupancy group(s): • Existing:
New:
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCII I'CEC•l' /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: JO • . j-u RQEN s, & A S Sot i / TE 5 rN C provisions of ORS,701 and may be required to be licensed in the
Address: 1 S S N. W, G R C - &N BR.1 ER PAR K WAy - • O Jurisdiction where work is being performed. If the applicant is
City: BEAUeRTON State: 0 g ZIP: 9. '7 00( 0
exempt from licensing, the following reason applies:
• Contact person:pAv 5'0 :WICK Plan no.: '
Phone: 69O I 9 Fax: 696 -09 3 E -mail: ,
ENGINEER OFFICE; USE ONLY
Name: 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 0 Visa 0 MasterCard - •
- work will be complied with whether specified herein or not Credit card number: / /
9 - Expircs
, Authorized signature: 'Date: V6/03 Name of cardholder as shown on credit card
' Print name: - DAN GRt SHAM - s '
Car dholder 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/COnt)
1
CITY OF TIGARD - • 24 -Hour
BUILDING Inspection Line; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received ° 2/y / Date Requested /� 7' AM PM BUP
Location / 4¥ - Suite MEC
Contact Person � � . Ph ( t r� r Q 2_3 .— PLM
Contrac 7n, Ph ( ) SWR
ILDIN Tenant/Owner ELC
Foo g
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing P/41"
•
Insulation e &■ / s 6-es
Drywall Nailing
Fir all /47fere &.. /2 `
�
Fire Alarm f � � ,,
Susp'd Ceiling (/'
Roof
Other:
Final
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 7.-%8*--k10.1 ADA Approach/Sidewalk Date /� /o �/ Inspector Ext
Other:
Final DO NOT REMOVE this inspection - record from the job site.
PASS PART FAIL .