Permit '` eli.---- `' BUILDING PERMIT
I�n C P ERMIT #: BUP2005 -00245
DATE A-41"-'1.---;' � DEVELOPMENT SERVICES ISSUED: 6/17/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -00200
SITE ADDRESS: 15618 SW 72ND AVE ZONING: I -P
SUBDIVISION: OREGON BUSINESS PARK III LOT: JURISDICTION: TIG
Project Description: Fire protection.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 74 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,304.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES WYATT FIRE PROTECTION INC.
15350 SW SEQUOIA PKWY #300 -WMI 9095 SW BURNHAM
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: 503 - 624 -6300 Phone: 503 - 684 -2928
FEES Reg #: LIC 64077
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/7/2005 $62.50
[TAX] 8% State Surchari 6/7/2005 $5.00
[BUPPLN] Pln Rv 6/7/2005 $25.00
Total $92.50
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 ea a turough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
callin; 503 -246 -6 9 - 0- 332 -2344.
Issu:d By: k ! Permittee Signatu �1 4 .rC+ - '`' --'
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.
/ sw 702-P°
Fire Protection_Svstem 1 44 "
Building Bnilding Permit Application h, a � ; ,�FO a {' � ,„� nl .
` City of Tigard Re
Date/By: l' :a Q f j I Permit No.: 60r;49- 1
13 125 S\ \' Hai: Blvd., Tigard, OR 9 7= EC 1VED 44' Plan Revie• r / O S
I% 6 7 Other Permit: y
<
Phone: 03.63 9.4171 Fax: 03 .-9,,S .:96 Da [e.BV:
Inspection Line: 503.639.4175 � f ".- I I Date Read Ju v/By: ��� RI See Page 2 for
Internet: www.ci.tigard.or.us
.JUN 200 N otified/Method : . ( j Supplemental Information
. ,
TVVCCF +i te REQUIRED DATA: 1- AND ?- FAMILY DWELLING :
❑ Net onstructton
tiU1LiAiJ'• IVISi n Dem ti on Permit fees* are based on the value of the work performed.
U
Indicate the value (rounded to the nearest dollar) of all
2 Additiomalterationreplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the i
CATEGORY OF CONSTRU ON work indicated on this application.
Valuation: 5
❑ 1- and 2- family dwelling Commercial /industrial
❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: •
;- :. .L OC Total number of floors
:JOB SITE L\FOR[�fATION AND "LATIO\
Job site address: 1G_, � 1L ,S�J 12 n V1 � v New dwelling area: square feet
City /State. ZIP: Ti Oa 01/ 1. O 1 22.... 22.... Garage /carport area: square feet
j
Suite/bldg."'apt. no.: Project name: LA V V l r e, Covered porch area: square feet
Cross street /directions to job site: T2•vi-1 NO \ 0 l91-er Deck area: square feet
Other structure area: square feet
.. REQUIRE . D,DATA: COMMERCIAL- USE.CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead. and the profit for the
- • - DESCRIPTION OF WORK - • work indicated on this application.
-TIM .
I f I tCilvt ' Valuation: $ \ 3c4 —
Existing building area: square feet
`,� New building area: square feet
f PRO ERTY OWNER ` .: `❑, TENANT - Number of stories:
/
Name: ((( p il-c___-10,u-% Type of construction: 5 r
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: O ...- te 360 Fax:( ) New:
APPLICANT ". D. : CONTACT PERSON NOTICE
Business name: see c,01\ l f(Ac.i /// J All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
' applicant is exempt from licensing, the following reasons
CityiState'ZIP: apply:
Phone: ( ) Fax: : ( )
E -mail:
CONTRACTOR :' . .
Business name: WYA t r e„ N a1 i ii oiN‘ BUILDING PERMIT FEES*
: \ddress: Tn\
VS • II. t NW Please refer to fee schedule.
CitiState. ZIP: . /] Z �(
�/� _
Fees due upon application
4 L l0
Phone: (' 1 ) CAW t� Fax: ( ) k... ../ • A G
Amount received
CCB lic ": 0 0-11
,t Date received:
Authorized signature: y/ p �� / This permit application expires if a permit is not obtained
/ /t / v� within 180 day's after it has been accepted as complete.
F Pint name: V 1. e" \ t/tATH f) I Date: Oo J O�J0 • Fee methodoloey set by Tri County Builuine Industry
/ Service Board.
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 ❑ heads: No plan review required.
❑ Alteration a 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
i ANT m p �= `'1'�'�
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: $ i f?) 04 —
B.) Type I - Hood Fire Suppression System ', . •
Hood Project Valuation: $
C.) Fire Alarm "s r} .r.. = z
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone ' :'=' :t- -• -
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50 � k; L.
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $ 1 tA- —
Permit fee based on valuation (see attached chart): $ l (Z. •50
Permit fee based on square footage (D) (see fees above): $ ./
State Surcharge 8% of Permit Fee: $ 00
FLS Plan Review 40% of Permit Fee: $ OQ
TOTAL: $ c42. e 3
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.
Bu:iCme Forms FPS C ecklist.doc 12.'29'03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00245
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/17/2005
Phone: (503) 639 -4171 !a
Inspection Requests (24 Hrs.): (503) 639 - 4175 '!'
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 82
SITE ADDRESS: 15618 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK 11I LOT #: TYPE OF USE:
PROJECT NAME: TECHNOCOM INC
DESCRIPTION: Fire protection.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 6246300
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 -684 -2928
Inspection Request Scheduled For: Date: 6/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 010518 -01 503 -684 -2928 N
Corrections /Comments/ Instructions:
/PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
Inspector: Date: dV Phone #: (503) 718-