Permit ` � BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2005 -00537 .
_ �li DEVELOPMENT SERVICES DATE ISSUED: 10/14/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S112DD -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 120 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: Fire sprinklers.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: MI:
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: 37 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: $ 2,900.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES T & L COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 87387 is
PORTLAND, OR 97224 2800 NE 65TH AVE SUITE A
Phone: 503 - 624 -6300 VANCOUVER, WA 98661
Phone: 360 - 737 -9725
FEES Reg #: LIC 67787
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/6/2005 $72.10
[TAX] 8% State Surchari 10/6/2005 $5.77
[FLS] FLS Pln Rv 10/6/2005 $28.84
Total $106.71
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
requir- , to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9 . " - 001 -0010 t , gh OAR 952 - 001 -0100. You may obtain a copy of these Ales or direct questions to OUNC by
ailing 503 - 246 -669 or 1-8,y 33 A4.
sued By: ,,,i, 4l 4 , �, _ 1 , Permittee Signat � i; i/ : �
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.
•
15 4 ' S 0a4a (bi-?' ,
Fire Protecti Systemv
i • Buililiii2 Permit Application FOR OFFICE USE ONLY
v
City of Tigard M Received i 0 t / s, , o 053 r
13125 SW Hall Blvd., Tigard, OR 97223 1� , 00' v iew �" P -
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF .__.•. D ate Ready i p��g . Poe Other Permit:
I Inspection Line: 503.639.4175 �-� '! ON ® See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIVISI. 1 Notified/Method / D Supplemental Information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
• ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Addition /alteration/replacement ❑ Other: Indicate the value (rounded to the nearest dollar) of all
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: $
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /S 9 'W7. tick 4 ,Je y New dwelling area: square feet
i
City /State/ZIP: Po, J efeY� T Garage /carport area: square feet
Suite/bldg. /apt. no.: / 2_0 I Project name: iii 1,-,,A, �., / Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. ..O
5 to.? nlz-te<5" Q_ J � D Valuation: $ y °C)...----
.-d i i 3 Existing building area: square feet
• New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction: SZ
Address: Occupancy groups: 4 37
City / State/ZIP: Existing:
Phone: ( ) Fax: ( ) New: '
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: 'T L . om 07 uvl l C a. ors All contractors and subcontractors are required to be
pp licensed with the Oregon Construction Contractors Board
Contact name:
I� S.5 E c _S kci. t,.1 under ORS 701 and may be required to be licensed in the
Address: PO g O,C.. 7' ' jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: t4,4-7..-I G Al 90 r (38 7
apply:
Phone: 3 Go) `3 7 9'72_,s Fax: : 36 0) 73 7 7 Y,,' \ 0./
E -mail: V 4
l e , A %
CONTRACTOR
Business name: / G Gcvwf#,c!" / C a I L. . BUILDING PERMIT FEES*
1 A
Address: P b B� tJ 23 g7
Please refer to fee schedule.
City / State/ZIP: z iG . L- > t* ?I P 7 03,1
Fees due upon application
Phone: (3E,o) 73 7 772_5— I Fax:3(, o) 7,3 7 p6 Y-- Amount received
CCB lic.: C„ )7 8 - 7 0 9 Si R___ FA
Date received:
Authorized signature This permit application expires if a permit is not obtained
p within 180 days after it has been accepted as complete.
Print name: r-5 U tirl-,a a-,---) l Date: G p— t- c)5 • Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Permits \FPS- PermitApp.doe 12/03 440.4613T(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
•
•
Page 2 - Supplemental Information
' q
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
• ❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: v{^
3
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
In Wet ❑
Additional 'Standpipes
Information: Hazard Group (R L1-
Density
Design Area PAISLi�
K. Factor s 6
Sprinkler Project Valuation: $ 7 0
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: $
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): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
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.
1:\ Building \Permits\FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: (3(k zc - 37
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171 ehocoot
Inspection Requests (24 Hrs.): (503) 639 -4175 ;1j..
INSPECTION WORKSHEET FOR DATE: ( f 1 TIME: PAGE:
SITE ADDRESS: (4 �'� S 12O CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: `�p�=
DESCRIPTION: ` r" ` 1 ���
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
919 t-ttti - L .R 0 ?Z o f
Corrections /Comments / Instructions:
•
t` l
AS v S PAR
❑ ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL . � ❑ CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Art Date: ( z4 Phone #: (503) 718 -
CITY'.OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00537
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/14/2005
Phone: (503) 639 -4171
Ins ection Re uests 24 Hrs.: 503
_.„
P 4 ( ) ( (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/16/2005 TIME: 7:06AM PAGE: 36
SITE ADDRESS: 15495 SW SEQUOIA PKWY 120 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DENTAL PROFESSIONALS
DESCRIPTION: Fire sprinWers.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #: 503-624 -6300
CONTRACTOR: 1 & L COMMUNICATIONS INC PHONE #: 360 -737 -9725
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 023620.02 503 - 888-0214 N
Corrections /Comments/ Instructions:
— 000 Silk MLf�C( -c 9S
to C� a • A , : L_ g ' eft ii�?..irl - t ' i .
❑ P'S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
-- ahl_L_____ Inspector: Date: (2I('phone #: (503) 718- Z
CITY OF TIGARD
BUIt_DING DIVISION PERMIT #: BUP2005 00537
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/14/2005
Phone: (503) 639 -4171 � °'q t I�I��
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' ":_..
INSPECTION WORKSHEET FOR DATE: 11/18/2005 TIME: 7 :17AM PAGE: 105
SITE ADDRESS: 15495 SW SEQUOIA PKWY 120 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DENTAL PROFESSIONALS
DESCRIPTION: Fire sprinklers.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503- 624 -6300
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #: 360 - 737 - 9725
Inspection Request Scheduled For: Date: 11/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 021774 -01 360.737 -9725 Y
AA Corrections /Comments/ Instructions:
Sp(_.( 00V-Lue 5
FOV& 1 bj
(:),__________
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ------67/0 Inspector: Date: I t � Phone #: (503) 718-