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Permit CITY OF TIGARD PERMIT. PERMIT #: BUP2003 -00327 � DEVELOPMENT SERVICES DATE ISSUED: 6/5/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S113AC -00101 SITE ADDRESS: 16655 SW 72ND AVE 200 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I -P BLOCK: LOT: 029 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: : 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:15 - 00 OO Remarks: Install 4 sprinkler heads. Owner: Contractor: PACIFIC REALTY ASSOCIATES DISCOUNT FIRE SYSTEMS INC 15350 SW SEQUOIA PKWY #300 -WMI 7402 SE JOHNSON CREEK BLVD PORTLAND, OR 97224 PORTLAND, OR 97206 Phone: Phone: 777 -5030 Reg #: MET 0 FEES LIC REQUIIZED4INSPECTIONS Description Date Amount Sprinkler inspection [BUILD] Permit Fee 6/5/03 $62.50 Final Inspection [TAX] 8% State Tax 6/5/03 $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 -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: AO Perm ittee Signature: / i � ��� ��� - / Call 639 -4175 by 7 p.m. for an inspection the next business day yfre Protection System Building Permit Application Received FOR OFFICE USE ONLY Building .. DateB : • _ ~ —D A • Permit No.: B ` // 0 I . , City of Tigard Planning Approval Other DateB Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 4 l i DateB : Permit No.: Phone: 503 639 - 4171 Fax: 503 - 598 - 1960 �""� ('� Post - Review Land Use A h .' Date/B : Case No. Internet: www.ci.tigard.or.us Contact ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 Name/Method: Su , • Iemental Information TYPE OF WORK REQUIRED DATA: ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING Addition /alteration/replacement ❑ Other: CATEGORY OF O■STRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate ❑ 1 & 2- Family dwelling Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation $ JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: 35 S ( ,J , Iv Total number of floors ��6 7e New dwelling area (sq. ft.) Suite #: 0 0 Bldg. /Apt. #: , Garage /carport area (sq. ft.) Project Name: f7 ,Q ,./O /4 /C j Covered porch area (sq. ft.) Cross street/Directions to job sit Deck area (sq. ft.) Other structure area (sq. ft.) REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: 1 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, overhead and profit for the work indicated on this application. „ — 0 /c/ /'c ek O r( ' vet e 7 < . 6 Valuation $ S. 00 U Existing building area (sq. ft.) /AV Sy ,r i a /O44 7 , ,e, 5 ei vox) eC° eorn ` New building area (sq. ft.) Q Number of stories / ❑ PROPERTY OWNER j TENANT Type of construction /�� �� � ife Occupancy group(s): Existing: Name: /? / O!??/ . Address: //��� r, J 7 2 ed New: City/State /Zip: 3 e Y C7o 7'N , / v O NOTICE: All contractors and subcontractors are required to be hone: Fax: licensed with the Oregon Construction Contractors Board under APPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: 12 co a ,,, -- r ye .5 YaLJ jurisdiction where work is being performed. If the applicant is exempt Contact Name: aJ0axi e C p e to v1 redo from licensing, the following reason applies: Address: 74/(C7,a S_f t�lic/Se,,rs (? /3 / i s City /State /Zip: Ror77,74id ©v 72 a0-:S Phone503 777 5oid I Fax - ,519S 777 06.5'T� BUILDING PERMIT FEES* E -mail: Please refer to fee schedule. CONTRACTOR Business Name: 5 le e O . , Fees due upon application $ Address: City /State /Zip: Amount received $ Phone: I Fax: Date received: CCB Lic. #: r,3 vg/ Authorized Notice: This permit application expires if a permit is not obtained within Signature: `,( / "ow°. �9/LlP,_ .u1Qn$ ate: (� / °J � � C%S 180 days after it has been accepted as complete. ��/Q x/ e a4i Q d z 67, e, *Fee methodology set by Tri- County Building Industry Service Board. ( n t name) is \Dsts\Permit Forms\BldgPermitApp.doc 01/03 4 / V1 Fire Protection Permit Check List A.) ❑ New Addition ❑ Alteration ❑ Repair B.) odification to sprinkler heads only: Describe work to 1. 1 -10 heads: No plan review required. be done: . 11+ heads: Plan review required. • Number of sprinkler heads: Additional description of work: y h e04 / oul,ie- Tt c1 c s Type of System (Complete A, B or C as applicable) A.) Sprinkler Wet ❑ Dry ❑ Standpipes Additional Hazard Group Information 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: $ • Project Valuation Subtotal (A, B & C): $ Permit fee based on valuation (see chart): $ 8% State Surcharge: $ FLS Plan Review 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. i:\dsts \forms \FPSchecklist.doc 11/21/01 CITY OF TIGARD 24 -Hour BUILDS Inspection Line: (503) 639 -4175 INSPECTION DIVISION Bu in (503) 639 -4171 MST (2(, - � / ��..aa�t BUP .3 - 003°.7 Received Date Requested to — 0 11 AM PM BUP Location % = =_ Suite a un MEC Contact Person �-' , • •h( ) '7 77 5 3a PLM Vill r ., Contractor ,i i Ph ( ) SWR BUILDING Tenant/Owner F.-&-j-4-74- l7 - ELC Footing (/ Foundation ELC Ftg Drain Access: ELR Crawl Drain _ -_— Slab ctl n Notes: SIT Post Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Alarm Susp'd Ceiling Roof Other: ( # PART FAIL •t TV BING Post & Beam Under Slab Rough -In - 'Water S ervice 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 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE E Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date (( Inspector ` Ext Fina r DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL