Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00118
o'rA DEVELOPMENT SERVICES DATE ISSUED: 4/2/02
r � I i � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S112DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 160
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 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: 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: $ 390.00
Remarks: Tenant Improvement - relocate 4 existing sprinkler heads
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 9384 SW TIGARD ST
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 4/2/02 $62.50 27200200000 Final Inspection
5PCT CTR 4/2/02 $5.00 27200200000
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature: ( v'I i .n (,,
,__
Issued By: k_Q 7 Viz '
'Call 639 -4175 by 7 p.m. for an inspection the next business da
Y P P day
•s
, .. A Building Permit Application / Datereceived: - D.-- OZ Perm4 1 IV ,1 g
�
lei City of Tigard y
Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory : Commercial/industrial 0 Multi-family 0 New construction 0 Demolition
❑ Addition /alteration/replacement 1;1'I`enant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: efi ♦ L! � /� r Bldg. no.: Suite no.: MIMI
Lot: Block: Subdivision: vw' , _ ll/1:mAn:mi Tax map /tax lot/account no.:
Project name: 1 01/ (s a410,27 Description and location of work on premises/special conditions:
i/ , . i
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: pi- IT Sr (Floodplain, septic capacity, solar, etc.)
Mailing address: • $ sp III GS ' I 1 & 2 family dwelling:
M1 State: & ZIP: 9-1 22, M Valuation of work $
Phone:(oM - ,300 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: cis:0 1.,0 it Le b.. S. �1 Deck area (sq. ft.)
ZIP q 7 Other structure area (sq. ft.)
Phone: k ( j ti 1323M, E -mail: Commercial/industriallmulti- family: O #4. CONTRACTOR Valuation of work $
Business name: . Existing bldg. area (sq. ft.)
��� New bldg. area (sq. ft.)
Address: q5$ 1 _ (. i LA (:?_rili Number of stories
Statepl2 ZIP: 49722_3
Phone: ( —(p L qt, . is E- mail: Type of construction
CCB no.: (p� : Occupancy grou Existing:
New:
I CU rid c. no.: a Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: •,. . C DM S , provisions of ORS 701 and may be required to be licensed in the
♦ jurisdiction where work is being performed. If the applicant is
Address: S _ _ ; D an *a 4
•
` i., �L exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $ 67.SV
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 a and ordinances governing this 0 Visa 0 MasterCard
work will be complied w'th, whether ifie 1 herein or not. Credit card number: /
Expires
¢
Authorized signatu / / 2
Name of cardholder as shown on credit card
Print name: 52u // r O�/K�(� ((( 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 (6ro0ICOM)
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: $ 39r0. DL)
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): $ 3q 0 . 0 0
Permit fee based on valuation (see chart): $ (o2 5D
8% State Surcharge: $ 5.00
FLS Plan Review 40% of Permit: $ .-f}
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.
is \dsts \forms \FPSchecklist.doc 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION : Business Line: (503) 639 -4171
SUP c900 l S'
Received Date R - • ested AM PM B4
Location i - i # — ii���� Suite 160 MEC
Contact Person Ph ( ) 'Fa PLM
Contractor Ph ( ) SWR
BUILDING 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
re Sprinkler
Susp'd Ceiling
Roof
Other: teUV G H i .1.'5 �/�
PART FAIL
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 I=1 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
c �
Approach/Sidewalk Date ( cj Inspector cc 6N/z/\ Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIG ' RD 24 -Hour
BUILDING ' Inspection Line: (503) 639 -4175
INSPECTION DI ION Business Line: (503) 639 -4171 MST
BUP �6� d
�l U U Z
Received Date Requ ted i% AM PM 8UP �0�� C2 Location k - . * I r r Suite l0 d MEC •
Contact Person C QtA Ph ( ) 3/ ? PLM
Contractor Ph ( ) SWR
ILDING Tenant/Owner ELC
Fo ting
undation ELC
Ftg Dr Access: ELR
Crawl Drain
Slab Inspection Notes:
Post & Beam e - �
Shear Anchors Al L----- L
Ext Sheath/Shear -
Int Sheath/Shear _�
Insulation �)) C/9 S (' ND
ing} ��.
Firewall . riAi9 13 / � /c / / 9 Fire Sprinkler
Fire Alarm C G 0
Susp'd Ceiling
Roof
b . .
:� PART FAIL
PLUMBING \ \ _
Post & Beam
Under Slab
Rough -In .
Water Service
Sanitary Sewer L� — Z 06 Z - do/ l 9i
Rain Drains
Catch Basin / Manhole • r1-t CI, s ie
Storm Drain /
Shower Pan .,
Other:
Final
PASS PART FAIL r
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 111 Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line 6
ADA 5/q Approach/Sidewalk Date /0 L Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL