Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00403
.-,414-
DEVELOPMENT H BMEN (503) 639 -4171 DATE ISSUED: 7/1/03
SITE ADDRESS: 13535 SW 72ND AVE 140 PARCEL: 2S101DC -00200
SUBDIVISION: 72ND AVE OFFICE BUILDING ZONING: C -P
BLOCK: LOT: 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: 3N : 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: $ 1,100.00
Remarks: Add (3) fire sprinkler heads and relocate (4) heads.
Owner: Contractor:
PACIFIC NW PROPERTIES LTD PTNSHP AFP SYSTEMS INC
9665 SW ALLEN BLVD STE 115 19435 SW 129TH
BEAVERTON, OR 97005 TUALATIN, OR 97062
Phone:
Phone: FAX- 692 -1186
Reg #: IME 692 -9 ®
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 7/1/03 $62.50 Sprinkler Final
[TAX] 8% State Tax 7/1/03 $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 -00.10 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (50 - •'. -•. • • or 1- 800 - 332 -2344.
Issued By.
/' ,1/ ► ceica.n.L.34.i,/ t i •
Permittee
g '.
1,\ 1. %
VP
Signature: . ,
Call 639 -4175 by 7 p.m. for an inspection the next business day
/� •
r Building Permit Application
- P ► ereceived: C � -��j . i i�� city of Ti ga rd � ect/appl. no.: e:
Cityogard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 e issued: I Receipt n o.: Fax: (503) 598 - 1960 e file no.: ype:
Land use approval: 2 family: Simple
TA PE OF 1'1• :ItNII I
0 1 & 2 family dwelling or accessory 0 Commercial/industrial • 0 Multi - family 0 New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement - Cl Fire sprinkler /alamt 0 Other:
JOB SITE INFORMATION
Job address: 5 S S ■ , ' , 1 a- Bldg. no.: Suite no.: D
Lot: Block: Subdivision: Tax map/tax lot/account no.:
Project name: . _ „. i ,
Description and location of work on premises/special conditions: .• , .. rf - „ - ` 1 le a ,...41
OWNLIt FOR SPECIAL INFORMATION, USE CHECKLIST
r o\ 14 .P P � 0r J,fi_r ( Floodplain ,septiccapacity, solar, etc.)
Mailing address: IVMEIZEIE - 1 & 2 family dwelling:
State: C°, g ZIP: Valuation of work $
Phone: 503- (,21, -$SoO Fax:5o3- 611 -"ou' E-mail: No. of bedrooms/baths
Owner's representative: Pal 6gv' 4 Total number of floors
Phone: . i E New dwelling area (sq. ft.)
A I' I' L I CA N I Garage/carport area (sq. ft.)
Name: . Covered porch area (sq. ft.)
Mailing address: • Deck area (sq. ft.)'
City: - State: ZIP: Other structure area ( .. ft.)
Phone: Fax: E-mail: • ' Commercial indostrlaUmoiti -family:
C ON I It %CI OR Valuation of work.: $ ( i1C5Na
Business name: Existing bldg. area (sq. ft.)
--' - New bldg. area (sq. ft.)
Address: . Li IS S i V Number of stories
State: a ZIP: 1�+,1•�,' Type of of swri ction
Phone: !,t2- LIb Fax: Pf9 1 cw, E-mail:
CCB no.: (►� 1
Occupancy group(s): Existing:
New:
City /metro lic. no.: 3,: f
' Notlee: All contractors and subcontractors are required to be
Alt( III I 1,( I / I )1: S I (; N I •: It licensed with the Oregon Construction Contractors Board under
Name: ti -_,, t "i , -; . ; *provisions of ORS 701 and may be required to be licensed in the
. , c , , ^-- - , jurisdiction where work is being performed. If the applicant is
c ommlammummemrgia up: ., - Address: y 0 .t ,. r r _ : exempt from licensing, the following reason applies:
Contact person: ,,- 7 -.., -,-,-. , -, Plan no.: - -
Phone: Y i ` r : ., Fax: _ E-mail: .
1:: \INI:
• Name: II Contact . a .n: Fees due upon application $
Address: Date received:
City: State: ZIP: ' - • - Amount received - $
Phone: Fax: E - - Please refer to fee schedule.
I hereby certify] have read and examined this application and the Not as jurisdiction accept aest cads, please cell jmtesodon for MOM informatioa
attached checklist. All provisions of laws and ordinances governing this Ovum 0 Mast12Card
work will be compli with, latter specified herein or not, .. • oust cad number: / /
j �--�'
Bxpirea
Authorized signature: t' Date: (C' D- C Name of ardbotau as .Hawn on credit card
Print name: Siva. e- c signature • 3 Ama®c
Notice: This permit application expires if a permit is notobtained within 180 days after it has been accepted as complete. 440.4613 (6 00/COM)
. ,
Fire Protection Permit Check List
A.) ❑ New ❑ Addition I AAlteration ❑ 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: A. --s h-
4`
_ Type of System (Complete A B as applicable): ` 4 µ
A.) Sprinkler Wet P Dry ❑
Standpipes
Additional Hazard Group L Lela
Information Density o 10
Design Area I S00
K. Factor • 5
Sprinkler Project Valuation: $ 7 OD a a
B.) Type I - Hood F ir a Suppression System .
Hood Project Valuation I $
- - 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.
LidstsltonnsWFPSc diet doc 11/21101
CITY OF TIGARD 24-Hour •
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 41710" -,
RS 3 - oa�o3
Received Date Requested 7 F AM PM BUP
Location " 3 53.5- 7a. Suite / MEC
Contact Person Ph ( ) 1 9a g ' / PLM
Contractor Ph ) SWR
BUILDING Tenant/Owner ILA 1 h � — 5.1., (6.M ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
11 0\
Firewall
ire • arm
Susp'd Ceiling
Roof
e PART FAIL
PLUMBING '
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 El Please call for reinspection RE: ID Unable to inspect — no access
Fire Supply Line 747 / '
ADA Approach/Sidewalk Date G../ Inspector 97)).-2 Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL