Permit T CY OF �� �I BUILDING PERMIT
PERMIT #: BUP2007 -00026
COMMUNITY DEVELOPMENT DATE ISSUED: 1/22/2007
TIGARD!, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AA-00100
SITE ADDRESS: 16350 SW 72ND AVE B4 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: OOA JURISDICTION: TIG
Project Description: Power Telephone: 7 sprinkler heads.
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: $ 1,250.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 230545
PORTLAND, OR 97224 TIGARD, OR 97281 -0545
Phone: Contact #: PRI 503 - 620 -6140
FAX 503 - 620 -6141
FEES Reg #: LIC 63846
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/22/2007 $62.50
[TAX] 8% State Surcha 1/22/2007 $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. r
C� Issued By: Permittee Signature: {
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. v
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 EC , ,
Fire Protection Syste -4 '
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Building Permit Application ..,, -0 -. i c1R �l I Icl pus► �_��1 �� . `', l = }max
SAN 22 2001 N. fz:.S .ti tC ,,,. n:), , „ .
0,
h; 2 , R eceived
City of Tigard Date/B p I R Permit No.: U , 2 At, 000l
4 13125 SW Hall Blvd., Tigard, OR .9722 4 a Plan Revie
®: k ` Phone: 503.639.4171 F 5 Ill, �''' Other Permit:
,� ¢3� �. �� Date/B .
r x2 " `I Inspection Line: 503.639 4 g r Z Date Ready/By: ®See Page 2 for
I' I L A "It'U ." 7 i N 111= S u S Information
I! Internet: www.tigard - or: 111 °° ��� PP
TYPE OF WORK - REQUIRED 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.
Valuation: $
❑ 1- and 2- family dwelling 121,c ommercial /industrial
❑ 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: /6o3s1) g C>Ll ?ZSub C New dwelling area: square feet
City /State /ZIP: Ad ri4. (7z ?7Z2.4— Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Awe/2 _ r� / a p u/ er Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
Rck1 , \ 1 �\ S Valuation: $ 1 23-0 °"
Existing building area: square feet
New building area: square feet
• ' X PROPERTY OWNER ❑ TENANT Number of stories:
Name: ) 41e jn Type of construction:
Address: /13So /) 4 7S T / p/A 4t'1 .'7 Occupancy groups:
City /State /ZIP: f!7' /I Aib U� Existing:
Phone: (S ) gz4 , .43 2 Fax: ( ) New:
APPL ICANT ❑ CONTACT PERSON . <
NOTICE:
Business name: ae S C 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: 7.-0 0k 2...: OS c - jurisdiction in which work is being performed. If the
City /State /ZIP: T 09__ 9 -j z is/ apply:
a
applicant is exempt from licensing the following reasons
Phone: (esl ) (C 20 -- (c ■ 4 C Fax:: ( SCs) lG - 4,14/
E -mail:
CONTRACTOR BUILDING PERMIT FEES* '
Business name: civO 3� (Please rejerla fee schedule)
Permit fee: (ab
Address: Z . — e x: p c 2,6 OS $' State surcharge (8% of permit fee): S
OV
City /State /ZIP: ' k C,e_ Ci 72_81 FLS plan review (40% of permit fee):
Phone: (cb 3) ( lb -L140 Fax: ( - '03) Le 2 -(, — lF I q 1 (Due upon application)
CCB Iic.: I.0 (.. Total permit fees:
Amount received:
Authorized signatur /7/, 5
_ This permit application expires if a permit is not obtained
Print name: D within 180 days after it has been accepted as complete.
� t d Qj�p l ZZ�U 7 ■ Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building \Pennits\FPS- PermitApp.doc 03t23/06 440 -4613T(11 /02/COM/WEB)
. 4
City of Tigard: Fire Protection Permit Checklist •
Page'' 2 Supplemental Information
,Describe work to,be done:
1.) ❑ New 2.) 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 Sprinkler
❑ 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.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) . Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"Nev" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
I: \Buildin \Permits \FPS- PcrmitApp. 2
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BUILDING DIVISION PERMIT #: SUP20O7'OOO26
13126SVV Hall B|vd.. Tigard, ORQ7223 DATE ISSUED: 1/22/2007
Phone: (503) 639-4171
nspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/9/2007 TIME: 7:04Ak4 PAGE: 51
SITE ADDRESS: 1635O B4 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK! LOT #: ODA TYPE OF USE:
PROJECT NAME: P0VVFRTELEPM0ME
DESCRIPTION: Power Telephone: 7 sprinkler hmado.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: F|REST0PC0 PHONE #: 603'620'6140
Inspection Request Scheduled For: Date: 2/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 043182-01 603-8048272 Y
Corrections/Comments/ |notruchona: �~*�~` ~--
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PASS | | PARTIAL APPROVAL CANCEL n NO ACCESS
FAIL ` CALL FOR INSPECTION | | ADDITI NAL EES ASSESSED
Inspector: Date: Phone #: (503) �� r� ~-