Permit i4' -
CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2004 -00371
DEVELOPMENT SERVICES DATE ISSUED: 8/3/2004
4^, I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 450 PARCEL: 1S1266C -01506
SUBDIVISION: ZONING: C -G
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: : 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: $ 875.00
Remarks: Add 4 and relocate 3 pendent sprinkler heads.
Owner: Contractor:
PORTLAND OFFICE ASSOCIATES AFP SYSTEMS INC
BY TC PORTLAND, INC 19435 SW 129TH
8930 SW GEMINI DR TUALATIN, OR 97062
BEAVER TON, OR 97008
Phone: FAX= 692 -1186
Reg #: X615(131 03459
FEES LIC REQUI INSPECTIONS
Description , Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 8/3/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchari 8/3/2004 $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 OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 46 -6699 o 1- 800 -33 -2344
Issued By:
Permittee •
Signature: alliW A A
Call 639 -4175 by 7 p.m. for an inspection the next business day
AUG -02 -04 02:5TPM FROM- Automatic Fire Protection 5036921186 T -865 P 008/010 F -182
a. Building Peril' ' e , , �_ ��
W it
Date received / Y Permit no w - ("4-7/ , :.iv City of Tigard //��II'' �2 �j1114 f -
Address: 13125 SW Hall Blvd I srd; QR`'97ZZ3 Project/appl.no.: Expire dare: _____,
City ofTigard Phone: (503) 639-4171 Date issued: By' I Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment DIVISION PY � °tic
Land use approval: 184 family: Simple Complex:
• TYPE OF PERMIT
❑ I & 2 famil welling or accessory Coma nerci . ' ' dustrial • D . ∎ J ti-fanril ❑ New construction ❑ Demolition
B Additio teratio placement etTenant improvement . ire s . rinIde Cl Other.
JOB SITE INFORMATION
Job address: 426 ,t - t uc 40111,1Mafrja. Bldg. no.: Suite no.: " 5t
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: �� ; 1 ,.1 �l _ . - r otC G ■ - t = T 'L
Description and location of work on premises/special conditions: 1 -11 .1 w 4 _
OWNER FOR SPECIAL INFORMATION, USE CIIECI:LIST
(Floudplaiu, septic capacity, solar, etc.)
Mailing address: W t ■ N i TC 1 l Otz, I & 2 family dwelling:
Kora State: ptZ, ZIP: °InCt Valuation of work $
Phone: • • — t. + Fax: E -mail: No. of bedrooms/baths
Owner's representative: E .,, Total number of floors __
Phone: EMINIIIM E -mail: New dwelling area (sq. ft.) ......
AI' I't,IC•ANT Garage/carport area (sq. ft.)
Name: a Iv ASCRIMIIIMIIIIIMMIMIN Covered porch area (sq. ft.)
Mailing address: 1 „ a AZUROMIMIIM= Deck area (sq. it)
City: T State: at ZIP:' -10(c. Oth- it tun: area (s • . ft.)
Phone: ' .6, a'`,711 Fax: al.) E t 1 M r dastrinlfmulti family:
CONTRACTOR Valuation of work $ I. •
Business name: r i ff ra mminfil Existing bldg. area (sq. ft.) I,139
New bldg. area (sq. ft.)
Address.
~ ' � * • Number of stories 1
City:: I - 7 ZIP: � 16402 r1Z
Phone: ( 92 Fax: a4 .1 ( ;__ E -mail: Type of construction .....
CCB no.: CPS Occupancy group(s): 8 Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIT1 ECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: y a, N/k a UL EL ZI provisions of OILS 701 and may be required to be licensed in the
jurisdiction where work is being performed. If the applicant is
Ads : Pal d !�� exempt from licensing, the following reason applies:
ICEEn .. State: c.. ZIP:: 9
Contact person: Plan no.: - -
Phone:561 .4!9S( Fax: E - mail.:
ENGINEER
' Name: -- Contact person: Fees due upon application $ Col. S.
Address: Date received:
City: Stare: ZIP: Amount received $
Phone: UMMIIIIII E-mail: Please refer to fee schedule. .
I hereby certify I have read and examined this application and the Not all jniscactioas accept c ed t cords, pleats can Jarittactian for more infcmn �on
attached checklist. All . rovisions a f laws and ordinances governing this 0 visa 0 MasrarCard
work will be complied , w he1, r specified herein or not. Credit °��" - /ax�r /
Authorized signature: +, \- ,% a i !..1 Date: 8 -Z- L4 No.ne ar ma: • shown on am= mud
Paint name: „ '?. AT-.1 f& t. —+d.$ $
CanGnolder atmute Amouw
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o46ta omnicoM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION- DSVISION Business Line: (503) 639 -4171 MST
BUP46 V - 66 - 37 l
Received • Date Requested ' ' ' AM "FS-6 BUP
Location 70 z C) , S Suite FS -6 MEC
�y uJ ft
Contact Person ( Ph ( ) PLM
a ct Ph ( 97/ ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
• Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler '
Fire Alarm *1
Susp'd Ceiling _
Roof 4it
Ot
1
PASS PART FAIL
PL BING
ost & 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 _ 1
. Service
Rough-In r'�I J NIEMEM��PAM
UG/Slab
Low Voltage GROOM' MIEWli
Fire Alarm
F PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: fl Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other: -
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL