Permit ,
CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00365
DATE ISSUED: 8/12/2004
- 13125 I DEVELOPMENT H BMENT Tigard, 2CES 639 -4171
SITE ADDRESS: 15575 SW SEQUOIA PKWY PARCEL: 2S112DD -01600
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: : 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: $ 1,523.00
Remarks: Waterflow alarm in each tenant space.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES HONEYWELL INTERNATIONAL INC
15350 SW SEQUOIA PKWY #300 -WMI 15495 SW SEQUOIA PKWY #100
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone:
Phone: 503 - 968 -3300
Reg #: LIC 150191
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[FLS] FLS Pin Rv 7/28/2004 $25.00 Final Inspection
[BUILD] Permit Fee 7/28/2004 $62.50
[TAX] 8% State Surchari 7/28/2004 $5.00
Total $92.50
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 -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: ��y_.
Perm itu a re:
Signature: � V '
i g nu CAA
Call 639 -4175 by 7 p.m. for an inspection the next business day
/,53 as w SCQuo/4
PAS .01.4 Di System pP�oV Asa 8.9-
Building Permit Appli tion
. Date received: �7 Q Pernit:no.:13 t1,:Woy a6 36 S
: r F�
,y � City of Tigard �/
:_ . Project/appl. no.: Expire date:
CiryoJTigard Address: 13125 SW Hall Blvd, Tig6 97
Phone: (503) 639 -4171 ( ``/ � � _ Q Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 ( ` . %, Case file no. Payment type:
Land use approval: � ■ .....1/4 t O 1 &2 family: Simple -y- 1 V Complex:
T OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commerci. 'i • ustrial 0 Multi- family O New construction 0 Demolition
*Addition/alteration/replacement 0 Tenant improvement 4 Fire sprinkler /alarm 0 Other:
.108 SITE INFORMATION
Job address: I 5 7 (• W .rat t.t_o s 4. Pa w /C w ay Bldg. no.: Suite no.:
Lot: I Block: !Subdivision: I Tax map/tax lot/account no.:
Project name: roc( z (,drrp a rate art far
Desc ption and location of work on premises/special c % e%n7 ,,Ir r ow 4- 7- R e oh" -3a /V- et") fr'/tQ a /arwl
Cc/41 / A44 . ; • , ' Q hated / ski, b � ;,,./ ea c t.,.../4,4/7 5'eotee. CoYxnt.d,/ q rtG .
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: /A4 )#4/4 / i' /e►r / 0/4"/Afe4.•0,✓ /- ,D . (Floodplain, septic capacity, solar, etc.)
Mailing address: /S'3Sp SZv Selcarsa i3Ar f6wA.y 1 & 2 family dwelling:
City: for i' / !Kate: 02 IZIP: 1 9 7 a-.1- y Valuation of work $
Phone: Sd3 62.' -E5d'0 'Fax: 1E -mail: No. of bedrooms/baths
Owner's representative: 37 4,,, 1 ` / Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Brad 11.1 b 1e Covered porch area (sq. ft.)
Mailing address: jry elf fl .t.../ . fel r.,o A rit ✓K If✓ay Deck area (sq. ft.)
City: Poe 4/c,..taf I State: t j I ZIP: q 72.-,17 Other structure area (sq. ft.)
Phone: Q 3 ' b6'- 3 3 4 Fax: r f I 33 r E-mail: Commercial /industrial/multi- family:
CONTRACTOR Valuation of work $ I, 5 ov
Business name: HONEYWELL INTERNATIONAL INC. Existing bldg. area (sq. ft.)
Address: 1 54 95 SW Sequoia Pkwy. #100 New bldg. area (sq. ft.)
City: Portland I State: OR I ZIP: 97224 Number of stories
C Type of construction
Phone:503= 968- 33QQLFax: 968 - 33981 Ezinail:
CCB no.: 150191 Occupancy group(s): Existing:
New:
City/metro lic. no.: 4619 Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: (State: Imp: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: .. Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application • $
Address: . • Date received:
City: !State: IZIP: Amount received $
Phone: 1 Fax: I E -mail: • Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0visa 0 MasterCard
work will be complied wi , w, ether ified herein or not. Credit card number: / /
/ , Ex
Authorized signature: .si / Date: • 1- 2 7 0 Name of cardholder as shown on credit card
�t/
Print name: . 1 07 , e /10t4 Se $
• Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.4613 (M XiICOM)
•�.� ,
Fire Protection Permit Check List
A.) ❑ New ❑ Addition Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:
Additional description of work:
Type of System:(Complete A, B .orC as applicable):
A.) Sprinkler Wet Li Dry (2I
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation f $
C.) Fire Alarm
Submittal shall Battery Calculations Yes l
include: Individual Component Yes ID
Cut Sheets
Fire Alarm Project Valuation: $ % 5a 3
Project Valuation Subtotal (A, B & C): $ i 5 a 3
Permit fee based on valuation (see chart): $ &A. 50
8% State Surcharge: $ s. o0
FLS Plan Review 40% of Permit: $ g5,00
TOTAL: $ GJ 2.
Plan review requires a completed application and . 3 sets of plans at submittal. v
• 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 \fortes \FPSchecklist.doc 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING . Inspection Line: (503) 639 -4175
INSPEvi•ION DIVISION Business Line: (503) 639 -4171 MST
BUP 0 .700 Vi
Received 3 g Date Requested 4 9 AM PM BUP
Location / ''975 fj&t.) joceJdl Suite MEC
Contact Person YGiln Ph ( ) PLM
Contractor -G,„ ph( 6T 7 -2) 701 10/7 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: l,rit SIT
Post & Beam �� // --�
Shear Anchors G-
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
F'
usp d Ceiling iF0
Roof I
0th- r_
,(b
'� R*
PART FAIL
: ING `�
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer j
Rain Drains • li►Q
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El 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: I=1 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