Permit III a CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT DATE SSUED: BUP2007-00274
5/22/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S113AD -01800
SITE ADDRESS: 16650 SW 72ND AVE B12 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG
PROJECT: JOHNSTONE SUPPLY
Project Description: Fire alarm.
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: S2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 260 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: $ 2,400.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADVANCED SECURITY & FIRE
15350 SW SEQUOIA PKWY #300 -WMI 2218 NE SUNRISE LN
PORTLAND, OR 97224 HILLSBORO, OR 97124
Contact #: PRI 503 - 519 - 4550
Phone:
Reg #: LIC 16176
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/22/2007 $72.10
[TAX] 8% State Surcha 5/22/2007 $5.77
[FLS] FLS Pln Rv 5/22/2007 $28.84
Total $106.71
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 rul ect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued 1 r/Le"..( Permittee Signature: I
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 System FOR OFFICE USE ONLY
11,4 City of Tigard Date/By: .7 /Y , �jCU7� 7 �
7 Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C . Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T 1 G n It D Inspection Line: 503.639.4175 Date Ready/By: Jur' • El See Page 2 for
Internet: www.tigard -or.gov Notified/Method: a. Supplemental Information
TYPE OF WORK 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
b dtedition /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: , �l-" 4t----- New dwelling area: square feet
City/State /ZIP: 2 4- -i ,e.✓ J O/Z 77 +, L Garage /carport area: square feet
Suite/bldg. /apt. no.: Project nam ._ /
e: 4, x- �`/ Covered porch area: square feet
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.
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 WORK work indicated on this application. ,
Valuation: $C2,/,Id
j; Ai i Pc& � ST - P- Existing building area: square feet
tuck) RF_ Qe) mit / New building area: square feet
to'PROPERTY OWNER ❑ TENANT Number of stories:
Name: c '*� v �S- Type of construction: 6
Address: J P � f 5'79 e J),' -/ SF, vI / /J— f / Occupancy groups: '0
7 v - jQ
City /State /ZIP: "A f 1 4 r . / e___ ,,,..-c- / Existing:
Phone: ( ) Fax: ( ) New:
'APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 4 22 c � el LS ���� , l • All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZIP: /State /ZIP: applicant is exempt from licensing, the following reasons
ty apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: at e. L Z Cu a e 1 y N- /� 14� (PleasereJertojaschedalel
J Permit fee:
Address:
State surcharge (8% of permit fee):
City/State /ZIP:
FLS plan review (40% of permit fee):
Phone: ( ) I Fax: ( ) (Due upon application.)
CCB lic.:
Co to / 7 Total permit fees:
Authorized signature: Amount received: 44 . 7/
' - . . .2, ,,,... This permit application expires if a permit is not obtained
Print name: /�f° Date: within 180 days after it has been accepted as complete.
�� �Y�t t /tJ� • Fee methodology set by Tri -County Building Industry
Service Board.
I.\Building\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(I I /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist L
Page 2 - Supplemental Information
Describe work to b e done:
1.) ❑ New 2.) 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 Sprinlder
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
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: $
•
D.) Residential Sprinlder (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: \Building \Permits \FPS - PermitApp.doc 2