Permit ..: !: :: r / I d `""
A. CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00282
���; DEVELOPMENT SERVICES DATE ISSUED: 5/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY
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: 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: $ 1,855.00
Remarks: FLS Work is being done on 2 nd 3 floors and basement.
Owner: Contractor:
TIGARD TRIANGLE I LLC MASTER FIRE CONTROL, INC
4650 SW MACADAM AVE STE 220 12125 SE HWY 212
PORTLAND, OR 97201 CLACKAMAS, OR 97015
Phone:
Phone: 503 - 656 -0782
Reg #: MET 00002891
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[TAX] 8% State Tax 5/19/03 $5.00 Sprinkler Final
[FLS] FLS Pin Rv 5/19/03 $25.00
[BUILD] Permit Fee 5/19/03 $62.50
Total $92.50
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 (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: • I1V
— i . /
Pe mn ittee /
Signature: / / � ✓/
Call 639 -4175 by 7 p.m. f. r an inspection the next business day
TT• eT
ire Protection System " N
FOR OFFICE USE ONLY
BuiYcill • Permi ication , Received Building
V E Date/By: D —/ y - 03 Pe No. o 3 'od2s�
City of Tigard �/ c Planning Approval Other
Date/By: Permit No.:
13125 SW Hall Blvd. MAY ?003
Tigard, Oregon 97223 Cl 1 9 D S'Z 9 Permit No.:
- e 0 S
/ /a r � iµA ( Plan Review Other
€�i Post - evew Ri [ 3
Phone: 503 - 639 -4171 F � ! G a R r � �4i l.-- DateDate/By: St l a D Land Use
Case No.
Internet: www.ci.tigard.or.us G DI � Contact Juris.: ® See Page 2 for
Sl �' "�"
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
;IKAddition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATI • N and LOCATIO No. of bedrooms: No. of baths:
Job site address: 'a��SrI'FATEA' Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: -Li1LT4) NET --r. t. Covered porch area (sq. ft.)
Cross street/Directions to job ite: Deck area (sq. ft.)
Eil � .0i - 7 ZNP 21-7 Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivisio . ' 1111]i' 43 r ,lb. ''t ° if Lot #:
Tax Inap /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
D r N r W 5Pla1 L N ri OS overhead and profit for the work indicated on this application. �[' n�
G 1 � 1 £�C 1 yCs f-1�10 D� Valuation $ f n J � A v v
� La O ( ��--//�� Existing building area (sq. ft.) 1` Z�
�[> rn L✓xl New building area (sq. ft.) w
Number of stories `T
P ROPERTY OWNER 1 ❑ TENANT Type of construction
N e: TIG1 2/4106 -Le 1 L L C Occupancy group(s): Existing:
New:
Address: 4 � M! CAf 1Y1 Mg 50116120
City /State /Zip: pna an 0 .F Q no f
Phone: Fes; NOTICE: All contractors and subcontractors are required to be
APPLICANT PERSON licensed with the Oregon Construction Contractors Board under /// provisions of ORS 701 and may be required to be licensed in the
B u mess Name: (2 jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address: S C� "' _
City /State /Zip: ,�
Phone: 1 Fax:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
O.. CONTRACTOR
Business Name: W— Wire/AM 17! (� 4 Fees due upon application $ 1 2 s
Address: 11.1 2, , ! au) 1 Z,
Ci /State /Zi.: , ■ _ ■ Li ■ r .0 ,1 • • (s Amount received $
Phone: � zactr im r. -0 f?)Z/ Date received:
CCB Lic. #: S 1
Authorized ]] C�2 Notice: This permit application expires if a permit is not obtained within
Signature: // / ai1i �, . Date: S -1503 180 days after it has been accepted as complete.
A LEx D 61O S P *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
•
Fire Protection Permit Check List
A.) ❑ New ❑ Addition ❑ 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:
Additional description of work:
Type of System (Complete A, B 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 $
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.
is \dsts \forms \FPSchecklist.doc 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
3
BUP 'DI�OZ
Received ` Date Requested 6 AM - PM BUP
Location /3 a s g ' p I Suite a 00 MEC
Contact Person Ph ) 5�/ � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner �L�P�� ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 3 A d SIT
Post & Beam o`
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing "�—
Firew- / M / J `P (1 eo / i.'
•
e prinkler
Fire arm ° 120 r)"4- S 7
-
Susp'd Ceiling _
Roof � / .� 1'l�✓ . � 1 G1/ �'jeL� e S /� � /`'
xd
Other:
72-O
PART FAIL
-.'.' BING •
Post & Beam
Under Slab / e :Ct S t d /'e ^� U
Rough -In `* *r
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 for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA / / �
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL