9400 SW WASHINGTON SQUARE_MERVYN'S l
.
• +••••o • • • • •• i ... . • • • • • i 4
PLANS CHECK AND PERMIT APPLICAT'ON
ww.NomT cow, tit)3 a- J-i_li
OCPARTMENT OF FARC WM V 1 T1MNa►pRY10N _
LAN'1 F 1EVELOTTMENT SERA AE.TKGN
nowirN FLAAItT NUMBER
ODIaRNCTIpi PIaPEOTpN EE
: -ri
IMd wFc'iOA1012• yAn•
V t1 1 9,
r PLANS CHECK NeHBEA_.
PROJECT LOCATION I LAND USE -
AoORE3$_ 9461PS:W.N'as111n�(tonS . RoadR
DEVELOPMENT DIST
NF ARE ST CROSS sT -NSEW _- CENSUS TRACT_
TAT MAP
_ LAND LAND USE CASE
LEGA.L`E SI-RIP*u?N , r,4c, YARDS MIN FRONT _----_ - -- -
d&C>:K.TCM NSHII, MIN REAR
_ MIN sof
SUBOIVISKJWR n NI.E __ TOTAL SIDE YARDS
PARCEL NO ��1 I - NOTES fe Qvvus READ�L
w BUILDINGS ARE ON TME LOT, .4 514 M NON g 4G.� •,I T__ K -- _.
`J� l
, ae u,u4tuA1 a4uaab
Now ARE THEY useDT_ Retail Store.; liS193- L/��
OWNERSHIP Z ,4. r ?erC .
PROPERTY OWNER ____Ilsinya'y_ -__.-----
ADOREss 22301_Foothill Blvd. i FEES
Hayward. CA 94541
Pwi.wE(4151 727-31)82 ESTNATE0 VALUES DOT 0 64
PROJECT DESCRIPTION Pc FEE .
NEW ADDITION X ALTER 'REPAIR '
[FM FEE
FMFEE • 24 HOUR
DEAEOI'SH 'MOBILE NOME
INSPECTION
_
AREA 102.490 So FT HEIGHT 32' 10" FT TOTAL d�Ao; 1,-04,4..1 640-7561
HEIGHT _STORIES USE OF STRUCTURE WILL BE PD I S t7 •��1-.-
Retail Store B-2 -Z-^J i DUE -�—
lfZrJIMII OTHER _ PLEASE
BLDG Ii. 4.33,oC CALL FOP
INSPECTION
ESTIMATED MARIE i VALUE S 500,000.00 ELECT' ualLI ONE WORKING
--- � ',`Y � DAY IN ADVANCE
DESIGNER/BUILDER MEC,.
-1— b.° OF NEED
DESIGNER Dennis E. .reske, Architect qq gg PLUMB o i ((Q CO
ADOREss •'600 I . Hayshor.. Rd,,Pr� Alto pHt88?9600 slurk co, _ 24 —I( IJ. i '
ENGINEER STATE TAXIAA►OFS TOTAL) f I 64.41,
ADORES. 'TRAFFIC IMPACT FEE • �.
PH
ADEVELOPMENT COMP REV • I
ROIL CIE R
) I
ADDRESS PH ADDRESS • -
_.-..._-_- --._—. •
APPLICANT APgowsIOEYowu( 17� r
•AME F...1 Dennis E. Teske. Architect 11yy OTHER p ,%•�1 • 42.o
•AnnRF� 'Ann F..RRYA hore Rd.,Polo . Ito '30�9601 TOTAL L�..I 12_ZA.,11
I HME READ ME TES AND CONDITIONS ON THI' PERMIT,
ACCOMPANYING PLANS I AGREE TO MEET OR EACEED
�Q�y�• ARPL ICARLE CODES AND LAWS WHETHER OR NOT RE PRE SEN
SIGNED X 412//4 7 DATE 7.29 86 IN OR ON MY APDL IIONnAND PLANSASSUCH./
PRFLIMINAPV PLANS C.EIT-C4.EEE SIGNATURE y/ri..j/,f4. 6 /,
PIANS CHECK FEE f 931.45 , POINT NAMEC421Q /V,../ Iff/.D Q-4.
r,PIE 4 LIFE FEE E 573.20I PRELIMINARY PLANS CHECK RECEIPT_ -
TTA,P..F , 1504.65
i t /s 9:1(7 J 4' L.C./t 114? r . `S C.
PLUMBING FEES PC # 6-6- Z/ 7=
FIXTURES NO. x UNIT FEE s
SINK (KITCHEN) / b.UU (€ O 0
WATER HEATER / 6.00 G `��
DISHW1,SHER 6.00 _
DISPOSAL 6.00
WATER CLOSET Cl 6.00 5-y , C) p
COMPOST TOILET (( 35.00
Bre.$INS 6.00 3 4• t Q C)
TUBS _ 6.00
SHOWERS 6.00
C. WASHER _ 6.00
L. TRAY / 6.00 G.; ( ()
URINALS ". 6.00
FLOOR DRAINS -_ 6.00 / " L) C)
RAIN DRAIN/DOWNSPOUT _ _ 6.00 Ist/4 .30
DRY WELLS 6.00
WATER SERVICE 15.00 1st. 100'
SAN. SEWER CONNECTION _ 20.00 1st 100'
SAN. SEWER - EA. AMT. 100' _ 10.00
WATER - EA. AUDIT. 100' 10.00
DRINKING FOUNTAIN 6.00
OTHER FIXTURES (SPECIFY) E.00
LAWN/FIRE SPRINKLERS .1. 515.00 j Oii
STORM SEWER - UP TO 4" DIAM. - 10.00(PER 100')
STORM SEWER - OVER 4' DIAM. 15.00(PER 100')
CATCH BASINS 10.00 EACH
MOBILE HOME SPACE 25.00
INSP. OF EXIST. PLUMBING 40.00/HOUR j
SOLAR - MINIMUM 25.00
HEAT EXCHANGE 6.00
COLLECTOR/PANEL 6.00 1
TANK 6.00
SUBTOTAL MINIMUM 515.00 FEE /6 5-. C 1
4% STATE SURCHARGE G 2-7 .)
L
Ci IPLAN REVIEW 7r+ OF °-KNIT 1'`)e
oc Q' �1 510.00 (MINIMUM) 1i ,),, c :
TOTAL FEE L.)' I 6 ,n '--)'•
DLUT 3/86
MECHANICAL_ PERMIT FEES
UNIT FEES NO. OF UNITS FEE
Permit Issuance
I For the issuance.i cacti lrrmn S,u ___ _
For issuing each suppie,nental permit i 00 —�
Unit Fee Schedule
I For the instalts:ion or relocallon of each forced-air or gravity-type furnace or burner.
including dixts and vents attached to such appliance,up to and including 100.000
Btwh 6(10
For th installation or relocation of each forced-air or gravity-type turnace or burner.
including ducts and vents attached to such appliance over 100.00D Btwh 1 50
3 For the installation or rrocatton of each floor furnace.including sent 6(Xl -- --
4 For the installation or relocation of each suspended heater.recessed wall heater or
floor-mounted unit heater 6(10
S For the installation,relocation or replacement of each appliance vent installed and ---
mit included in an appliance permit 3(XI
6 For the repair ot.alteration ot,or addition to each heating appliance.refngeration
unit.cooling unit.absorption unit.oreach heating.crusting.absorption,or evapora-
tive cooling system.including installation of controls regulated by this code 6(Xl
7 For rhe installation or relocation of each boiler or compressor to and including three
horsepower.or each absorption system to and including 100.000 Btu.h h'30
l+ lex the installation or relocation Wench boiler or compressor over three horsepower
to and including 15 horsepower.or each absorption system over 100.000 Btwh and
including SIXI.'XX)Btwh II OD f
o For the installation,:r relocation of each boiler or compressor over 15 horsepower to
and including 30 horsepower.in each absorption system over 500.000 Btu h to and
includinf:1.000.000 Btwh 15 00
IP For the installation or relocation of each boiler or compressor over 30 horsepower to
and including 50 horsepower.or for each absorption system over 1.000.(00 Btu h to
and including 1."50 000 Btwh 22 50
11 For the installation or relocation of each boiler or refrigeration compressor over 50
horsepaver or each absorption system over 1.750.000 Btwh 3'50
12 For earn ainhandling unit to and including 10.000 cubic feet per minute.including
ducts attached thereto 4 50 •
Nein: This fee shall not apply to an air-handling unit which is,.portion of a factors
assembled appliance cooling unit.evaporative cooler or absorption unit for which a
permit is requicel elsewhere in this code 4•�O
13 For each sir-handling unit over 10.000 cfm .50
14 For each evaporative cooler other than portable type 4 50
'-
15 For each ventilation tan connected to a single duct 7(X)
16 For each ventilation system which is not pardon 01 any heating or air-conditioning
system wthonzed by a permit : 50
17 For the installation of each hood which is served by mecha..'cai exhaust including
the ducts for such hood 4 50
18 For the installation or relocation of each domestic-type incinerator 750
19 For the installation or relocation of each commercial or industrial-type incin-
erator 30(Xi
20 For each appliance or piece of equ.pment regulated M this code hut not classed in
other appliance catesones.or for which no other fee is listed in this code 4 tai
21 When Chapter .2 is applicable'see Section 103i.permit tees tor!del-gas piping
shall hr as fellows
For each gas piping system of one to four outlets ;flli
For each gas-piping syste•n of five or more outlets.per outlet It S0
I ither Inspections and Fees:
Inspections cutside of normal business hours 815 IXl per hour r- —
i minimum charge—two hours
Reinspection lee assessed under ptiwisions of
Section 10S,f. SIS(beach
3 Inspections for which no tee is spectilcalls indicated 515 00 per hour — — — _
'minimum charge--one half hour
4 Additional plan res iew required hs •hanges.additions or
rev sum,to approved plans S I s tilt per iv-
'minimum charge— tie-half Mori
SUBTOTAL 4i• sO
4% STATE SURCHARGE ..cia
DLUT 3/86 TOTAL /S , 08
'br)►"'►s �= 1 NNIT ECT
LETTER OF TRANSMITTAL
ARCHITECTS PLANNERS _
2600 EAST AAvSIIORE RD.BOX 10033.PALO ALTO.CR1 303 \ I PATE '%Tt41 / JO Ne O415 856-9600 '�
YNS _h Vri o0�-L
TO . ,_400_ S W. wAst-owarew s'Q
W 1014.1 IN inn) (-4.1v1.41-1/4( WA J N 1 ta6-lo N u P ___
1,4440 Gla 'r E.l"l�/ICLIS D l�iLOr,) Ti a.�o Oeecoo r..)
150 _ fig.1r Avr. Ze9 FL .
--14 ippselogatOlcaom 4712.4 —J
i Attn.:jig_. VoWam.p 4131j►tru. J
WE ARE SENDING YOU:— tg Attached -_ ' under separate cover via_fria. F/ P. _ the following items:
H Prints [l Shop drawings dans <Specifications _ ' Samples
❑ Change crder n Copy of letter _
T_. --.__—
COPIES DATE I NO DESCRIPTION
---2-• 81,0c. Pis 4 :apes _-
.1___-1 . Raw rimer. Fv. _IN The A-mou,..rr or k544_V
__ EST.� Qa aw.
THESE ARE TRANSMITTED AS CHECKED BELOW:
[_j for approval , Approved as submitted Resubmit copies for approval
❑ for your use Approved as noted ' Submit copies for distribution
❑ As requested Retu.ned for corrections Return corrected p•Ints
❑ For review and comment 5j541-n'F.P P& 1`ANI X.- _
❑ FOR BIDS DUE 19 j PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO '17idi K.a_Cieurgait6)
SIGINED:Th vii E �_ge, 414 _ _ _ _
It.ncio,w,.s are not at',Wad..oneiy notary us al nnc.
V1.ASNINOTON COUNTY ' ❑ wk.
CEPARTTAENT OF LANG USE ANO TRANSPORTATION ❑ VA• ❑ CTv riL[
NON-STRUCTURAL ❑`in'.
OATI VAIIL�
PLAN CHECK
BUILDING Washington Square- Mervyn's Dept. Store Remodel
ADDRESS 9700 SW Washington Square Road
OWNER Winmar Pacific, Inc. PH.NO. 639 8860
ADDRESS
ARCHITECT/EN4114t Dennis E Teske 41'i PH.NO. 56 9600
ADDRESS 2600 East Uayshcre Road, Palo Alto. LA 94301
FIRE
PERMIT 0 PLAN CHECK 9 6649 OCCUR. 2-2 CONST. V-N DIST. :a',h• Ct '. �1
LOCATION ON PROPERTY: North South East West
STREETS: North South East West
REQUIRED FIRE RESISTIVE RATINGS: Exterior Walls
MATERIALS:
Structural Members [ . 'sing Roof Existing
Exterior Walls Cover Interior Walls G-psuln tJall Board
Ceilings Supsended Acoustical Floors Caruet, Ceramic Tile. V;nvl
BASIC MAXIMUM AREA:
Max. Heignt Max. No. Stories
Max. lncreasi-77r Yards Sprnklers_ Throurihout _
TOTAL ALLOWABLE Unlimited
BUILDING JSE: Retail Sales - Mervyn's Remodel Occupant Load
BUILDING AREA:
Basement _ 1st Floor 2nd Floor _ 3rd Floor _
AREA SEFARATION None HR RA':NGS OPENINGS HR RATINGS
OCCUP.SEPARATION None HR RATINGS OPENINGS HR RATINGS
CORRIDOR CONST. ATTIC DRAFT STOPS FLOOR CEILING DRAFT STOPS
STAIRS Existing WIDTH ENCLOSED
OTHER VERTICAL SHAF'S ENCLOSED
EXITS REQUIRED: Nc. Existing WIDTH
EXITS PROVIDED: No. LxistiaiL WIDTH
EXIT ILLUMINATION REQUIRED Yes SEPARATE CIRCUITS
EXIT SIGN REQ. Yes ILLUM. Yes SEPARATE CIRCUITS Yes TWO °OWER SUPPLY Yes
HANDICAPPED ' .CESS REQ. Yes ELEVATOR Exis_tin5 RAMPS_
HEATING Existing - HVAC FUEL Gas COOLING SYSTEM Ut_Cegrdl
41 The plans for this project were received by this office on 7/25/86 and examined for the
non-structural , fire and life safety portion of the plans review on 8/11/86 . Listed
on the back of this sheet are the items we find to be in violation of, or for which .ve find
no provisions for the requirements of the 1982 Edition of the .,tate Uniform Building Code.
9/83 (0'irR)
Plan Check #6649
Page 2
1 ) F restopping consisting of 2-inch (nominal ) lumber, gypsum plasterboard
or equivalent material is required to cut off all concealed draft
openings (both vertical and horizontal ) and shall form an effective
barrier between stories and between a top story and roof space. It
shall be used in specific locations as follows:
a) In all wood-framed walls and partitions at floor and ceiling lines.
c) At maximum horizontal intervals of 10 feet in the case of double
stud walls, partitions and furred spaces.
d) Penetrations made in this prescribed firestopping to accommodate
wiring, plumbing, duct work and similar utility runs must be packed, in
a manner, which will effectively maintain the integrity of the
firestopping and cut off all concealed draft openings which could afford
a passage for flame. Reference Section ?516, S.B.C.
21 Approval rrom the Unified Sewerage Agelcy is required prior to the
issuance of the building permit.
3) Plans for the installation or altera',:ian of the automatic sprinkler
system must be provided tc and approved by fire marshal 's office having
jurisdiction and t .is office prior to installation or alteration.
4) Subject to the above listed items the plans for this project are
approved for construction, insofar as the Land Development Services
Division requirements apply.
Donald W. Howick
Plans Examiner
WASHINGTON°°1*."
V✓ DEPT OF AN°USE AND TRANSPORTATION
COUNTY, ILand Development Se.v.cei Dwnwn
OREGON Ind Flop
15031 648 8)61
February 27. 1986 /
"1n
Dear Client:
Your plans will be filed by this number. When inquiring about the
progress of the review of your plans, please use this nur,ber.
We want your plans review to move as swiftly and as efficiently as
possible. You can help in the process.
Your plans will be reviewed in the order in which it was received. Simple
plans, that is, small , one-story, rectangular buildings, reissues of single
family permits, and tenant improvements, will be taken out of order.
When your plans were submitted for review you were asked to estimate the
fair market value of the construction. The fee for plans review and
Fire Marshal 's review was calculated based on that estimate. As a part
of our plans review process, we will estimate the value using the Marshall
Swift, Inc. evaluation s 'stem, which is supplied to us by the International
Conference of Building Officials in a form which corresponds to building
code designations. The value determined by this estimation will be the
value used for determining the final plans check fee. Adjustments will be
made for any over and under payment at the time of submission.
Your plans will go through a coordinated review. This means that it will
be reviewed by a structural plans examiner, a nonstructural plans examiner,
and a land development compliance review, as an example. You may be
contacted by a reviewer for clarification of the data on your plans or for
mere information. If the information cannot b' supplied at tnat time,
your plans review will be interrupted until the requested information
is supplied, at which point your plan., will be the next in line for review.
Upon completion of the review you will be notified by phone. To get your
building permit, you will need the following:
1. An approval from USA for your sewer service or an approval
from the Health Department for your septic system.
2. If there is a land development case which relates to your
construction project, you will need to show that the
condition(s) of approval (if any) of that land development
case have beenfu1f TTed7--Tn some instances his requires
financial assurances to guarantee the later fulfillment of
these conditions.
3. You will have to pay the fees for approvals for various
permits and reviews.
Of !larticular note and new in this process is that you will be paying along
witn your building permit fee the plumbing permit fee and the mechanical
permit fee. The permits, themselves, i.e. the permission to perform
plumbing and mechanics work is not granted until the contractors doing
the work inform the Washington County Building Inspection Division of
ter participation—in—the project, giving their name, address, Builder's
hoard number and the scope of the work they are doing on their letterhead.
You, as permittee, will be responsible for the registration of these
contractors. A list may be asked of you prior to occupancy of the
building.
You will note when you receive your building permit that a letter has
been attached to the end of the number. Be sure to include this letter
along with the permit numbers when you request inspections. We will be
filing your application and plans Ly this number.
You will also receive an inspection-record card to be posted on the job
site and to be maintained during the construction process. This record
will he signed by the field inspectors as they make their inspections
and will he your record of completion of the various steps of the
.Inspection process.
You have 180 days from the date of submission to secure your permit.
If your construction is delayed for reasons beyond your control , a 180
days extension may be granted. Only one extension is allowed. Invalidated
plans must be resubmitted for review prior to construction.
In conclusion, I hope knowing this will result in a �muother and more
responsive process for you. If I can help, please let me knw.
Yours very truly,
William E. Schlecht
Building Official
ja
Page 2
l$ WASHINGTON COUNTY FIRE DISTRICT NO. 1
,,,,,,,,,,, is i 20665 S.W. Blanton St. • Aloha, Oregon 97007 • 503/649-8577
August 11 , 1986
Mr . Dennis Teske , Architect
2000 E . Bay Shore Road _4l 6.54t 7'/
Palo Alto , CA 94304
Dear Mr . Teske ,
RI Mervyn' s Department Store (PC6649)
Washington Square
The plans for the remodeling project within this occupancy have
been examined with reference to fire safety regulations and are
hereby approved as submitted .
One set of these approved plans , bearing the stamp of the Wash-
ington County Building Department and this office , must he main-
tained on the project site throughout all phases of construction
and must he made available to building and fire inspectors for
reference during required construr.tion inspections .
Inspection and approval of construction by a representative of
this office is required prior to the cover of any new framing
elements following the installation of all utility runs which
will be concealed within wall and partition cavities . Also ,
upon completion of construction a final inspection must be oh-•
tainnd from a representative of this office so that we may clear
our records with reference to compliance with fire safety regu-
lations . In addition , a certificate of occupancy or other writ-
ten instrument of approval must be obtained from the Washington
County Building Department .
I trust this letter will assist in clearing the way for obtain-
ing the_- ecessary building and related permits . If I can be of
service n any other way ple• e let me know.
Since y ,
( WAS/ GTOeli . TTY FIRE D CT 1 .
/# -(A ......"
Wilburn Dodge
Fire Prevention Officer
ssw
cc : Washington Caunt / Bldg . Dept . (2)
Inspector Dalby
STOP FIRES — SAVES LIVES
.,.•rules
` :1)I WASHINGTON COUNTY FIRE DISTRICT NO. 1
�= + 20665 S W. Blanton St. • Aloha, Oregon 97007 • 503/649.8577
September 10 , 1986
Mr . Charles Rabitoy
Fire Systems West
109(16 N .E . 39th Street , Suite A- 1
Vancouver , WA 98652
Dear Mr . Rabitoy ,
RE : Mervyn ' s Department Store
9400 S .W . Washington Square Road
The plans for the alteration of the automatic sprinkler protec-
tion within this occupancy to accommodate the remodeling present-
ly underway have been examined with reference to the applicable
regulations of this jurisdiction .
As I mentioned in our telephone conversation , ceiling-mounted
automatic sprinklers must not be located closer than 4 inches
(preferably not closer than 12 inches ) from any full -height
partition or similar bulkhead .
Subject to this stipulation , the plans are hereby approved as
submitted . One copy of the drawings is being retained for the
public record . The remaining copies have been delivered to the
job site and were left upon the desk of the construction super-
intendent at approximately 11 : 00 a .m . September 10.
It is my hope this letter will assist in clearing the way for the
further development of the project . If I can be of service in
any other way please let'meknow .
Sincerely ,
WASHINGTON COUNTY FIR IS RIC), NO . 1
Wilbu n o ge /
Fire Prevention Officer G
ssw
cc : Washington County Bldg . Dept . ( 2 )
Inspector Dalby
STOP FIRES- SAVES LIVES
WASHINGTON COUNTY INSPECTION CARD /
DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO. ...'s '��Z -
FOR INSPECTIONS CALL: 640-3561. 24 HOURS /
FOR INFORMATION CALL: 640-3470 DATE p/,p/ (' (
ADDRESS l VL...._ - �1 ///-1- - ' i'� `-• t t-+ PERMITEE _
DIRECTIONS /' 7 ) - 1�{ 4.A_ 41r 5 el du-v- PHONE NO.__
INSPECTIONS: ErSTRUCT ()PLUMB ElMECH DELECT �(�
CALLED IN BY / 'I dr- �.c_*A' 1— I C.'
APPROVED. 1L'-t ,,I 1:i ' // ' -2''1 `-,..L(.' -1 4 (6-,
4,4
REQUESTED INSPECTION APPROVED .IJ'
4,-217) '1, .'•T'/ C( 15.I. f1,..,,,/,‘,
r---i
NOTE:
NOT APPROVEDe _c I .I . I ( ,r.1 f-'"/ Jr �hrl�- 1\1 tv,
I IREPAIR OR REPLACE AND RE-INSPECT: /
❑STOP WORK UNTIL
DATE - ` I I a
INSPECTOR__._:4-1_. s --
FIRE PREVENTION BJ@EAU
-
• OFF'CE OF FIRE MARSHAL
INSPECTION NOTICE
OWNER - __ _ DATE
OCCUPANT __ - OCCUPANCY
LOCATION
- -
Cu• ll AT TENT,ON 41 CALLtO TO TN! 1,061.0.41,40 r,RE 1•r!Tr D!►IC,tNC,FV,
r• LUN! TO CORRECT TNF •1.10V! CONO,•,ON1 w .,. . 'A.% nn(. MA..[ yOU Lue, I ,0 ' nO•rr.,V .y 1..^,,n!• r Rf
Rr1V'. • 'ROM 1UC ' CONO,TiON1 vOU M•v RI , ••R,{ TOR f.•MA(:r1 To Pr RSOKs% OR +•RO••t Rt. u..t•IR i•Ruv,• n•.1 Or
ORr ••a ,10
BY
WASHINGTON COUNTY FIRE DISTRICT M1 FIRE MARSHAL
20685 S.W. BLANTON STREET
I
ALOHA,OREGON 97006 849.8577 PRESENTED TO
-'
101w 900 40
OWASHINGTON COUNTY INSPECTION CARD I ,3yct?_ 4
DEPARTMENT OF LAND 118E AND TRANSPORTAT)ON PERM I NO. t�1 '
FOR INSPECTIONS CALL: 640-3551, 24 HOURS
F INFQRMATION CALL: 640,T(221.-C, ) `----- -�7 DATE _
ADDRESS C.L/ �,„,,,, / Z (l0 5�k.' PE _
DIRECTIONS PHONE h0.
•
INSPECTIONS: STRIICT 0 PLUMB 0MECH 0ELECT /2-1-4-'y)--`----!�!
CALLED IN BY
liMilliMIOINIIIIIIIIIMMINIIIMMINF
MIAPPR!)VED. Lam_—_ _/�,( �'C)U f.”' f -
im REQUESTED rISPECTION APPROVED ', , i , i t t IIs I, ' 6 z CI 4/ /: .4...;.—..
HOWEVER NOTE:
NTT APPROVER c /o J �' �" '^ I PS t
REPAIR OR PEPLACE AND RE-INSPECT: ('
' ./ rC. `-
.STOP WORK UNTIL:
DATE
INSPECTOR-/� )42
FIRE PREVENTION BUREAU
OFFICE OF FIRE MARSHAL �I ) , y
INSPECTION NOTICE
OWNER __ - - DATE
-
OCCUPANT OCCUPANCY
LOCATION
- - - --
YOU. •TTENIION .1 C•LLIIO TO T..E rOLLOvf,NG r,..E S•rE T. OfriC ••••0.••• -- --- - -- -
r•ILU11I TO co.-Ec7 T.,r •IIOvE CO,- • OYS . ... ri n•.S b,11. .4••f .o , L.•111 f ro rpOffrUT,oN n.CULfT rinr
11ElULT 1,110.4 IOC. CON0,Ti0N1 TOIL , PE L,•11Lr T011 D•.4•ur• TO of w1ONS ON ',worrier. VNCr.IT ',wOT.T r
011E•.• ,E^ OHS O
WASHINGTON COUNTY FIRE DISTRICT#1 FIRE MARSHAL
20665 S.W. BLANTON STREET
ALOHA,OREGON 97006 649.8577 PRESENTED ro_ - ___
•01114 •0f 40
/1 e-o --` "
411101% WASHINGTON COUNTY INSPECTION CARD
DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO. " -
OR INSPECTIONS CALL. b40-35bI, 24 HOURS
L C�
FOR INFORMATION CALL: 640 3470 DATE _ Q
ADDRESS _ lG LS. lZ "/i A PERM'TEE
DIRECTIONS-- Attx�- ` �LU'� �`' PHONE NO`s
INSPECTIONS. ''STRUC T PLUMB ElMECH DEMI' +" e/
1 '4-.4 -
CALLED IN BY
PPR OVE
Fl IN
REQUESTED SPECTION
APPROVEDG" , i' ��c i - i`>-r'n JAI .-/
HOWEVER NOSE:
NOT APPROVER l c <c'�% /t .' 'C• i` _ C'< . /J
❑REPAIR OR REPLACE AND RE-INSPECT: / feno
EISTOPV7RK UNTIL
DATE_1 C A �]►/�C
INSPECTOR
_..,P��IIIIwI
FIRE PREVENTION BUREAU ( l i
')FFICE OF FIRE MARSHAL
INSPECTION NOTICE
OWNER DATE
OCCUPANT OCCUPANCY
LOCATION
YOUR •TTENTiON CALLED TO Tr-E FOLLO*WO FIRE E•FE • '•F FlcrrNCiri
F• LURE TO CORRECT T. r •ROVE COND.T,ONE *'1' 1 !••t *'L_ .•VF •Ou L.•P' r lO r Iry 0'Fr Trt nr
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WASHINGTON COUNTY FIRE DISTRICT N1 FIRE MARSHAL
20665 S.W. BLANTON .TREET
ALOHA,OREGON 97006 649.8577 PRESENTED TO
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Oft WASHINGTON COUNTY INSPECTION CARD
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OWNER
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BY____
WASHINGTON COUNTY FIRE DISTRICT 01 FIRE MARSHAL
20665 S.W BLANTON STREET
ALOHA,OREGON 97008 849.8577 PRESE .TFJ TO
FORM POO •n
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WASHINGTON COUNTY INSPECTION CARD / yc,� f1
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0�`\� DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO., 1,9
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OWNER DATE
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BY
WASHINGT^N COUNTY FINE I71S fRICT M1 FIRE MARSHAL
20665 S.W. EILANTON STREET
ALOHA,OREGON 97006 64 •8577 PRESENTED TO
` FoaM SOO 40
WASHINGTON COUNTY INSPECTION CARD �• ���q�
DEPARTMENT OF LAND USE AND TRANSPORTATION PERMIT NO.
II. ; Olt
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ink {NFORMAT . k Al t f140-14 111 DATE or5IC-'_
ADDRESS i/- - id leiter %/jI/f/0-1/_ _ PI .1�. �1 1��e' -4{ -
DIRECTIONS- _ --PHONE NO._____
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INSPECTIONS ST RUC PLUMB OMI(II I(f I i _-__ ! L 14_ /2c 'I 14 `b .1^ 7 1
(All fp IN BY
lAPPROVED.
IJREQUESTEINSPECTION APPROVED
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( NOT APPROVED
I J EPAIR OR REPLACE AND RE-INSPECT:
C1STOP WORK UNTIL:
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FIRE PREVEN"ION BUREAU
OFFICE' OF FIRE: MARSHAL 34134
INSPECTION NOTICF-
OWNER DATE
OCCUPANT ' OCCUPANCY
LOC<.T I O N - , I -- ------
r, • 'S fA F 10 T..F. tOL:.f Wir.. r•AF SwrESv OF FICIrNCIr3!
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RESULT rAOM Suc.. colra ',ow; r0.; M1` .•F,k rOA 01MAGF1 TO F•FASf)NS CA P1. UNC`rf r•RO,..S•ONS Or
OAS 414 100
BY
WASHINGTON COUNTY FIRE DISTRICT#1 FIRE MARSHAL
20665 S.W. BLANTON STREET
ALOHA,OREGON 97006 649.8577 PIIESENTEO TO
rOAM 900 40