Permit 0 CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00231
° COMMUNITY DEVELOPMENT DATE ISSUED: 7/7/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 112 DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 105 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: ASSOCIATED BLDG MATERIALS
Project Description: Relocating (1) fire sprinkler head.
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: UNK 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: A ra 7o) , od
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: Contact #: PRI 503 - 620 -4020
FAX 503 - 620 -1058
Reg #: LIC 64174
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/7/2008 $69.65 •
[TAX] 12% State Surch 7/7/2008 $8.36
Total $78
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 �` /� i _sue.` Permittee Signature: , '. _ A L , I
— giro - /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project. .
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
/- -Fire Protection System FOR OFFICE USE ONLY
City of Tigard �O Received U ` PermitIvo. p
IN •
�` Plan Review
7 0 9, P �(f CJ -(��}'
13125 SW Hall Blvd., Tigazd,OR'• Plan Review
R . Phone: 503.639.4171 Fax: 50 •V - .. Q �O D Other Permit:
TI G A K D Inspection Line: 503.639.4175 �Q� Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard or.gov \� Notified/Method: Supplemental Information
1
< P w `
TYPE OF W a •, — ■ 1� � s\0` REQUIRED DATA: 1- AND 2-FAMILY DWELLING
❑ New construction kt.O Permit fees* are based on the value of the work performed.
's Indicate the value (romded to the nearest dollar) of all
Addition/alteration/replacement ■ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION • work indicated on this application.
❑ 1- and 2- family dwelling �Commercial/industrial
Valuation: S
Accessory building Number of bedrooms:
❑ g ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND. LOCATION Total number of floors:
Job site address: 15 c] 30 1\ �pni UO•tt.� epai.lI�IJ�C, , ,", , , New dwelling area: square feet
I City/State /ZIP: ic j oc Garage /carport area: square feet
Suite/bldg. /apt. no.: ins— p Q "j rojject name: j 1/4 _ 50c , vat Ankefial Covered porch area square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:,COMMERCIAL- USE;CRECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value romded to the nearest dollar) of all
Tax map /parcel no.. equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. /�/�
?lei OC Ca.�e. 0) orl,e rite 3 pr in (ktei her/ (� Valuation S 700.00
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
A APPLICANT ❑ CONTACT PERSON ' NOTICE
Business name: �i e a a �1 1 1 f C . All contractors and subcontractors are required to be
Contact name: v kp , • / FJ c (b f 0 1 :\k / licensed with the Oregon Construction Contractors Board
�.( ` under ORS 701 and may be required to be lensed in the
Address: I(,17 5 7anct. jurisdiction in which work is being performed. If the
City/State /ZIP: t,�.� OP, `7 99-LI applicant is exempt from licensing, the following reasons
,� ^ l apply:
CD pV
Phone: ( 505 ' 09.0 I Fax: : 603) (090 — I l /� Jb�
E- mail:h�di S &c ife.
CONTRACTOR BUILDING PERMIT FEES* •
Business name: 1 f `-e -rile • (Please referiojeesehedule)
• . 5 n� Permit fee: (C (0 5
Address: i U 7 ' ]' A t .
T 1 ' `Y State surcharge (12% of permit fee): $ . 55
City/State /ZIP: a
( 69 .0 ... N� ^^ ) FLS plan review (40% of permit fee):
Phone: 9. t'KJ Fax: 6�O - '5g (Due upon application.) A A
CCB lic.:r� I 7U '7? Total permit fees: r 0 1
dc 4 e.ae(d 4 tY + Amount received:
Authorized signature
This permit application expires if a permit is not obtained
Print name: t . ; • \ � Date: -7 0 i. within 180 days after it has been accepted as complete.
* Fee methodoloe' set by Tri -County Building Industry
Service Board.
I' Building\Permits/FPS- PermitApp.doc 03123/06 440.4613TO1,02iCOMM•EB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition � , 1 -10 heads: No plan review required.
0 , Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: I -
Additional description of work:
--
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet ❑ Dry
Additional S tandpipes AA,
Information: Hazard Group LISA
Density ,
Design Area b00
K. Factor 6, ( •
Sprinkler Project Valuation: $ a • OC
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ AA
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ N A
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: A I sq. ft.
Fire Protection Permit Fees ' V
Project valuation subtotal (see A, B & C above): $ 1.2 7n0
Permit fee based on project valuation (see fee schedule): $( Co 5
Permit fee based on square footage (see D above): $ N A -
State Surcharge (12% of permit fee): $ ¢,3
FLS Plan Review (40% of permit fee): $ I f A
TOTAL: $ 78,)
Plan review requires a completed application and 2 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.
l: \Building\ Permits \ FPS- Perm,tApp.doc 2