Permit III a CITY OF TIGARD , BUILDING PERMIT
e - P #: BUP2009 -00023
COMMUNITY DEVELOPMENT , ` DATE ISSUED: 2/25/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DC - 00100
SITE ADDRESS: 15605 SW 72ND AVE ZONING: I - L
SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG
PROJECT: BRIDGEPORT DIST
Project Description: Reinstalling sprinkler system in area of roof collapse.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: S1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 25,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 230545
PORTLAND, OR 97224 TIGARD, OR 97281
Phone: Contact #: PRI 503- 804 -8272
FAX 503 - 620 - 6141
Reg #: LIC 183279
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/9/2009 $226.95
[TAX] 12% State Surch 2/9/2009 $27.23
[FLS] FLS Pln Rv 2/9/2009 $90.78
Total $344.96
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 thes= •' ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue • = ` / ' / / , _ .. f i ; Permittee Signature:
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.
Building Permit Application
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard Received Q
hr g FEB 9 200 rate B : q VA
Permit No. 3007Q .0002_5
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
p X . her Permit:
Phone: 503.639.4171 Fax: 503.598.19{ Date/B :
T I G A R p Inspection Line: 503.639.4175 tt�� OF TI(�jA� Date ReadyBy: El See Page 2 for
Internet: www.tigard- or.gov BUILD DIV ii . 0 `.) Supplemental Information
1 e W is .�! 1 •
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.
❑ I- and 2- family dwelling Commercial /industrial Valuation: $
❑ 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: /57 s 54„) -72„ALA New dwelling area: square feet
City /State /ZIP: p440 / /C 0 97 Zz4 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name :ae /eGer kd 7• 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: I 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.
b IN i ZL N0 _, / A /J Al 4 / N t1,/J !'�'��- 5.
Valuation: $ 2' 0 0
'op k ,[pr/' /" _Existin building area: square feet
New building area: square feet
1 ROPERTY OWNER ❑ TENANT Number of stories:
Name: P4CTnr'S7 Type of construction:
Address: / 5 sti) tip/ 4 kW J 71 Soo Occupancy groups:
City /State /ZIP: ,%QTZ ,v / 0/` 97274 Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT )21ONTACT PERSON NOTICE
Business name: + , El - ) All contractors and subcontractors are required to be
Contact name: 5n (JO� /�� fd/V licensed with the Oregon Construction Contractors Board
Si nder ORS 701 and may be required to be licensed in the
Address: 70 00 SW - /14- /PIPAI J • jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
/ A apply:
Phone: (So3) 204- - 8 �7z- Fax: : (, 3) f o - (G /4/
E -mail:
CONTRACTOR BUILDING PERMIT FEES* •
Business name: H2 , eo - (P refer tofu schedule, / P. D . ,5 73 4 Permit fee:
Address: t�„r J —
City/State/ZIP: K/`d O2 7 Z j State surcharge (12% of permit fee):
ity /State /ZIP:
�� i FLS plan review (40% of permit fee):
Phone: ( • ) Fax: ( ) (Due upon application.)
CCB lic.: Total permit fees:
Authorized signature: .-. Amount received: 354.496
e i This permit application expires if a permit is not obtained
Print name: 5,/[ U i) , PFf 0 A/ Date: 2/q f 0) within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I:\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
r . ,
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 Sprinlder (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 (12% 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.
•
l: \Building\ Permits \FPS- PcrmitApp.doc 06/25/08 2
CITY OF TIGARD `~ - P7 ,e_______
'-''' BUILDING DIVISION 1 PERMIT #: BUP2009- 00023
13125 SW Hall Blvd., Tigard, OR 97223 j ') DATE ISSUED: 2/2512009
Phone: (503) 639 -4171 Atav �, � 6��
Inspection Requests (24 Hrs.): (503) 639 -4175 J ] I
INSPECTION WORKSHEET FOR DATE: 3/2/2009 TIME: 7 : 00AM PAGE 14
SITE ADDRESS: 16605 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK!!! LOT #: 002 TYPE OF USE:
PROJECT NAME: BRIDGEPORT DIST
DESCRIPTION: Reinstalling sprinkler system in area of roof collapse.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRE STOP CO PHONE #: 503- 804 -8272
Inspection Request Scheduled For: Date: 302009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinllcr rough -in /test 080945 -01 360 - 909-8273 Y
Corrections /Comments /Instructions:
. 1//(C7 4 ,‹ fri/" ------- - - -
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17 f.1 ,-/f . Virt C, / 2e._4*--6e.__L- c--716 ee-g--
1
❑ PASS PART PPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Z_—■- Date7/ !j v / Phone #: (503) 718 - (72(>7
4
ti CITY' OFTIGARD ;
BUILDING DIVISION - PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 ( 0 v DATE ISSUED: 7J2' !7M08
Phone: (503) 639 -4171_
pv J �
Inspection Requests (24 Hrs.): (503) 639 -4175 � _ / O ,/
INSPECTION WORKSHEET FOR DATE: 3nJ2Ct;f9 TIME: 1:00AM • PAGE: 14
SITE ADDRESS: if.i 6i35 9. 72ND AVE CLASS OF WORK:
SUBDIVISION: +..3W J&A J SIN: X .1 PARK Ili LOT #: ;)t) TYPE OF USE
PROJECT NAME: t 32II V :PORT DIST
DESCRIPTION: Reinttsill41 spririkler sVttern in area^. 1J roof
OWNER: PAC11: C ULALTY AS: OCiAll:S, PHONE #:
CONTRACTOR: ;it& ;it 'Th)P ('0) PHONE #: t:03-s-1C'4 t1; /
Inspection Request- Scheduled For: Date: 3/2/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
990 :�I��i:�;�± r r.a; � s� r� /iE�,�c 0130946.G1 3t t,0.; !?': -1 -927:
Corrections/Comments/Instructions:
/4
Vl/t: /
❑ PASS PAR ' PPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone Phone #: (503) 718-
CITY OF TIGARD -' ` ,
BUILDING DIVISION �,\\ PERMIT #. B 1P 009.001023
13125 SW Hall Blvd., Tigard, OR 97223 f VS ISSUE ,';f�f,:ei)09
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �.:. ° L ' / '�� //�
/ /,3 INSPECTION WORKSHEET FOR DATE: 3/2/2009 TIME: 7 :00AM PAGE: 13
SITE ADDRESS: 16605 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINES 5 PARK III LOT #: 002 TYPE OF USE:
PROJECT NAME: BRIDGEPORT DIST
DESCRIPTION: Reinstalling sprinkler system in area of roof collapse.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRE3TOP CC) PHONE #: 503. 804 -8272
Inspection Request Scheduled For: Date: 3/2/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
995 Misc. inspection 080946.02 360-909-8273 N
Corrections /Comments /Instructions:
erk*
. •-/ /_---- ill / z3 -
..
- PAA S`S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL _ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3/7 b Phone #: (503) 718-
.
CITY OF TIGARD
7
BUILDING DIVISION PERMIT #: iLL ii--" ' ?UU - C1X;i2:3
13125 SW Hall Blvd., Tigard, OR 97223 -• / Os DATE ISSUED: 2r,'.F.i>`Ji! r - : f
Phone: (503) 639 -4171 Til 1 l I ,t'
Inspection Requests (24 Hrs.): (503) 639 -4175 — - /-
INSPECTION WORKSHEET FOR DATE: 3'/2/200. TIME: 7 :00AN1 PAGE: / 13
SITE ADDRESS: 1 t V 7:1141) AVE CLASS OF WORK:
SUBDIVISION: tM- F:t ON i _1`S1NNE.SS PARK Iki LOT #: 002 TYPE OF USE:
PROJECT NAME: Bl:ii _-;! `'OR f fai r
DESCRIPTION: Roirsrtaiiiii ..prsrii.cto• , z'ystc -, ni in area of Lod collapse
OWNER: PACIFIC. REALTY ASSOCIATES, PHONE #:
CONTRACTOR: r IF:.'i . )P co PHONE #: 5t.13.004 1 2/2
Inspection Request Scheduled For: Date: 3/2F200Fi Pour Time:
Code # Inspection Description Confirm # Contact # Message
; a MISC. ir1;.ipst t 5094 :; -02 ;t60.Wle827S N •
Corrections /Comments /Instructions: 04
(3 / f" ./i6i/ 23 — •
r
C ---- PA - S --- S pi PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` -/` Date: Od Phone #: (503) 718 - .2