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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00451 eo, DEVELOPMENT SERVICES DATE ISSUED: 9/23/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AA -00500 SITE ADDRESS: 16100 SW 72ND AVE B -18 SUBDIVISION: OREGON BUSINESS PARK I ZONING: I -L BLOCK: LOT: OOA 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: NONE : sf N: S: E: W: OCCUPANCY GRP: 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: $ 600.00 Remarks: Install (2) new heads in office & repipe (2) existing heads in restroom area. Owner: Contractor: PACIFIC REALTY ASSOCIATES FIRESTOP CO 15350 SW SEQUOIA PKWY #300 -WMI 9384 SW TIGARD ST PORTLAND, OR 97224 TIGARD, OR 97223 Phone: Phone: 620 -6140 Reg #: LIC 63846 FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough -In [BUILD] Permit Fee 9/23/2004 $62.50 Sprinkler Final [TAX] 8% State Surchari 9/23/2004 $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 (503) 246 -6699 or 1- 800 - 332 -2344. Issued By: Ap Permittee Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection System _ Uti..2.-- 1. Building Per • • n FOR OFFICE USE ONLY Received Building _ Date/B : Permit No.: t• / a ' Cit of Tigard Planning Approval Other y g e� 2004 Date/B Permit No.: 13125 SW Hall Blvd. SEP 2 J Plan Review Other Tigard, Oregon 97223 F p � � ( QIISI � ' TIGARD Date /B : Permit No.: Phone: 503- 639 -4171 Fax: u i \ Post - Review Land Use ' lVl Y_ V1 I Date/B : Case No. Internet: www.ci.tigard.or.0 -' Contact luris.: Ei See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 Name /Method: Su . demental Information TYPE OF WORK REQUIRED DATA: El New construction ❑ Demolition 1 & 2 FAMILY DWELLING X Addition/alteration/replacement ❑ Other: CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate ❑ 1 & 2- Family dwelling ('CommerciaLIIndustrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building 0 Multi- Family ❑ Master Builder ❑ Other: Valuation $ JOB SITE INFORMATION ay LOCATION No. of bedrooms: No. of baths: Job site address: /62/00 S/ -)21)11 Total number of floors New dwelling area (sq. ft.) Suite #: 1 Bldg./Apt.#: Garage /carport area (sq. ft.) Project Name: / g lima 4S 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: Lot #: Tax map /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, / ,JJ Z /V r 4 / - I Q Met overhead and profit for the work indicated on this application. Mb xe-p w 7 EX I S 17 fit. /J%j S Valuation $ TODD /A ke p Yf x200 / Existing ( ting building area (sq. ft.) ,•/ New building area (sq. . ft.) .) Number of stories ( PROPERTY OWNER ( ❑ TENANT Type of construction N e: g j pn . Occupancy group(s): Existing: Address: / S W . S Ulu / �,t�l dAT New: '3 City/State /Zip: 4 / O 97Z`Z - Phone: (024 4.500 Fax: afge.44,0 NOTICE: All contractors and subcontractors are required to be ❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under provisions of ORS 701 and may be required to be licensed in the Business Name: jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing, the following reason applies: Address: City/State /Zip: Phone: Fax: BUILDING PERMIT FEES* . E -mail: Please refer to fee schedule. CONTRACTOR Business Name: � ecitP et) s Fees due upon application $ Address: , 0, 5 23t S4S City /State /Zip: TGki ©Q 97g/ Amount received $ Phone: t 20 s6 /4 0 I Fax: 62() - t 14 I Date received: CCB Lic. #: 63$4 Authorized Notice: This permit application expires if a permit is not obtained within Signature: AA py. jPil / e: 8 180 days after it has been accepted as complete. B,e'rtci b . - }O") *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms\B1dgPermitApp.doc 01/03 Fire Protection Permit Check List Describe work to be done: A.) ❑ New B.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Wet k Dry ❑ Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ &eV 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): $ Permit fee based on valuation (see attached chart): $ Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ FLS Plan Review 40% of Permit Fee: $ TOTAL: $ 6 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 02/28/03 CITY OF T'ARD 24 -Hour BUILDI . Inspection Line : (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Cile2 Received Date Requested � , — �� AM PM BUP Location / / O 0 7 a Suite MEC Contact Person 6/141- -- Ph ( ) / 4 4-g?- -- 7 2 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner p��/ 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 Firew IL41 Fire Alarm - , / V Susp'd Ceiling Roof Other: PAS PART FAIL 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 E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please cal or rei pection RE: Unable to inspect — no access Fire Supply Line / ADA Approach/Sidewalk D a t e l� Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL