Permit CitY TIGARD BUILDING PERMIT
AA, PERMIT #: BUP2005 -00422
DEVELOPMENT SERVICES DATE ISSUED: 8/25/2005
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 450 ZONING: MUE
SUBDIVISION: TIGARD OFFICE BUILDING LOT: JURISDICTION: TIG
Project Description: Relocate /add (4) 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: 2 - HR sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf , ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 117 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: $ 1,067.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
. 15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Phone: 503 - 620 - 4020
Reg #: LIC 64174
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/25/2005 $62.50
[TAX] 8% State Surcha 8/25/2005 $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 throu h 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 -234 .
Issued By: - 97, /6A5L Permittee Signature: 1 e — —
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.
• Fire Protection System
Building Per><tiii'An 0 ��
' �� J ;I Di FOR OFFICE USE ONLY
City of Tigard Dee :e -1 !, /�)
//` )' Q� � N�...I Permit No.� ��� 3 .- eJ V . 4L
13125 SW Hall Blvd., Tigard, OR 97223 ? x % 7 260 Plan Review Y~
Phone: 503.639.4171 Fax: 503.598.1960 Itsi 'll`j Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: turis ® See Page 2 for
Internet: www.ci.tigard.or.us CITY Or (ICz/� Notified/Method: - r � Supplemental Information
BUILDING DIVISION
.. _ .
TYPE ',OF. WORIfi „ l .• , - -. ' , # ,; -. + REQUIRED DATA. -1 z iiiii YDliiEEl6tPi4
•
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
,Zddition/alteration/replacement ❑ Other: equipment, materials. labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION'`' ;...'. -' . ' work indicated on this application.
Valuation: $
❑ I- and 2- family dwelling Commercial /industrial
L ❑ Accessory building I ❑ Multi- family Number of bedrooms:
I ❑ Master builder I ❑ Other: Number of bathrooms:
'' Total number of floors:
JOB stn.- INFORMATION ANDS �LOGATION•' = •' - ' -' - -
Job site address: i v Oct S LA (, Oil j� i4-- A w New dwelling area: square feet
City/State/ZIP: I t� Gt, r - i o f . _ R --1 ZZ3 Garage/carport area: square feet .
Suite/bldg.%apt. no.: C , Project name: T?... l� t1 i iiirt tr . -A l To 5 ,, e ,„..,,_ Covered porch area: square feet
Cross street/directions to job site: C
at.tevut, Deck area: square feet
Other structure area: square feet
,REQUIRED DATAC.OMMER F..CHEG :
Subdivision: 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
s� ; , ,.;;. it .= work indicated on this application. '
DESCRIPTION °OF WORIf : ?- l'� ':' 1j µµ
Valuation: $ 1 U (O 1 .(if)
L � d c 6i 1 A ..-. eh -z_ Ctr 1 (h. el Ill ctOS • -
I L c V l � Existing building area: square feet
New building area: square feet
. a PROPERTY. OWNER - - • •TENANT -. " ¢tt ;; :.`•;:': Number of stories:
Name 2, IAf1UPTS���'lSit C_a�n6�t Type of construction:
Address: 1 Zei a `i 5 e. c , - '7" 1 Occupancy groups:
City /State /ZIR: rti/ ..., c 1 , U / q �7 Existing:
Phone: 1 ) L I Fax: ( ) New:
N . APPLICANT ❑ CONTACT PERSON . - . :. • rNOTICE'.;,' - - :. ' -,- := .:::.
i Business name: i�F j Q2 L � nr -. t All contractors and subcontractors are required to be
h licensed with the Oregon Construction Contractors Board
Contact name: p
��'i 1 l i ee i <lo . under ORS 701 and may be required to be licensed in the
Address: / Ll •) l s w z n d • rlve_L (4Q. jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State /ZIP: > _ , I e CIC `j, apply:
Phone: it:03 )62_0_ Lib Zv Fax: : (9:33 ) t'o Z.6 -la Ss
E -mail:
- CONTRACTOR
Business name: 12 l 1 N(ZP t T vv. , BUILDING :PERMIT: FEES *•
Address: 1 i s- � �,, "1Z , t! , y�e,,l (.t Please refer to fee schedule.
I City/State/ZIP: ecAg. = , l.t " L�- el ZZU Fees due upon application
Phone: (SD3) 6 2_0._ z i I Fax: ($a.3) (o z - l as 8 Amount received
CCB Iic.: 6
Date received:
Authorized signature: 44, This permit application expires if a permit is not obtained
within I80 days after it has been accepted as complete.
Print name: . Mo rip 2
Date: . (-1 J 6, s ' / • Fee methodology set by Tri-County Building Industry /// Service Board.
Building Pet mns FPS- Per4 Appdug 11'03 440 46 13T(I I /02 /COMVWEBI
,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200 QOa2z
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/25/2005
Phone: (503) 639 -4171 / m �jp�1lll`I
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 9/26/2005 TIME: 7 :12AM PAGE: 89
SITE ADDRESS: 12909 SW 68TH PKWY 450 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
TIGARD TRIANGLE CENTER
PROJECT NAME: TRINITY UNIVERSAL INSURANCE
DESCRIPTION: Relocate/add (4) sprinkler heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: 503. 620 -4020
Inspection Request Scheduled For: Date: 9/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message C
999 Sprinkler final 016542 -02 503- 620 -4020 0
Corrections/Comments/Instructions:
0 \
AI •
IWArAllirr
111, 1
I� 1 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 9/2 7" /0 Phone #: (503) 718-