Permit l w
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00446
i DEVELOPMENT SERVICES DATEISSUED: 9/22/2005
. - - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S1 12 D D -01600
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: Fire sprinkler.
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 79 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: N MEZZ ?: U 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: $ 2,560.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES T & L COMMUNICATIONS INC
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 87387
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 9/6/2005 $72.10
[TAX] 8% State Surchari 9/6/2005 $5.77
[FLS] FLS Pin Rv 9/6/2005 $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
req ' - ' • . • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9; - 001 -0010 thr• gh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
. alli ng 503 - 246 -669 • - r :00-332-2344.
Is ed By _ 01 / _j/ _/ Permittee Signat r l re-
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 Prs Yee) 5-fgodfet
FAT Protection System
/
Building Permit Application A FOR OFFICE USE ()NIA
City of Tigard R� Recei ' � J /tom ►i / Permit No 1 _ /in; ..
131 Hall Blvd., Tigard, OR 9 927A
ECEIVED PIanRev'. e I � /
L (': ��
Phone: 503.639.4171 Fax: 503.598.1960 ' D �4 Other Permit:
Inspection Line: 503.639.4175 • ,, , r, r. 2 0 0 5 .�. __ 1 „ I I I
Date Ready/B , : v' 3u ® See Page 2 for lnformatioa
U
Internet: www.ci.tigard.or.us V I Notified/Method � Supplemeatal
t.;; t OF -11614-0.) REQUIRED DATA: 1- AND 2- FAMILY DWELLING
RI ITIYhtIP; F ny
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded 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: $
❑ 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: 1 <-9 d rSS� 5e ,[ O 1 ,,t, fi.,,,-ki a` t New dwelling area: square feet
City /State/ZIP: f2 r � 0 re _ Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: f �TJ `o 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. .
Valuation: $ g6
Existing building area:?S'(, 6 square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: /
Name: Type of construction: 33
Address: Occupancy groups: Qs., 7 9
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: i e e 44 (k 0l c _ or t � -- All contractors and subcontractors are required to be
� � licensed with the Oregon Construction Contractors Board
Contact name: IQ .2C S! S
- / y f 1-e-r a l under ORS 701 and may be required to be licensed in the
Address: (D r�)3e jurisdiction in which work is being performed. If the
•
applicant is exempt from licensing, the following reasons
City /State /ZIP: t....,./i.97,7 C O(. t [ c i s r t1 ' apply:
P h o n e : Q 6 0 0 ) ,-23y T p 7 Z� a I Fax:: Ga) 73 K 7 9
E -mail:
CONTRACTOR
Business name: G 64",~l,4,6G+4,,, r Co
BUILDING PERMIT FEES*
Address: 9-6 "5 >D , R 31>.;-7 Please refer to fee schedule.
City /State/ZIP: ( .171L ' ' tii IA Aue.4ezy f r3r7
Phone: (?ea 7: )/ �8 I F (3) 73-7 9 Y4 Amount application
6„,.-y—) Amount received
CCB lip.:
Date received:
Authorized signature: / This permit application expires if a permit is not obtained
d within 180 days after it has been accepted as complete.
Print name: l s 5 1 3 4 11'"•4t A ) I Date: 7"--6c-) S a Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Pe`mits\FPS- PermitApp.doc 12103 4104613T(II /02/COM/WI:B)
■
City of Tigard: Fire Protection Permit Checklist
Page 2 L. Supplemental Information . .
Describe work to be done:
1.) ❑ New : • ° ' 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration lit 11+ heads: Plan review required.
❑ Repair 3-3 0..,9Soc¢.
Number of sprinkler heads:.. VW-
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
3 3r�\0C�\ Design Area
P‘a- K. Factor
Sprinkler Project Valuation: $
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): $ '7a /0
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ , 7
FLS Plan Review 40% of Permit Fee: $ .g
TOTAL: $ 0(0 .7 1
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" techniciaps.
I:\ Building \Permits\FPS- PermitApp.doc 2
CITY, OF.. IGARD
BUILDING DIVISION PERMIT #: BUP2005 00446
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/22/2005
Phone: (503) 639 -4171 yd r lil
Inspection Requests (24 Hrs.): (503) 639 -4175 ! ° -_..
INSPECTION WORKSHEET FOR DATE: 10/17/2005 TIME: 7:04AM PAGE: 49
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: Fire sprinkler.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 - 624 -6300
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #: 360 - 737 -9725
Inspection Request Scheduled For: Date: 10/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 018444 -01 360- 737 -9725 N
Corrections /Comments/ Instructions:
— , Ai
".""—
ANIVIE,EN' 1 a ' 4 M11131..7.v4E A _
,i - V
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL , , CALL OR INSPECTION ❑ ADDITIO ,AL F ES ASSESSED
CO c7
Inspector: d Date: hone #: (503) 718-
CITY_ OF.TIGARD
BUII_DINO DIVISION PERMIT #: BUP2005 00446
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9!2212005
Phone: (503) 639 -4171 1
Inspection Requests (24 Hrs.): (503) 639 -4175 "'. �
INSPECTION WORKSHEET FOR DATE: 9!2812005 TIME: 7:08AM PAGE: 85
SITE ADDRESS: 15495 SW SEQUOIA PKWY 140 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: AIG
DESCRIPTION: Fire sprinkler.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE # : 503-624 -6300
CONTRACTOR: PHONE #:
T & L COMMUNICATIONS INC 360-737-9725
Inspection Request Scheduled For: Date: 9/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 016779 -02 360 - 737 -9725 Y
Corrections /Comments /Instructions: C MA NT r 04 e
1
. -4- 4
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ - NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITION' L F ' S ASSESSED C Inspector: Date: r , Phone #: (503) 718