Permit ,, "` h w „y ' « BUILDING PERMIT
PERMIT #: BUP2007 -00584
COMMUNITY DEVELOPMENT DATE ISSUED: 11/13/2007
TICARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AB-00600
SITE ADDRESS: 16160 SW UPPER BOONES FERRY RD BLD.0 ZONING: I -
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
PROJECT: EXELIXIS
Project Description: Install (9) fire sprinkler heads for TI
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: 3N : 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: $ 1,800.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 7000 SW HAMPTON ST #105
PORTLAND, OR 97224 TIGARD, OR 97223
Contact #: PRI 503 - 620 -6140
Phone:
FAX 503 - 620 - 6141
Reg #: LIC 63846
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/13/2007 $62.50
[TAX] 8% State Surcha 11/13/2007 $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 ' ' , ■ • ' -tion Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of th -:e rules or direc •ues , s toOUNC by calling 503.246.6699 or 1.800.332.2344.
t
Iss ed By: �! \14 J Permittee Signa # ,10 11 le '���
Call 503.639.4175 by 7:00 a.m. for an inspection th- • usiness 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.
b- `Luilding Permit Application
4 �" A "' FY h�` ine, y �4,s,�d?�'."i � ?r'I ,{:'ur $ 1 � 1 t S , .f
Fire Protection S stern���,,"p�� FOR + USEONLY 1 *� ".tT1Ff ' 1 ' "' t
`4� "r4.'?4V:;.4u i 1 iiTt I! wrR r.'ati. ±4e4+ +i''+nr� L s ,,,�'lts w ^rq.t�s. h 1 v� . 1'gito,�� ai ,i7 iPek _� S
u Received < City of Tigard Date /By � / b` v7 Permit No.: i 7 --005$
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 Date/By, Other Permit:
Inspection Line: 503.639.4175 Date Ready /By: Jeri ® See Page 2 for
T I G , R D , No tified/Method: «
t S u lemental Information
...�,a� Internet: www.tigard- or.gov PP
TYPE OF WORK REQUIRED DATA: I- 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
X Additionlalteration !replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling A.Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFO TION AND LOCATION - Total number of floors:
Job site address: 1 1 c, s' t ippet 5 leggy New dwelling area: square feet
City /State /ZIP: b /c II 4 jJ 04 Garage /carport area: square feet
i
Suite/bldg. /apt. no.: Project name: Ex EC 1 x 1' 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 OFF' WORK / work indicated on this application.
/,& S i 9 Mie e g iftir t/ t I i`°e-/Z Valuation: $ /gtX Od
T. t Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT ., Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT v J\CONTACT . PERSON .. NOTICE
Business name: rig ; S .�JP (20 1 All contractors and subcontractors are required to be
Contact name: 5/2 Ver I 1 Jt) licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1000 . .- e / ', I 7 (e f , /OS^ jurisdiction in which work is being performed. If the
02 �23 applicant is exempt from licensing, the following reasons
City /State /ZIP:
/ /�6 1 apply:
Phone: ( 503) 8'04 - g Z7 2- Fax:: ( )
E -mail:
CONTRACT OR BUILDING PERMIT FEES*
' (Please referto fee schedule)
Business name: „ / /2( , ee i Permit fee: �pZCO
Address: , a /Sox 730S 4 S O
p /� State surcharge (8% of permit fee): 54
4)
� I) i d � 17 Zd / FLS plan review (40% of permit fee):
Phone: ( ) Fax: (i @3) wZo -6 tel ( (Due upon application.)
CCB lic.: Total permit fees: ep`1 5
Amount received:
Authorized signature
This permit application expires if a permit is not obtained
Print name: 'weer b , f' m-gS'oA1 Date: ii /t 3/0 9 within 180 days after it has been accepted as complete.
f * Fee methodology set by Tri- County Building Industry
Service Board.
1: \Building\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02 /COM/WEB)
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 >I 1 -10 heads: No plan review required.
`Nt 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 N;N •
Density % .[Q
Design Area
K. Factor 5 • t
Sprinkler Project Valuation: $ l fro
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 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.
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