Permit • BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00142
�� #I DEVELOPMENT /iB
r So R 9 ICES 639 -4171 DATE ISSUED: 3/31/04
SITE ADDRESS: 06650 SW REDWOOD LN 180 PARCEL: 2S112DA 01400
SUBDIVISION: PP1996 - 048 ZONING: I -
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: 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: $ 520.00
Remarks: Relocate (4) 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
Description Date Amount Sprinkler Rough -
[BUILD] Permit Fee 3/31/04 $62.50 Sprinkler Final
[TAX] 8% State Surchart 3/31/04 $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 -I e : - e • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli . (503) 246 -669. 9 r 1- 800 - 332 -2344.
Is . ued By: , _ : 1, ' ; _V .� / ti AI
Permit ee .
Signature: K ,, • i , �_ 00 ��
Cal • -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Building Permit Application FOR OFFICE USE ONLY
Received ,L Building �/
DateBy: /� �{ 67
Permit No.: a, ` �f�l��
City of Tigard Planning App oval Other �`_
Date/By: Permit No.: orOr4 46e496q
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 '"�/ !' (`'� Post - Review Land Use
Internet: www.ci.tigard.or.us ...,--811' IL Date/By: Case No.
i,,
24 -hour Ins ection Request: 503-639-4175 Contact T t�-/, ® See Page 2 for
p 9 Name/Method: i CI* Supplemental Information
TYPE OF WORK
❑ New construction DATA . . ,
❑ Demolition I &'2 FAMI DWEL
E. Addition/alteration/replacement ❑ Other:
CATEGORY OFCONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ I & 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: ( 'j;, eEtiory b 1. iA►J� Total number of floors
New dwelling area (sq. ft.)
Suite #: (�,O idj /Apt. #: ( (o Garage /carport area (sq. ft.)
Project Name: (3 it7 s T AN; il`O(Y11C. i L , ( , Covered porch area (sq. ft.)
Cross street/Directions to job site: 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
' DESCRIPTIO WORJ(; , _ t , . the value (rounded to the nearest dollar) of all equipment, materials, labor,
1JC.e. ` 4 G K �-1! V uid overhead and profit for the work indicated on this application.
Valuation $ -6 20 U �
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
Fa PROPERTY OWNER . I 0 TENANT . Type of construction
Name: VA-C — c, Occupancy group(s): Existing:
�,�'`" 1 4 �S�
� New:
Address: t' ,) SpouL u p
- ' el
City/State /Zip: v � f�lZTt_ ta oe a /2.21
Phone(Jb)( j -( Fax t.(_" ') SS NOTICE: All contractors and subcontractors are required to be
APPLICANT 0 CONTPERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: ct ize -r by ( jurisdiction where work is being performed. If the applicant is exempt
Contac Name: e euce . peiNasoIJ from licensing, the following reason applies:
Address: cl.391 ) Tt6A -ab
City /State /Zi : 1-16p-et) , , q -j222 )
Phone(c353)62.0-61 1 11) Fax )b2D- -(,I�{ 1
E- mail: BUILDING PERMIT FEES *,
Please refer to fee schedule.
_ CONTRACTOR
Business Name: i`�I ra.E j P C ) , Fees due upon application $ ( 2 1 S°
Address: C 7 4 1 1610,- c •5r
City /State /Zip:'[((_ _ b , De 9--121. Amount received $
Phone 6=1))) (o2D-l D Fax(G2A 62o- 6(0) Date received:
CCB Lic. #: 63s ti (0
Authorized -
Signature: / .�, . 4 • I P ate: 3f ¢� Gte L
i 1 Notice: This permit application expires if a permit is not obtained within
. � 180 days after it has been accepted as complete.
f ' h r i7 Vf2E *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms \BldgPermitApp.doc 01/03
Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition a 1 -10 heads: No plan review required.
5l Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: &Load-
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: $
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: $
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): $ S
Permit fee based on valuation (see attached chart): $ (e.50
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ Do
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.
is \dsts \forms \FPSchecklist.doc 02/28/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 6 • • 75 MST
INSPECTION DIVISION Business Line: (503 if * ` y 'i
Received Z Date Requested y � � 7AM PM UP' #- 0000
Location Q i ' St �r/)4uite / c21 MEC
Contact Person Ph ( 6OZ (02. 0 - 6 ,15 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC /Mfg
Footing ` •
Foundation E
Access: AlligrIr
Ftg Drain
Crawl Drain Mr
Slab Inspection Notes: vI-
Post & Beam ....v. ,...,
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear It A l 0--e �A �E /a c-( ( `� .) )
Framing / '
Insulation
Drywall Nailing
F ire S r J ( _� � � �,
ire Alarm (Q 5 7 C--e ?LG S S •
Susp'd Ceiling
Roof
Other:� ` . ir
- r FAI ‘1109,, r,
t ` a
Pos & Beam
Under Slab �� C /
Rough -In Ct ') , 5 /���- Or 9 `"�`� i c-e �i-e- R-/ -
Water Service /l
Sanitary Sewer , ,e- (Ai
Rain Drains
Catch Basin / Manhole h- \ S. r 5 r1 c___LD @ vv a-,--..
Storm Drain
Shower Pan 6-0-t. c e
Other: j j�Z' •
Final c) C∎€- ® ,�Q� S4rC_ '-J2—+e._ S
PASS PART FAIL
MECHANICAL 1 / a Ar
Post & Beam ' "MIf
Rough -In
Gas Line / 1 41
Smoke Dampers � -•�►' ` 7 �`-(
Final •
PASS PART FAIL AL....-
ELECTRICAL �Q car �il S' f
l c
Service /
Rough -In C-4/1 C--Q_ (/ •
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: 0 Unable to inspect - no access
Fire Supply Line 2 - L�o ✓� ; fi t
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL Cu 7 / C - D-Lf? , /'