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Permit CITY OF TIGARD PERMIT PERMIT #: BUP2001 -00346 ��; DEVELOPMENT SERVICES DATE ISSUED: 9/28/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S112D6 00300 SITE ADDRESS: 07257 SW KABLE LN 300 SUBDIVISION: SOUTHERN PACIFIC TIGARD IND. ZONING: I -L BLOCK: LOT: 005 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: 5N : sf N: S: E: W: OCCUPANCY GRP: B TOTAL AREA: 0.00 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: $ 8,000.00 Remarks: Addition of a modified Alarm System - Occupancy is "B" - SYstems is allowed as approved on the plans Owner: Contractor: PACIFIC REALTY ASSOCIATES HONEYWELL INC 15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA PKWY PORTLAND, OR 97224 STT 7��g Phone: P Phone N tui` 8 Reg #: LIC 57824 ELE 26207CLE FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Electrical Permit Required PRMT CTR 9/21/01 $120.10 27200100000 Fire Alarm Insp Final Inspection 5PCT CTR 9/21/01 $9.61 27200100000 FIRE CTR 9/21/01 $48.04 27200100000 Total $177.75 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 -1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -669 • • r 1- 800 - 332 -2344. Pe rm ittee Signatur -. < A y� -r Issu : d By: , _._ COQ -44 o Call 639 -4175 by 7 p.m. for an inspection the next business day . F I-00/3_ A Building Permit Application Date received: q)-( a 1 Permit no.: 13u i00-0 / _ (x)34 (o “iy( A City of Tigard = Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 ^ Phone: (503) 639 - 4171 Date issued: 139126 Receipt no.: Fax: (503) 598 Case file no.: Payment type: rill S Land use approval: t &2family: Simple Complex: - TYPE OF PERMIT 0 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family 0 New construction ❑ Demolition ❑ Addition/alteration/replacement UTenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: a S'' Lo K.cJoLe Loc ;,,._ Q Bldg. no.: Suite no.: Lot: I Block: Subdivision: I Tax map /tax lot/account no.: Project name: T mot' i r Add Description and location of work on premises/special conditions: ADt� 1 77 D ■■ (9 Mc( ot_ r.0 a. L 7't. & t. L OWNER FOR SPECIAL INFORMATION, USE CHECKLIST �; Name: (Flood plain, septic capacity, solar, etc.) Mailing address: 1 & 2 family dwelling: City: IState: IZIP: Valuation of work $ Phone: I Fax: I E -mail: No. of bedrooms/baths Owner's representative: Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage/carport area (sq. ft.) Name: 0 -0 . te� LJ e Lc Covered porch area (sq. ft.) Mailing address: / c{ 5 g Le 9 5e4, uo i et. 1 ;,, � K City: 17toyL l Zcc , I State. I ZIP: 9 r2 2 42 Deck area (sq. ft.) 4 Other structure area (sq. ft.) Phone:-5 ^b, _ . Fax: E -mail: Commercial/industrial /multi - family: CONTRACTOR Valuation of work $ . 000 . 0 6 Existing bldg. area (sq. ft.) Business name: kr)"� Q i to -e LC ' New bldg. area (sq. ft.) Address: / 5 U op; 5 t t_� '$e u 0 . l ►t9 City: "Rost fl �ce 1 State: ©e_ I ZIP: c) a Number of stories Type of construction Phone:5a -% -.?33 3 I Fax: 9 (1) � �339$I E -mail: CCB no.: °� '�5j a � Occupancy group(s): Existing: New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: I ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: State: 'ZIP: Amount received $ Phone: I Fax: I E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied ith, specified herein or not. Credit card number: / / ,y _.....„whether Expires Authorized signature: 9 —''' Date: � -1 -0 Name of cardholder as shown on credit card Print name: 5-1-e(..• MO V14 Cardholder signature $ Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM) \7-D 1 0 1 7 S -T 0 1 (0 Fl-S. q .c)'L Fire Protection Permit Check List A.) ❑ New ❑ Addition ❑ Alteration ❑ Repair B.) Modification to sprinkler heads only: Describe work to 1. 1 -10 heads: No plan review required. be done: 2. 11+ heads: Plan review required. Number of sprinkler heads: Additional description of work: 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 ID include: Individual Component Yes Cut Sheets Fire Alarm Project Valuation: $ 4�0 Project Valuation Subtotal (A, B & C): $ - c' c9-O Permit fee based on valuation (see chart): $ / 2.p, 10 8% State Surcharge: $ 93,91 FLS Plan Review 40% of Permit: $ e-19.64 TOTAL: $ 11 "1 1 5 is \dsts \forms\FPSchecklist.doc 06/07/01