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Permit
BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2004 -00086 , ^ 1 4. - 13125 DEVE 639 -4171 DATE ISSUED: 3/5/04 SITE ADDRESS: 16655 SW 72ND AVE 500 PARCEL: 2Si I3AC 00101 SUBDIVISION: COUNCIL VIEW ACRES NO. 2 ZONING: I -P BLOCK: LOT: 029 JURISDICTION: TIG REISSUE: 1i l FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: P 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: 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,301.00 Remarks: 13 sprinkler heads. Owner: Contractor: PACIFIC REALTY ASSOCIATES DELTA FIRE INC 15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE PORTLAND, OR 97224 PORTLAND, OR 97224 Phone: Phone: 620 -4020 Reg #: MET 8 000 0 011934 FEES LIC REQUIRED INSPECTIONS Description Date Amount Sprinkler inspection [BUILD] Permit Fee 3/4/04 $62.50 Final Inspection [TAX] 8% State Surchari 3/4/04 $5.00 [FLS] FLS Pin Rv 3/4/04 $25.00 Total $92.50 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 -0_010. .through OAR 952 - 001 -0110. You may obtain a copy of these rules or direct questions to OUNC by calling 03) 246- 6699or1- 800 - 33222-2 , L . ► Is - ued By: I' \,_ \ � � �i , o ' �/ w 6 " " Pe ' tee Signature: % , ii 4 1 f _V C (XL_ r Call 639 -4175 by 7 p.m. for an inspection the next business day ' Fire Protection System Iuilding Permit Aqp Et VE D FOR OFFICE USE ONLY City of Tigard l L� Received Permit No.: 13125 SW Hall Blvd., Ti ard, OR 97223 3�� 'J, • t op .. 0170 ti l/ g Plan Review Other PermitD Phone: 503.639.4171 Fax: 503.598.1 4 2004 .' ' 4p '')j�h�� Date : - S y $ Uf 2 cf — ®©O , 3 Inspection Line: 503.639.4175 �' Date Ready/By: & L ]uric: ® See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: e 1 Supplemental Information BUILDING DIVISION lack/ t' -4'• o c, TYPE OF WORK REQUIRED DATA: 1 - AND 2- FAMILY DWELLING 1 Jew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all # Xddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. El 1- and 2- family dwelling ogr,Cernofeirtihntlystrial Valuation: $ ❑ Accessory building El Multi-family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: / l C/(s �� 7A " )� T , New dwelling area: square feet City/ State/ZIP: Dr Garage /carport area: square feet Suite/bldg. /apt. no.: S Project na e: t. ` Covered porch area: square feet Cross street/directions to job site: ai t fist-. Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CIIECKLIST Subdivision: I 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: $ / 30 ( cID Existing building area: l square feet New building area: square feet ❑ PROPERTY OWNER I ❑ TENANT Number of stories: Name: A r k Cit .., f--..4,,f____ Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) I Fax: ( ) New: %. APPLICANT ❑ CONTACT PERSON NOTICE Business name: - ` / . All contractors and subcontractors are required to be t licensed with the Oregon Construction Contractors Board Contact name: 1 7 ,:c• ��jJ under ORS 701 and may be required to be licensed in the Address: � � r -.��'� l 7 jurisdiction in which work is being performed. If the City/ State/ZIP: / { � 1 , I Y ^ y� rt applicant is exempt from licensing, the following reasons �( `�—� apply: Phone: C` ) Fax:: ( ) E -mail: CONTRACTOR Business name: 7 Lf • BUILDING PERMIT FEES* Address: /lt �" G7Ava_ Please refer to fee schedule. City/ State/ZIP: ep r -t---(.0.__Wc j �� 7 � n F ees due upon application �� , Phone: (3:a. Lo a (..�O� Fax: ( �d� — (�--+SS Amount received CCB lic.: 6.0 / 7 Date received: Authorized signature: This permit application expires if a permit is not obtained vv within 180 days after it has been accepted as complete. Print name: Date: 1 L ( / y .7 * Fee methodology set by Tri- County Building Industry + Service Board. i:\Building\Pemuts \FPS- PermitApp.doc 12/03 440.4613T(I1 /02/COMIWEB) Fire Protection Permit Check List Describe work to be done: 1.) New 2.) Modification to sprinkler heads only: Ln- Addition ❑ 1 -10 heads: No plan review required. Alteration jg .11+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ cD ( B.) Type I Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations El 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): $ /3 ( . CYD 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: $ 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:\ Building\Forms\FPSchecklist.doc 12/24/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST 41b 2 � — v . 4` f06-3 Received /' ' ( 1m Date Requested 3 29 /AM PM !, U g 6 Location Th& 55 7Z 14-' Suite • c -OD MEC Contact Person Ph ( 503) 240 " 96 PLM Contractor �J Ph ( ) SWR BUILDING Tenant/Owner 4 .!! �1 Q►4iLe-Q' 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 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: nai► ,�. PART FAIL r BING 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: fl Unable to inspect — no access Fire Supply Line ADA (� Approach/Sidewalk Date 3/2 4/ a LI Inspector ( 63-31 Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST Received t o , � — :b 7 Date Requested 3 ~� q '° AM PM BUP f l0 Location i(0 S S 7 2 « 'Suite MEC Contact Person Ph 6 20 —c Z� PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 9 aC_ to / tv - 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 l Insulation move ©v l ,p ((> I'\ C°C! d 4a ✓ f I y 4 / 7'/ j� �i)r -e Drywall Nailing d " ew Firall F prim Fire Alarm Susp'd Ceiling Roof Other: S S P RT FAIL PLUMBING 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 PA -S RT FAIL EL T • CAL Se c: 2f111110 r c... L • 'Rage re A rm final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA . 3 ._ q-oy Approach/Sidewalk Date ' Inspector Z2P '� /e // - Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL