Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00301
DEVELOPMENT SERVICES DATE ISSUED: 7/20/2004
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15055 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00800
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: 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 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: $ 6,600.00
Remarks: Fire sprinklers.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES WYATT FIRE PROTECTION INC.
15350 SW SEQUOIA PKWY #300 -WMI 9095 SW BURNHAM
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: 503 - 624 -6300
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/23/2004 $110.50 Sprinkler Final
[TAX] 8% State Surcharl 6/23/2004 $8.84
[FLS] FLS Pln Rv 6/23/2004 $44.20
Total $163.54
J
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 donein 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 B A:
Permittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
15 , s , sgusos Prear( rob
Fire Protection System
'f4 11-414. FOR OFFICE USE ONLY
Building Permit Application Received Building u 2 a .. _ 01
S. n E I E D Datemy0 /0, ,
RECEIVED Permit No
Date/By: Permit No.: proval Other
City of Tigard ° e
Datemy: � V� P �G y - � � Z,
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: 7-17 y � 5 Permit No.:
Phone: 503 639 - 4171 F {Q miO • -4:1401A Il�' Post - Review Land Use
1 Date/By: Case No.
Internet: www.ci.tigard. t� ING DIVISIO' Contact Juris. ® See Page 2 for t.
24 - hour Inspection Request: Name /Method: / / _ Supplemental Information
awl! a -• GO 1 c
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
' Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION , • • Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwellingommercial /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: /x"05 ,-efz) Vut A ? Total number of floors
1 F- " Y' New dwelling area (sq. ft.)
Suite #: jpO 15 Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: Toaci �`- y- C.o Now N ICAATIOIS 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: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK • the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
a ■ . lt _f►► L■ ' ■ 4 .1111
Valuation $ _
Existing building area (sq. ft.)
New building area (sq. ft.) -
Number of stories
❑ PROPERTY OWNER l ❑ TENANT ..,. Type of construction
Name: Occupancy group(s): Existing:
New:
Address:
City /State /Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
❑ APPLICANT ❑CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: (.se.e cab- ff
o) jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
. ' BUILDING PERMIT FEES *.. • • •
E -mail: P lease refer to fee schedule.
CONTRACTOR
Business Name: 'N'{ \}- ' V ' Q ok-ect1Ot.I Fees due upon application $
Address: 0\006 ANA iV V11A
City /State /Zip: Iowa De- 611223 Amount received $
Phone: ca61 (400.4 • '( Fax: spa ...,_1 • / 10-1--- Date received:
CCB Lic. #: 9 4 VI
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: j;4 - 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
1 Please print name)
is \Dsts \Permit Forms 1 • !,.,.! op dot: 01'03
- 'r
Fire Protection Permit Check List v. V
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition ❑ -10 heads: No plan review required.
,Alteration .— 1 heads: Plan review required.
❑ Repair
Number of sprinkler heads:_�t-
nn
1
Additional description of work:
Tet48 fl rtNeN1Pri
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: $ (p, koen
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Calculations , ' Yds ❑
include: Individual Component. • , Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System: __ `::*° =s ' r,,y ;
Square Footage: Permit Fee: ' .
1 '
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�: $ (p_(pbo
Permit fee based on valuation (see attacried'chart): "$
Permit fee based on square footage (D) (see fees above): $ /
State Surcharge 8% of Permit Fee: $ 53. .g.--
FLS Plan Review 40% of Permit Fee: $ 44 .Z0
TOTAL: $ (1p3 , S 4
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
��IDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP rid — 0430
Received l Date Reque X —/ G / AM PM BUP
l
Location .s s`S - 0 GC 4 Suite AO MEC
Contact Person ` 'Y�1Z O.c 4 .4_. _) Ph ( ) 6 R� — l c Z b PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Pac -.<« -- ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation r'�� f/ . I.
—
Drywall Nailing &_,A4 l ���_ {��� ' i �__ Oi `
Firewall g rtA�� �� ��/ %�' /� /�
lit pnnkle 1�. IA i �� � /Ifi� i ra i
Fire Alarm > !� j . , f / r !� ' � '
Susp'd Ceiling JV
Roof
Other:
� �:Z57 PA • /s� --
?' % BING r_
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer ASA°:
Rain Drains
Catch Basin / Manhole ��,� lav
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final ,
PASS PART FAIL • �
ELECTRICAL _1J
■II1r' NI r
Service WIWAIMAI
Rough -In
UG/Slab III I. •
Low Voltage
Fire Alarm
-
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL