Permit (15) ;. A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00432
�� a.�i� DEVELOPMENT SERVICES DATE ISSUED: 9/9/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113A6 01400
SITE ADDRESS: 07358 SW DURHAM RD BLDG G
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -P
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: 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: $ 350.00
Remarks: FPS add (1) head & relocate (1) head
Owner: Contractor: .
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 9384 SW TIGARD ST
PORTLAND, OR 97224 TIGARD, OR 97223
Phone:
Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 9/9/2004 $62.50 Final Inspection
[TAX] 8% State Surcharl 9/9/2004 $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 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: _ - _Ayala k
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Building Permit Application FOR OFFICE ONLY:
Received �(�i Building 7 fl a, J Le,
y g
Date /BDate /Byy: /� App-fa G`I 0 �-/ Permit No 2 1,c 'Q .G 0 . 0 �
Cit of Ti and Planning l Other
A, A
: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 D /By: Permit No.:
Phone: 503 -639 -4171 Fax: 503 -598- 1960 'ii' Post - Review Land Use
1 Date /By: Case No.
Internet: www.cs.tigard.or.uS " Contact Juris. El See Page 2 for
j V
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information
- _ j>F. . , - ,in :�jc.e,; p, ,. w� ,rv:�.ag`.;. =" =„ - ^i ?�' -sv' �y . "t
._. #;;• . "'TYPE; OF,;WORi-e, , -., . .. - 4:4,,f „• Et. «` .0 : ,4 ,t.
- � ,•, <. ;�:�' NREQUIl2EDIDATA: ��; i >,°~ "-..
New construction i] Demolition ,f.: k -� - ,..k, ;,
0 Addition/alteration /replacement ❑ Other: , ;,; 5: f =4,' ;z'
El New >` ' k &c2FAMIi Y DaWELL'ING
..
'' ` :, CATEGORY.OFTCONSTRUCT_ION "t- w' � ° ="e . Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling 1J Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation S
. , Job site address: No. of bedrooms: No. of baths:
_ .$.y ; ` T� %JOB`SITEIlYF.ORMATIO randLOCATIOIH "'��'f:' '; `:^ �"
ddress: -135'$ 4W . - b� - Lib Total number of floors
New dwelling area (sq._ft.)
t. #:
Suite #: Blds./AP 2,,, Garage /carport area (sq. ft.)
Project Name: 00/21174 LT 5/7t (./ /C Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
: I '. � , R EQUIRED DATA: r".: , , t� z
4 7' ' 0 COMIVIERCIAL.; USE 6'C ' " .4
Subdivision: Lot #: '
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
»:' 'r N' Vf - !'„t' •,`.; kr. 'OF
I ESCRIPTION' WORK `. "':� f ",7,1 ,.. the value (rounded to the nearest dollar) of all equipment, materials, labor,
• % . l : ' e Aldo n / overhead and profit for the work indicated on this application.
Valuation $ 3C'0
' Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
1>PROPERTY'OWNER: ' <F V �� ® aENAN:T ;: ,,, _�. . . Type of construction
Name: Mcp2a S r /� Occupancy group(s): Existing:
Address: /53S() g ,�' 0o,A. ,4 b'1 loo New:
City /State /Zip: Peigr(,9,v,■ , Q/2 97ZZ4-
Phone: 503 624'(0 300 Fax: NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
, [X- APPLICANT .,• "= : :;e :,:, °:''f .:. r.❑ °CONTACT` PERSONga:'?, ;;;e provisions of ORS 701 and may be required to be licensed in the
Business Name: car-Sr Co I jurisdiction where work is being performed. If the applicant is exempt
Contact Name: $ U ('t ) 4 S09 from licensing, the following reason applies:
Address: A0, ,o)c 23079/
City /State /Zip: T/G 1) 02 7Z
Phone: 620 --6/4,0 Fax: 620 _61S/
:_: rt �:.. �• .v k r .
' , i F , BUII:6WG:PERMI S:; g ° ;; ,, *
E -mail: ` , -; ' ,;, ,,, ,.,�.; , - 3::._ ..Y• :.,,. �. ,• .w , _ k-
P�`t {� :1 sctied'ule. -•�� -�',;k�••
ti r_� r... . :T.0-:?;',TA' "'`.{ G'QNTRAGTQR ".al . .. .ir�r: ._ ._:: ",::'. . . - _ . . R� � ; _ _
Business Name: Fees due upon application $
Address:
City /State /Zip: Amount received S
Phone: , Fax: Date received:
CCB Lie. #: _
Authorized
Notice: This permit application expires if a permit is not obtained within
Signature: Q — Date- 9/7/94- 180 days after it has been accepted as complete.
/ / ?C r b • / ire - wfod *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
is \Dsts \Permit Forms \BldgPermitApp.doc 01/03
Fire Protection Permit Check List
Des cribe work to be done: _
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial "
•
Wet ❑ Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C:) k" ,
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
D.) ` ResidentiOSprinkler. (Stand Alone:-:System) •
Square Footage: Permit Fee: •
0 to 2,000 $187.50
2,001 to 3,600 $232.50 kA`:'
3,601 to 7,200 $292.50 `>
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
Plan review requires a completed application and 3 sets of plans at submittal.
• Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon
licensed fire suppression engineer, or NICET level "3" technicians.
is \dsts \forms \FPSchecklist.doc 02/28/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST el
/ BUP iQO e °44
Received Date Requested cl — / (° AM PM BUP
Location 7 3S ' Suite MEC
Contact Person Ph ( )' a 4 1 - g - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
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 Alarm A l )
Susp'd Ceiling
Roof laid Al A Othe • -
kUMIN PART FAIL � �� /
\
Post & l abm
IMMIllir Mr Slab
Rough -In ,,
Water Service •
Sanitary Sewer •
Rain Drains I
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
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL