Permit a
Q OF TIGARD BUILDING PERMIT
IN PERMIT #: BUP2007 -00273
- . COMMUNITY DEVELOPMENT DATE ISSUED: 6/12/2007
. TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 135BB -00501
SITE ADDRESS: 10575 SW CASCADE AVE 130 ZONING: I - P
SUBDIVISION: CASCADE BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: HEMCON
Project Description: Add to existing fire alarm system.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: 1 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,050.00
Owner: Contractor:
HEMCON MEDICAL TECHNOLOGIES PROTEC INC
10575 SW CASCADE 720 NE FLANDERS STREET
TIGARD, OR 97223 PORTLAND, OR 97232 -2763
Contact #: PRI 503 - 235 -4000
Phone: 503 - 245 - 0459 FAX 503 - 235 -0363
Reg #: LIC 55414
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/21/2007 $72.10
[TAX] 8% State Surchart 5/21/2007 $5.77
[FLS] FLS Pln Rv 5/21/2007 $28.84
Total $106.71
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. Yo�btain a copy of these rules or direct questions
to OU y calling 43.24..6699 or 1.800.332.2344. •
Is ed By: 0 / ! � Permittee Sig _,
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.
1 06 75 � (A) S C8-1E.
/ Fire Protection System
Building Permit "Application � �� FOR OFFICE USE ONLY
. v. ece iv e d / �1
City of Tigard � L @I /=- = Date /B �7 /.d e ! B f' Permit No..:3U , or B OO.?
13125 SW Hall Blvd., Tigard, OR 97223
III C .' Phone: 503.639.4171 Fax: 503.598.1960 Mg a .i I r Plan Date /By: Rev i (0 167 Other Permit: • /z/ 7 —
TI GA R D Inspection Line: 503.639 _ Date Read / By: 3 1Z1 Se • Page 2 for
Internet: www.tigard - or.gov C0 v � - t h7 2.• �RL ° I Notified/Method: i e 10 Id Supplemental Information
TYPE OF WORK W r DATA: 1- AND 2-FAMILY DWELLING
❑ New 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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: j 0 5 }-5 5L.A..! Ca s-,...-,-, 1f+rt-
New dwelling area: square feet
City /State /ZIP: q�,k. �vc.. 5 7- 2-23 Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 7., Project name: f--(P mast Covered porch area: square feet
Cross street/directions to job site: GrizeS4-n Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 711 U'
I}d tZ - tb e4cr j -Y∎t At c �- S 7 5-Fe..— t —
l Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction: 4 )
Address: Occupancy groups: g // - I
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
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
a pp l y : - /D
Phone: ( ) Fax:: ( ) S, 77
E- mail: ,g)4
CONTRACTOR BUILDING PERMITCP1
—
(Please refer !o fee schedule)
Business name: ..r-g � C _ Permit fcc:
Address: ?- IV (£ f- (ate oE,t..-s 9-
City /State /ZIP: Pia•(_� 2 Z State surcharge (8 % of permit fee):
`�� , 3 FLS plan review (40% of permit fee):
Phone: ( 3 a 7-, S 4-0o a Fax: (577 ?) 'a 3 - O 3 to 3 (Due upon application.)
CCB lic.: --- . t, `t Total permit fees:
Amount received: /�
Authorized signature: ' I1� 7j / r
This permit application expires if a permit is not obtained
Print name: 1U^0 cr 3 ,.bt-- Date: 7/2„, i / } within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I.\Building\Permits \FPS - PermitApp.doc 03/23/06 440- 4613T(II/02 /COM/WEB)
Jeanne Temple
/ .4/3
From: Debbie Adamski
Sent: Monday, March 10, 2008 3:31 PM
To: Jeanne Te
Subject: Hemco BU 2007 -00273 & ELR2007 -0015
With Dianna's permission - . -.. ese two permits by limitation as the work was done and inspected under other
permits(BUP2007- 00383/ELR2007- 00291). Chip told the general he needed to take care of these and this was the
solution we came up. I will let Chip know so he can proceed with finals.
Debbie Adamski
City of Tigard
Building Permit Technician
503.718.2450
1