Permit 1111 CITY OF TIGARD BUILDING PERMIT
11 PERMIT #: BUP2007 -00476
° COMMUNITY DEVELOPMENT DATE ISSUED: 9/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AD
SITE ADDRESS: 16640 SW 72ND AVE B10 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 009 JURISDICTION: TIG
PROJECT: VERIS
Project Description: Alteration of (10) sprinkler heads for TI.
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: 25 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: $ 2,500.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 7000 SW HAMPTON ST #105
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Contact #: PRI 503 - 620 - 6140
FAX 503 - 620 -6141
Reg #: LIC 63846
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/10/2007 $69.65
[TAX] 8% State Surcha 9/10/2007 $5.57
Total $75.22
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 es o ect q _ , tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By: l L; i f Permittee Signat
14 a/ - "7 '
• 1 it i 0 1,1 " ------
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
'Building Permit Application
Fire Protection'Syste !! FOR OFFICE USE ONLY
1 `� . ` '
City of Tigard �I Received • Date/BY: /0 0'/ Permit No.: ; AV 7 .0e0 y7
q 13125 SW Hall Blvd., Tigard, ' ' 2 Plan Review
°N 0 . Phone: 503.639.4171 Fax: 503.59 0 Date/By: Other Permit:
- 1i D Line: 503.639.4175 10 2007 Date Ready/By: Juns: A j Su ®pplemental See page 2 for
CT, A Internet: www.tigard- or.gov Notified/Method: ( Info
CITY Of ['LARD
REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
A Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
❑ 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: j &WIC 50 - 12. /4' /E New dwelling area: square feet
City /State /ZIP: 774A-12o r o . ! 7 4. Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: V /S i N A I/Sr/lies Covered porch area: square feet
Cross street/directions to job site: "?Z/VT 1- b ti 71 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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF )1 WORK �� , / work indicated on this application.
gT . to ti /P) ji E , n + Valuation: $ 'Z�
4 .42-03 �' L Existing building area: square feet
New building area: square feet
)( PROPERTY OWNER I ❑ TENANT Number of stories:
Name: p/le lIsF � Type of construction:
Address: t r3s go- ' 'otA t W- Occupancy groups: L /4
City /State /ZIP: lid kriork4 Q elk q727-4 Existing:
Phone: ( f; ) eV) ) - 1,3co Fax: ( ) New:
,APPLICANT AVONTACT PERSON NOTICE
Business name: F 12c--511, P Co , . All contractors and subcontractors are required to be
Contact name: bRiler ' a/J licensed with the Oregon Construction Contractors Board
S' (7 under ORS 701 and may be required to be licensed in the
Address: ' 7O�O S W ,I' /�7yJP7P /1t/ J t , 01 ) r jurisdiction in which work is being performed. If the
�� X722 applicant is exempt from licensing, the following reasons
City /State /ZIP:
776446 r apply:
Phone: ( ) .304- $272 Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: kit ir7) P ( ' (Please refer to fee schedule)
Permit fee: 0,(,s
Address: AO, I3a k 230 S' 4 S
^ n D � �� State surcharge (8% of permit fee): 551
Cit y � IC /State /ZIP: r/64-0 2r1 (40% � FLS plan review (40 of permit fee): —429 Phone: (S"t)3) 622 ..._ 6 ido Fax: (rv3) 64 - (, /4) (Due upon application.)
CCB lic.: 63f3¢(o Total permit fees: 15.13
Authorized signal • Amount received: /0;21
;21
This permit application expires if a permit is not obtained
Print name: /3€c, e_ p, PGmesO.✓ Date: 9//010 7 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\Building\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist.
Page 2 = Supplemental Information ' i
Describe work to be done: n q4P
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition 1 -10 heads: Noaplari review required.
(R Alteration ❑ 11+ heads: "gin,
review req f . 0 - 9 •
❑ Repair
Number of sprinkler heads: 10
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
V' Wet ❑ Dry
Additional Standpipes
Information: Hazard Group l j 4/I'
Density • ID
Design Area OO
K. Factor 1(4.
Sprinkler Project Valuation: $ 'L51 ° C
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm •
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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.
•
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 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.
I: \Buil ding \Permits \FPS- PemlitApp.doc 2
CITY OF TIGARD -. A .
BUILDING DIVISION PERMIT #: BUP2007- 00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/10/2007
Phone: (503) 639 -4171 m
Inspection Requests (24 Hrs.): (503) 639 -4175 y- 'I I..
INSPECTION WORKSHEET FOR DATE: 11/21/2007 TIME: 7:00AM PAGE: 55
SITE ADDRESS: 16640 SW 72ND AVE B10 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 009 TYPE OF USE:
PROJECT NAME: VERIS
DESCRIPTION: Alteration of (10) sprinkler heads for TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOP CO PHONE #: 603-620-6140
Inspection Request Scheduled For: Date: 11/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinldor final 060065 -02 503-320 -8601 Y
Corrections /Comments /Instructions:
ti
n
n PA$ ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL r CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,PT e
Inspector: Date: ` Z O Phone #: (503) 718- 4 - r ° 7 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: l3UP2007 -00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/10/2007
Phone: (503) 639 -4171 4 1 Inspection Requests (24 Hrs.): (503) 639 -4175 I I
INSPECTION WORKSHEET FOR DATE: 9128/2007 TIME: 7 :00AM PAGE: 64
SITE ADDRESS: 16640 SW 72ND AVE B10 . CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK i LOT #: U09 TYPE OF USE:
PROJECT NAME: VERI S
DESCRIPTION: Alteration of (10) sprinlder heads for TI.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #:
CONTRACTOR: FIRE STOP CO PHONE #: 503.G20 -6140
Inspection Request Scheduled For: Date: 9/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinlder rough -in /test 056542 -01 503804 -8272 dr
Corrections /Comments/ Instructions:
`: PAS 0 P RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ i FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 tg 67 Phone #: (503) 718 - 6