Permit `��/► (� BUILDING PERMIT
C ITY OF T I GA R D PERMIT #: BUP2004 -00214
�I� DEVELOPMENT SERVICES DATE ISSUED: 5/12/2004
-1 ,L .. II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER ZONING: I -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: 117 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 98,100.00 •
Remarks: Create rated corridor and new offices.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ROBERT EVANS
15350 SW SEQUOIA PKWY #300 -WMI 1200 NE 48TH AVE. STE 1250
PORTLAND, OR 97224 HILLSBORO, OR 97124
Phone:
Phone: 503 - 648 -7805
Reg #: LIC 14426
FEES REQUIRED INSPECTIONS
Description Date Amount Mechanical Permit Require
[BUILD] Permit Fee 5/12/2004 $738.83 Electrical Permit Required
[TAX] 8% State Surchari 5/12/2004 $59.11
Sprinkler Permit Required
BUPPLN Pln Rv 5/12/2004 $480.24 Plumbing Permit Required
[BUPPLN] Framing Insp
[FLS] FLS Pln Rv 5/12/2004 $295.53 Gyp Board Insp
Susp Ceilng Insp
Total
$1,573.71 Final Inspection
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 -0s : z • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 03) 246-669 or 1- 800 - 332 -2344. ,
Issue y: �
B - A • a./.6/24-
Permittee
Signature: /r , �•
/ Call 639 -4175 by 7 p.m. for an inspection the Zsines
ENV E®
Building Permit Appli '/ FOR OFFICE USE ONLY
of Tigard Received d �� �`7 Permit No.: . . 1:90,„9-04 13125 SW Hall Blvd., Tigard, OR 97223 ' 1 `V 1 � 20o Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 0, ' ,t / „ir :'•` \ Other Permit:
� Date/By: ,�' l2 ,i3S�
Inspection Line: 503.639.4175 t- ry OF TIG ter, Date Ready/By: lures. ® See Attached Checklist for
Internet: www.ci.tigard.or.us Dn'iSIO 1 Notified/Method: , Supplemental Information
yr.,u 2-
FA
• � • � • �. MII.:Y DWELLING
. 'TYPE OFD V, „...' - -, �
, ',1 , .
";REQUIRED D' . • • • , AND' ; •
„,..•'� :.. "+ alp +::;��� .�.'.� -- � �; � ��,• . ... ,I r... ,. ' .. ,.
Permit fees* are based on the value of the work performed.
C] New construction El Demolition
Indicate the value (rounded to the nearest dollar) of all
A Addition/alteration/replacement El Other: equipment, materials, labor, overhead, and the profit for the
":. F �CONSUC
T N °• 1"1 F' f ,” 1' `" ", '" work indicated on this application. • wr r { .: ''' C ° °0 .,. .., ... O . ' -:.d` 1 • Valuation: $
El 1- and 2- family dwelling XCominercial/industrial
❑ Accessory building
❑ Multi- family Number of bedrooms:
❑ Master builder El Other: Number of bathrooms:
,.... • I ., N<<. ... Total number of floors:
Job site address:
=�,.' `,; SITE 'INFURMAZIiO �.ANDi�i,UCATJUN, I ,;u ' r;,�9.
I New dwelling area: square feet
/�� S/� .���Ud� /r4 f Jr�/�/1►'
City/ State/ZIP: T��A_/ , FDA 9723 Garage/carport area: square feet
Suite/bldg. /apt. no.: /�tt7 Project name:L� 4C / .S /Ate . Covered porch area: square feet
Cross street/directions to job site: / Deck area: square feet
Other structure area: square feet
'r;,REQUIRED DATA 'COMMERCIAL, -USE CHECKLIST
Subdivision: /11e//t$7,,, C mil /,�� e / / r ~ •� Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
' ''J'' TM'' ;` work indicated on this application.
„�:`• "� ���DESCRI WORD ' '' � r�' -�+ r�. Q
Valuation: $ oar
J
Existing building area:0 t ' square feet
New building area: /
square feet
[�.
I • PROPEI W
ONER %i , :.: . .. ,1- , , ,',.•;• . ' e '•D TENA]VT -' • , Number of stories:
Name: PacTrust Type of construction: I/ •-/J
Address: . 15350 SW Sequoia Pkwy. , Suite 300 Occupancy groups: •
City /State/ZIP: Portland, OR 97224 Existing:
Phone: (503 ) 624 -6300 Fax: (503) 624 -7755 r New:
':t �'� _, 4 I
y CONTACI``'PERSON' : - 5'.> '} . : !'
i� ' APPLICANT S •�I,;�;:� ' ^Y . 'O Ir ;,� � ,i ' �` NOTI :,..
'�' ..r'.. ® „ .,,,.. r _......, .., ,.,.. nrl . .... .. .. ..... J.:•.r•- ...:r....: ,... . 'k;it.i i�11' ,_. .. , . . . .
Business name: PacTrust All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:
• under ORS 701 and may be required to be licensed in the
Address: 15350 SW Sequoia Pkwy., Suite 300 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/ State/ZIP: Portland, OR 97224 apply:
Phone: ( 503) 624 -6300 Fax: : (503) 624 -7755
E -mail:
, • V., � . !. l.r . CQNTIt'4t0 ' °,.Wel aK, ;!. i Ai I h,. 1 V=r.
Business name: ,`-
• Robert Evans Co. , Inc. Inc ���� 4'�, ` '
, �`.1 ' FEES*
Address: 1200 NE 48th Ave., Suite 1250 Please refer to fee schedule.
City/ State/ZIP: Hillsboro OR 97124
Fees due upon application
Phone: ( 503) 648 -7805 I Fax: ( 503) 648 -5883 Amount received
CCB lic.: 14426
Date received:
Authorized signattu ��,`` This permit a pplication expires if a permit is not obtained
� yam— within 180 days after it has been accepted as complete.
Print name: \4 ,y , J/ • /�Q�P/Sj Date: /J�i p * Fee methodology set by Tri -County Building Industry
I , Service Board.
i:\ Building \Permits\BUP- PermitApp.doc 12/03 440- 4613T(1i /02/COM/WEB)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business ine: (503) 639 -4171 �.,q
o BUP Get' — 4
Received Date Requested AM PM BUP
Location 5 j S UO t th6-- Suite tp0 MEC
Contact Person q24\-imby Ph ( ) - 3 E-'1( PLM
Contractor Ph ( ) SWR
4: UILD ► - _ Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
"' ASS . P • RT FAIL _`:'■
MUG -mar
- earn
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
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 E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call f r rein pection RE: r 1 0 Unable to inspect — no access
Fire ADA Line 4K �/
Approach/Sidewalk Date ` Inspecto _P
J
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
AUG -13 -2004 14 52 HONEYWELL 503 968 3398 P.01/02
' OA 5 OF FIRF A[ARA! SYSTEMS 72 -
P • � �
ye j e _ FIRE ALARM SYSTEM RECORD OF COMPLETION
Name of protected property: - P0. a -rte 5% Co r (# - (C 011"..r 1 > 5..
.. -L
Address: 15 51 s , �J 5 uela �o�r k. ,w 1 t `r' q :,� o
Representative of protected property (n m hgnc): J
Authority having jurisdiction: i q ai d , ,
Address/telephone number:
Organization name /p /wne kepresentatiue'mina /phone
Installer I 11-net- ._.� d r
Supplier
Service organization •
Location of record (as-built) drawin : F AC t NkormtAil..,e,1� eQ.e.% lr.�
Location of operation and maintenance manuals: FAC. V
Location of test reports: F AC , ._
A contract for test and inspection in accordance with NFPA standard(')
Contract No(s): !J 1 A Effective date: Expiration date:
System Software • •
(a) Operating system (executive) software revision level(s) ]s,I A •
(b) Site - specific software revision date:
(c) Revision completed by:
(name) (firm)
1.Type(s) of System or Service
NFPA 72, Chapter 6 — Local
If alarm is transmitted to location(s) off premises, list where received:
NFPA 72, Chapter 8 -- Remote Station •
Telephone numbers of the organization receiving alarm:
Alarm: �.r...
-
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter E — Proprietary •
Telephone numbers of the organization receiving alarm:
Alarm: . - - - ,M. .. -
Supervisory:
Trouble: •
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
' 72, Chapter S — Central Station
Prime contractor.
Central station location: ��`t' S u �� a ..a a P VIRIMI f • .
•
(NFPA 72, of 4)
FIGURE 4.5.2.1. Record of Completion.
•
2002 Edition
AU6-13 -2004 14 38 HONEYWELL 503 968 3398 P.02/02
72-32 — NATIONAL FIRE HARM CODE
o Wong of transmission of signals from the protected premises to the central station
McCulloh Multiplex One -way radio
✓ Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the public fire service communications center:
(a) .
(b)
System location: — .
NFPA 72, Chapter 9 — Auxiliary
Indicate type of connection: •. , Local energy Shunt ' . Parallel telephone •
Location of telephone number for receipt of signals: . ,
2. Record of System Installation
(Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.)
This system has bp installed in accordance with the NFPA standards as shown below, was inspected by
-r, `k � a fi I 'e To r on / 3 / a y , includes the devices shown
in 5 aid 6, and has n in servi 8 since 8 L t Z 1 0 .1 - .
_NFPA 72, Chapters 1 2 3 4 6 6 7 9 10 11 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other (specify):
Signed: e5P.••----t J Date: S I I - S J 0 Li
Organization:
•
3. Record of System Opera on
Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached
All operational features and functions of this system were tasted by Laws 4.,. cam, A 6(- date e) 1 13 I '
and found to be operating properly in accordance with the requirements of: ,
_NFPA 72, Chapters 1 2 3 4 6 6 7 E 9 10 11 (circle all that apply) _
NFPA 70, National Electrical Code, Article 760 •
_Manufacturer's instructions
— Other (specify):
Signed: ----\--
– ' V _ Data: J I 1.3 I0 H
Organized..: — - ' , 0
4. Signaling Line Circuits •
Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6..1):
Quantity: l — Style: Class:_.13
•
(NFPA 72, 2 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
TOTAL P.02
AUG -13 -2004 14 52 HONEYWELL 503 968 3398 P.02/02
• FUNDAMENTALS OF FIRE ALARM SYSTEMS 72_33 •
5. Alarm- Initiating Devices and Circuits •
Quantity and class of initiating device circuits (see NFPA 72, Able 6.6):
Quantity: Style:__
MANUAL
(a) Manual stations Noncoded t Transmitters Coded Addressable
(b) Combination manual fire alarm and guard's tour coded stations
--- -
AUTOMATIC
Coverage: Complete Partial ) ,r
Selective Nonrequired
(a) Smoke detectors �_.__ Ion Photo __ I Addressable
(b) Duct detectors Photo Addressable
(c) Heat detectors FT RR FT/lIlt RC Addressable
(d) Sprinkler watcrflow indicators: Transmitters Noncoded .Z Coded Addressable
(e) The alarm verification feature is disabled /( or enabled , changed from _ seconds to seconds.
(f) Other (list): cc rk • t.c A a L.1 � � �.., , 31. („
6, Supervisory Signal - Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUAR.D'S TOUR •
(a) Coded stations
(b) "Noncoded stations •
(c) Compulsory guard's tour system comprised of transmitter atations and intermediate stations
Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour.
SPRINKLER SYSTEM
Check if provided
(a) ✓halve supervisory switches
(b) Building temperature points .
(c) Site water temperature points
(d) Site water supply level points
Electric fire pump:
(e) Fire pump power
(f) Fire pump running
(g) Phase reversal
Engine -driven fire pump:
(h) Selector in auto position •
(i) L Engine or control panel trouble
(j) . Fire pump running
ENGINE - DRIVEN GENERATOR:
(a) Selector in auto position
(b) Control panel trouble
(c) Transfer switches
(d) Engine running
Other supervisory functions) (specify): , ^
(NFPA72,
FIGURE 4.5.2.1 Continued
2002 Edition
TOTAL P.02
AUG -13 -2004 14 38 HONEYWELL 503 968 3398 P.01/02
72 - 34 NATIONAL FIREAIAI.M CODE
7. Annunciator(s)
Number. I Type: LED _ Location: C A C � — T .'�
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter 6 — Emergency Voice/Alarm Service
Quantity of voice/alarm channels: Single: _ . Multiple:
Quantity of speakers installed: Quantity of speaker zones:,
Quantity of telephones or telephone jacks included in system: I •
Quantity and the ass of notification appliance circuits connected to system lave NFPA 72, Table 6.7):
Quantity: Style: Class: _ _ .
Types and quantities of notification appliances installed: •
(a) Bells With Visible _
(h) Speakers With Visible •
(c) Horns 3 With Visible �Q s
(d) Chimes, With Visible •
(e) Other With Visible •
(i) Visible appliances without audible: r` b n a_
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: 1 1 0 'I A t; urrent rating: Zo A
Overcurrent protection; ,�,,����/ Location: IS.r�ak4! Current rating:
. �a.� �..4. L I C.S wt 4- 411 -
(b) Secondary (standby): "
Storage battery: Z 1 2g De- Amp -hour rating: 1 Ali
-A, Calculated capacity to drive system, in hours: Go
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency system used as backup to primary power supply: v.e.: a— I • •
Emergency system described in NFPA 70, Article 700:
10. Comments
Frequency of routine teeth and inspections, if other than in accordance with the referenced NFPA standard(s):
A
System deviations from the referenced NFPA standard(a) are:
/, 6 g -r3•• oy
• for Installation contractor /supplier ( tile) (dale) �.
‘0111 „13 '-oy •
(sign for alarm service company (title) (date)
fr \ Soy
(s n for central station (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
( representative of the authority having jurisdiction (tato) (date)
(NFPA 72 4 of 4)
FIGURE 4.5.2.1 Continued
•
2002 Edition
•