Permit BUILDING PERMIT
46,, CITY OF T I GA R D PERMIT #: BUP2005 -00494
� ��; � DEVELOPMENT SERVICES D ATE ISSUED: 10/7/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -00400
SITE ADDRESS: 15912 SW 72ND AVE B17 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 017 JURISDICTION: TIG
Project Description: Fire sprinkler TI, (63) 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: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 56 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: $ 8,500.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: 503 - 624 -6300 Phone: 503 - 620 -4020
FEES Reg #: LIC 64174
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/26/2005 $129.70
[TAX] 8% State Surchari 9/26/2005 $10.38
[FLS] FLS Pln Rv 9/26/2005 $51.88
Total $191.96
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
requ - - au to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9; -001 -0010 rough OAR 952 - 001 -0100. You may obtain a copy of these les or direct questions to OUNC by
alling 503 - 246 -6.•9 or 101 ' -•344. -
. sued By: _ _ i� s VA _ , LL. /.., ' Permittee Sig .ture: 4,, /�e jrl/ff �- •
Call 503 - 6394175 by 7:00 a.m. for an inspect on 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.
/691R, 72.0°19/A.
Fire Protection System 0) O Building Permit Applicati � /� /� FOR OFFICE USE ONLY
` `` Received n
City of Tigard C Ee 2' ` DateB : PTO 4 Permit No. • u P, -
13125 SW Hall Blvd., Tigard, OR 97223 J / t Plan Review
t.��' hl'
Phone: 503.639.4171 Fax: 503.598.1960 i D : N. / Other Permit:
Inspection Line: 503.639.4175 i'( �( 0 , ; • � • r'�!
n .. Date Ready t . !�s'� ® See Page 2 for
Internet: www.ci.tigard.or.us _, , " Notified/Method: i�. Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction El Demolition P ermit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ® Commercial /industrial
❑ 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: 15912 SW 72nd Avenue New dwelling area: square feet
City /State/ZIP: Portland, OR 97224 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: Oregon Business Park I - Covered porch area: square feet
Cookie Lee, Inc.
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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $$8,500.00
Addition or relocation of sprinkler heads
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Oregon Business Park 1 - Cookie Lee, Inc. Type of construction: 53
Address: 15912 SW 72nd Avenue Occupancy groups: is
City /State /ZIP: Portland, OR 97224 Existing: 5 (2
Phone: ( ) Fax: ( ) New:
0 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Delta Fire, Inc. All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: Amy R. Morse under ORS 701 and may be required to be licensed in the
Address: 14795 SW 72nd Avenue jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: Portland, OR 97224 apply:
Phone: (503) 620 -4020 Fax: : (503) 620-1058
E -mail: AmyM @deltafire.com
CONTRACTOR
Business name: Delta Fire, Inc. BUILDING PERMIT FEES*
Address: 14795 SW 72nd Avenue Please refer to fee schedule.
City /State/ZIP: Portland, OR 97224 Fees due upon application
Phone: (503) 620 -4020 Fax: (503) 620 -1058 Amount received
CCB lic.: 64174 Date received:
Authorized signature: ,\/' This permit application expires if a permit is not obtained L4jj2___,
/ within 180 days after it has been accepted as complete.
Print name: Amy R. Morse Date: 9 / 2 3 / �� * Fee methodology set by Tri-County Building Industry
//( Service Board.
i. \ Building \Permits \FPS- PmnitApp.doc 12/03 440- 4613T(1l /02/COM/WEB)
CITY OF TIGARD '''
BUILDING DIVISION PERMIT #: BUP2005-00494
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/7/2005
Phone: (503) 639 -4171 4 1. 1 11 �9pgtr ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 ._..!,i `__..
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 116
SITE ADDRESS: 15912 SW 72ND AVE B17 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 017 TYPE OF USE:
PROJECT NAME: COOKIE LEE
DESCRIPTION: Fire sprinkler TI, (63) heads
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: DELTA FIRE INC PHONE #: 503620.4020
Inspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 018147 -01 503 -620 -4020 N
Corrections /Comments/ Instructions:
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i ,p IVEri'Weirir
Ali
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: to C #: (503) 718 -
.