Permit BUILDING PERMIT
CITY OF TIGARD
P ERMIT #: BUP2004 -00415
,� DEVELOPMENT SERVICES DATE ISSUED: 9/16/2004
--- '�� 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 13221 SW 68TH PKWY 460 PARCEL: 2S101 DA -00102
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT: 002 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: 2FR : 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: $ 9,401.00
Remarks: Add /relocate (39) fire sprinklers heads.
Owner: Contractor:
ROBINSON, ROY MASTER FIRE CONTROL, INC
2655 SEELY AVE. 12125 SE HWY 212
SAN JOSE, CA 95134 CLACKAMAS, OR 97015
Phone: 408 - 943 -1234
Phone: 408 - 943 -1234
Reg #: SE3T656- 0t 2
6GG
FEES LIC REQU IRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 8/26/2004 $139.30 Sprinkler Final
[TAX] 8% State Surchari 8/26/2004 $11.14
[BUPPLN] Pln Rv 8/26/2004 $55.72
Total $206.16
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 ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 :11-0010 thr.. • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
c- ing (503) 246 -669• .r 1- 800 -332• .
i ' 4ars eovtz.a
Is - ed By: • 9 4 ,
Permittee
Signature: )c, __
Call 639 -4175 by 7 p.m. for an inspection the next business day
/3Z1-1 S w 6& ? ,.,
Fi�� Protection System
it rot) PA FOR OFFICE USE ONLY
`. ding Perm: r W" Received i Buildin � /
Date/B : 0 ' / / Permit No. S
AUG ���p, Planning Ap. oval Other
City of Tigard G�� 51 Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 CITY OF TIGARD Date/By:''�S'0 8s� Permit No.:
Phone: 503- 639 -4171 FRY UA> 1VitigBM ^�'� c "'Ii— Date/By: view Case Noe
Inte www.ci.tigard.or.us y:
Contact See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name/Method: - (T Supp lemental Information
- .., TYPE OF WORK .. .. REQUIRED DATA: •
0 New construction ❑ Demolition 2 FAMILY DWELLING
ddition/alteration/replacement ❑ Other:
" ,'^ `CATEGORY 0 ONSTRUCTION . . Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling 6. Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
• Accesso Buildin: • ■ Multi -Fa
• Master Builder Other: 71j Valuation $
'"i, t, B • N -and 1 • TION . `. > , , No. of bedrooms: No. of baths:
• Total number of floors
Job site address: - _ _ u New dwelling area (sq. ft)
Suite #: ' - • Bld:. /A i t. #: i RT a l LI Garage/carport area (sq. ft.)
Pro•ect Name: I rih1 NL`■AIS Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
. - -- < • ' REQUIRED DATA: . -
. COMMERCIAL - USE CHECKLIST .
Subdivision: 1 Lot #: .. ,
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF - WORK .• ' . - a the value (rounded to the nearest dollar) of all equipment, materials, labor,
l ifiY ar / V P I r overhead and profit for the work indicated on this application.
QS 1 C . 1 Valuation $
//VV IJ G Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
: - PROPERTY OWNER . . { CI TENANT • .. - Type of construction
Occupancy group(s): Existing:
Name: New:
Address:
City /State/Zip:
NOTICE: All contractors and subcontractors are required to be •
Phone: F . • : licensed with the Oregon Construction Contractors Board under
A .OYEaQArrr. '; _ - . . :i4 � C' NTACT PERSON _, provisions of ORS 701 and may be required to be licensed in the
Business Name: Ul i �is� ilL!!.,. 1 •_ J A jurisdiction where work is being performed. If the applicant is exempt
Contact Name: 4 L.E�C ' 141 4 A)O-F from licensing, the following reason applies: •
Address: _ , l.t) / 2
Ci /State/Zi
ri t!:_ /�f ' 0 —
Phone: .�►'�.�i'I�ir�� �ir• 10 ■ * Y r
.$iTILDING PERMIT FEES
E - mail: ' to fee scitedule. .
CONTRACTOR
Business Name: Fees due upon application $
• t'
Cit y/ State/Zip: Amount received $ r
City/State/Zip:
Phone: 1 Fax: Date received: are" Z.6 2 ,00 4 .
CCB Lic. #: •
Authorized Q L� Notice: This permit application expires if permit is not obtained within
Signature: /�/� Date: U '! [7 180 days after it has been accepted as complete.
A 1 11X A I4/00/1/OP *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i :\Dsts\Pemrit Forms\BldgPermitApp.doc 01/03 .
Fire Protection Permit Check List
A.) ❑ New Li Addition LI Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required. ",
Number of sprinkler heads: 3 ge.�C�
Additional description of work:
Type of'System'(Complete.A, or C as applicable): .
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation 1 $
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
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.
• tAdssts\fonns\FPScheCcAst.doc 11/21/01
CITY_OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPESIION DIVISION Business Line: (503) 639 -4171
BUP Oe -66 yi
Received Date Requested / 1 q AM PM BUP
Location 1 3 4D- a- 1 co w Suite 4- 6 MEC
Contact Pers 611 j G DGZ-4(J Ph ( ) 5— —,5-4 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Al aNAV
Fire Alarm
Susp'd Ceiling
Roof OP 111111
WNW '1 " WIPP w
a PART FAIL
• L :ING
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 $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call • r rein • -ction RE: Unable to inspect — no access
Fire Supply Line i
ADA spi4
Approach/Sidewalk Date Inspec Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL