Permit BUILDING PERMIT
CI TY OF T I GA R D PERMIT #: BUP2003 -00190
xiA DEVELOPMENT SERVICES DATE ISSUED: 4/24/03
.� II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 370 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: zi p, FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: AL'T r 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 837.00
Remarks: Add (3) 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 84 000 0 011934
FEES LIC REQU INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 4/24/03 $62.50 Final Inspection
[TAX] 8% State Tax 4/24/03 $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: 69kitit,o,L.A.
Permittee
Signature: 7 4 , 111 .,� / r _(j AB&
Call 639 -4175 by 7 p.m. for an inspection the next business day
PIP Fire Protection System
L _. ig,
Building Permit Application
:e. [Datereceived: / -2 /. 5 Permit no. ( co 3 'PO /9
t� 1 L i 1 City of Tigard
Project/appl. no.: Expire date:
Ciry of7igard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:2 i s I Receipt no.:
Fax: (503) 598 -1960 - Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory a ommerci • , industrial ❑ Multi-f• ' ❑ New construction ❑ Demolition
0 Addition/alteration /replacement '=L enant improvement Xl-Fire ,. /alarm ❑ Other,
JOB SITE INFORMATION
'
Job address: 0 • r o _ r�a ,.•" Bldg. no.: i : i Suite no.:
SD sw � - - /lam = - . � � => • "."� 3,14 L
Lot: Block: Subdivision: 4(�I ax map /tax lot/account no.: , j.,() -_=
Project name. - c- ■■:■-� - =.-- _ $ h � i_
Description and location of work on premises/special conditions: 4 la a_ . . as. itrat - _4 _s
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: 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.)
Covered porch area (sq. ft.)
Mailing address: 9 _ • f Deck area (sq. ft.)
• • [a r ZIP: ' 7
Other structure area (sq. ft.)
Phone: • _ a - 0, - Fax:(is - 0 a E -mail: CommerclaUlndustrialmulti- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
�' New bldg. area (sq. ft.)
Address: -- ?' JUMNIMIIIME
�� d Q
�����A� ZIP: • Number of stories
f �i+ii�� ' - Type of construction
Phone: i _ 6 Q - Fax:(p?pj -(p - E -mail:
Occupancy group(s): Existing:
CCB no.: 0 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: t� provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed. If the applicant is
Address: _ f 7 (.J ? ZIP: exempt from licensing, the following reason applies:
IIIM 1• C��!'�7 �iI� T1�
Contact person: Plan no.:
Phone: , ` • __y Fax' o de-/ 58' E -mail:
ENGINEER
Name: Contact person: Fees due upon application • . $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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 0 Visa Cl MasterCard
work will be complied with, whether s. cified herein or not. Credit card number. nn a
P
Authorized sign. �� 1,1,,, • Aid ' i_ _. Date: 4-t( 't) 3 Name of cardholder as shown on credit card
Print name: e_ 1 I ��/'W___ cardholder sigoanue $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.4613 (6f00/COM)
r - ,
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: 3
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 I $
•
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $ $3 7
Permit fee based on valuation (see chart): $ Co. a so
8% State Surcharge: $ S.Ox
FLS Plan Review 40% of Permit: $ '! , - -
TOTAL: $ 6 ?, 6O
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
BUILDING, Inspection Line: (503) 639 -4175
INSPECTION 'DIVISION Business Line: (503) 639 -4171 MST
BUP —0o /Fa
Received _'2 /a 2-4' Date Requested 7 r AM PM BUP
Location 6&4'D ' L`1 Suite " 370 MEC -
Contact Person �R 4C1 Ph ( ) (OR 9 /' Z O PLM
Contractor DoI f f i Ph ( ) SWR
XIZBING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain 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
Ot :r:
'iR1 • RT FAIL
NG
Post & Beam
Under Slab
Rough -Ins
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 0 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA a C
�/ 3 `'7 '9'.0 Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL