Permit .T CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00058
lii DEVELOPMENT SERVICES DATE ISSUED: 2/15/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DA -00101
SITE ADDRESS: 13190 SW 68TH PKWY 200
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: C -P
BLOCK: LOT: 003 JURISDICTION: TIG
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: 2N : 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: $ 400.00
Remarks: Add (1) fire sprinkler head for TI
Owner: Contractor:
SCHNITZER INVESTMENT CORP A PROFESSIONAL FIRE SYSTEMS
PO BOX 10047 17273 S STEINER ROAD
PORTLAND, OR 97296 BEAVERCREEK, OR 97004
Phone: Phone: 632 -4353
Reg #: LIC 41650
FEES REQUIRED ITEMS AND REPORTS
Description Date Amount
[BUILD] Permit Fee 2/15/2005 $62.50
[TAX] 8% State Surchari 2/15/2005 $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 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling e " •. -•_ •9 or 1- 800 - 332 -2344.
r
lss :d By: . 1 / �i /iu
Permittee
Signature: X /C .
....--•--4-/e----
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Bui,Jdind Permit Application FOR OFFICE USE ONLY
City of Tigard RDate ed ii , I � Permit No.: ,�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �
Phone: 503.639.4171 Fax: 503.598.1960 //dtv kke,: 1 " '`i\ B Date : Other Pe is
Inspection Line: 503.639.4175 a1.1 ..• II Date ReadyBy: /'S: //�pa 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 1 t ' Supplemental Information
. • 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
gi Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling NICommercialfindustrial 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: New dwelling area: square feet
City/State/ZIP: 1's k 9 Q Sw ( 8i Garage/carport area: square feet
Suite/bldg. /apt. no.: 6 969 Project name: S R C SC r q(t E 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.
■r O \ S V fe. t .•11L L. t 2 Valuation: $ 400. 22—
Existing building area: 1G square feet
New building area: $- square feet
0: PROPERTY OWNER ❑ T ENANT Number of stories: 2,
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
g
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON .
a NOTICE . • • ." .
Business name: A 1, ESS % L, F12E. 6yS T E .,S CO . All contractors and subcontractors are required to be
Contact name: 1Z�Gl, -{ e�R el �•1 cite R. licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: k'1 Z1 3 6 ST EI 14 S R. Po . jurisdiction in which work is being performed. If the '
City/ State/ZIP: 6E1 J 1G2rC 2EEIt a2 9704 4 applicant is exempt from licensing, the following reasons
_ apply:
Phone: (Sb3) (032•— 4 353 Fax: : (503) ‘1L. 48 3 5
E -mail:
. CONTRACTOR . ,'
Business name: 5 (ssIv■ BUILDING.PER :
Address:
Please refer to fee schedule.
City/State/ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
Amount received
CCB lic.:
Date received:
Authorized signature: / i This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: ti74%c. t-1 A 6i N () (Z Date: 2. 12.- zoo S * Fee methodology set by Tri-County Building Industry
Service Board.
i:\Building \Permits \FPS- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
Fire Protection Permit Check List
Des cribe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
Addition 7 .ST 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: f
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: $ 46 • ou
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.
Project Valuation Subtotal (A, B & C): $ 47tO •. ° `�
Permit fee based on valuation (see attached chart): $ 6A .50
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ S, o
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ 41, 50
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.
i:\ Building\Forms\FPSchecklist.doc 12/24/03 .
CITY,OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received Date Requested l 7 AM PM BUP
Location /3190 �p �'�`` -`" Suite •6 MEC
Contact Person /9v-044 J U Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Jnspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firew-
Fire Alarm
Susp'd Ceiling
Roof
Ot• . •
A PART FAIL �
BING ��. 4I
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
• Low Voltage
Fire Alarm
Final Reinspection fee of $ requir- . be ' re next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please !I for re spection RE: 1 , Unable to inspect — no access
Fire Supply Line • --.�
ADA
Approach/Sidewalk Date ■ . Inspect r Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL