Permit C ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00132
1 P I_.
DEVELOPMENT SERVICES DATE ISSUED: 4/19/2006
.�� II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 112 D D -01601
SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG
Project Description: T.I. Walls - (MRI space).
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: 18 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: . IMP SURFACE: PRO CORR: PARKING:
VALUE:$ , SD ) io,
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FORTIS CONSTRUCTION, INC.
15350 SW SEQUOIA PKWY #300 -WMI 1705 SW TAYLOR ST #200
PORTLAND, OR 97224 PORTLAND, OR 97205
Phone: Contact #: PRI 503 - 459 - 4477
FAX 503 - 459 -4478
Reg #: LIC 155766
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/19/2006 $1,714.30
[TAX] 8% State Surcha 4/19/2006 $137.14
[BUPPLN] Pin Rv 4/19/2006 $1,114.30
[FLS] FLS Pin Rv 4/19/2006 $685.72
(additional fees not listed here)
Total $3,851.46
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- .
AV§ /1 ,
Issued By: `�
/ .�� 1 lir
Permittee Signature: n
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.
tt �_ i `� FOR OFFICE USE ONLY
Building Permit Application -�� y
n %,3 v Receive
City of Tigard {�� �� Date /B �` vZ Permit No . d •
13125 SW Hall Blvd., Tigard, OR 9 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 �81 Date/By: Other Permit.
Inspection Line: 503.639.4175 Date Ready /By: Juris �/ El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified Method: -1 V Supplemental Information
14N.tAR REQUIRED DATA: 1- AND 2- FAMILY DWELLING
Permit fees* are based on the value of the work performed.
❑ New construction Demolition P
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.
❑ I- 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: 15755 SW Sequoia Parkway New dwelling area: square feet
City /State /ZIP: Tigard OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: D 6 Project name: Bridgeport MRI Covered porch area: square feet
Cross street/directions to job site: 1 -5, Carman Drive, Sequoia Parkway Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S112DD01601 , R2028087, PACIFIC CORP. CENTER, LOT PT 4, 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.
MRI installation, hallways widened to accommodate ADA and new dressing. Valuation: $350,000.00
Existing building area: 13,720 square feet
New building area: square feet
❑ PROPERTY OWNER ® TENANT Number of stories: 1
Name: Bridgeport MRI Type of construction: VN
Address: 9200 SE 91 Avenue - Suite 330 Occupancy groups:
City /State /ZIP: Portland OR Existing: B
Phone: (503)774 -7700 Fax: (503)774 -7701 New: B
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Jon R. Jurgens & Associates, Inc. All contractors and subcontractors are required to be
Contact name: David H. Johnson AIA, Project Architect licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 15455 NW Greenbrier Pkwy. #260 jurisdiction in which work is being performed. If the
City /State /ZIP: Beaverton OR 97006 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 690 -1779 Fax: : (503) 690 -0913
E -mail: djohnson @jrjarch.com
CONTRACTOR
N Business name: Fortis Construction Co., Inc. BUILDING PERMIT FEES*
Address: 1705 SW Taylor Street - Suite 200
Please refer to fee schedule.
City /State /ZIP: Portland OR 97205
I Fees due upon application
Phone: (503) 459-4477 Fax: (503) 459-4478
Amount received
CCB lie.: 155766 MM. ' ' -
. Date received:
Authorized signature: II / 4 d This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: David H. Johns t Date: 04 -19 -06 * Fee methodology set by Tri- County Building Industry
Service Board.
i:■Building \Permits■BUP- PermitApp.doc 12/03 440 -46 t 3T(I I /02 /COM /WEB)
644-1 4
\\ NFPA RECORD OF COMPLETION
Name of Protected Property: k • I d f. r'4" T 1‘ 4 �CS , 4 , - � Lies �--
• Address: /57.7 SW Sec l s9 PAr fir - /An Q az.
Rep. of Protected Prop. (name /phone): •
Authority Having Jurisdiction:
Address /Phone Number:
1. Type(s) of System or Service
F NFPA 72, Chapter 3 - Local
If alarm is transmitted to location(s) off premises, list where received:
n N FPA 72, Chapter 3 - 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:
N FPA 72, Chapter 4 - Auxiliary
Indicate type of connection:
Local energy: Shunt: Parallel telephone: •
Location and telephone number for receipt of signals:
n N FPA 72, Chapter 4 - Remote Station
Alarm:
Supervisory:
(� N FPA 72, Chapter 4 - Proprietary
If alarms are retransmitted to public fire service communications center or others, indicate location and telephone number
of the organization receiving alarm:
_ Indicate how alarm is retransmitted:
1 ✓ (FPA 72, Chapter 4 - Central Station
The Prime Contractor: A '') a 'C n Sec ✓ e • A 49 re
Central Station Location:
Means 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:
Organization Name /Phone Representative Name /Phone
Installer e rcc k .t� rGCtr % c- i 44- k[ he V
Supplier 5 ;0 . Cors , nne �1 °YAn g
Service Organization " ' rgvc - Ste: J
Location of Record (As- Built) Drawings: 0 Ore -
Location of Owners Manuals: 00- St ie
Location of Test Reports: G h - 3 �C
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). dated , is in effect.
2. Record of System Installation
(Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.)
This system has been installed in ccordance with the NFPA sta ar as sho n below,
was inspected by G9e �1 �1k� I� _ on, • ; includes the devices shown below,
and has een in service since ,,//��/����"
NFPA 72, ChaptersC t�7uu1�(circle all that apply)
V / NFPA 70, National Electrical Code, Article 760
✓ Manufacturer's Instructions
Other (speci
Signed: io;_ .111111•111 a 7/ 2Co7b
Organization: ' ) T �
AHJ - White; Owner - Canary; District - Pink; Site Copy - Goldenrod MC24 -2 -014 Part 1 of 3
3. Record of System Operation P
All operational features and functions of this system were tested by u s ki" `�" �) on, -..7c � �C
C
and fou}id to be operating proper) in accordance with the requirements of:
// NFPA 72, Chapter- op 4 N t. i circle all that apply)
v NFPA 70, National lectrical Code, Article 760
Manufacturer's Instructions
Other (speci At -
Signed: 'iv Date: ' r '
Organization: Si +'+p eG" ^ no
4. Alarm- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
MANUAL
(a) Manual Stations Non coded, Activating Transmitters Coded
(b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete: Partial:
(a) Smoke Detectors Ion Photo
(b) Duct Detectors Ion Photo
(c) Heat Detectors FT RR FT /RR — RC
(d) Sprinkler Waterflow Switches: Transmitters Non coded, Activating Coded
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded Stations
(b) Non coded Stations, Activating Transmitters
(c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations
NOTE: Combination devices recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches, Activating Transmitters
(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) Engine or Control Panel Trouble
(j) Fire Pump Running
Engine- Driven Generator:
(k) Selector in Auto Position
(I) Control Panel Trouble
(m) Transfer Switches
(n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits I
Quantity of indicating appliance circuits connected to the system:
Types and quantities of alarm indicating appliances installed:
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) Visual Signals Type: with audible w/o audible
(g) Local Annunciator
7. Signaling Line Circuits
Quantity and Style (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: Style:
AHJ - White; Owner - Canary; District - Pink; Site Copy - Goldenrod MC24 -2 -014 Part 2 of 3
8. System Power Supplies
(a) Primary (Main): Nominal Voltage: no c Current Rating: ‘9 A
Overcurrent Protection: Type: Current Rating:
Location:
(b) Secondary (Standby):
Storage Battery: Amp -Hour Rating , /
Calculated capacity to drive system, in hours: 24 ✓ 60
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply:
Emergency System described in NFPA 70, Article 700
- Legally Required Standby System described in NFPA 70, Article 701
- Optional Standby System described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701
9. System Software
(a) Operating System Software Revision Level(s): 4//1
(b) Application Software Revision Level(s): VIA
(c) Revision Completed by:
(name) (firm)
10. Comments:
(signed) for Central Station or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standards(s):
System deviations from the referenced NFPA standard(s) are:
/at
� .
F,
.7,5 IQI! 1�l� 7 �G a�
signed) for Central Station or Ala Service Company (title) (date)
Upon completion of the system(s) satisfactoryest(s) witnessed (if required by the authority having jurisdiction):
dal Ucr _ • g A.
, s i gned) representative of the authority having jurisdiction (title) date)
AHJ - White; Owner - Canary; District - Pink; Site Copy - Goldenrod MC24 -2 -014 Part 3 of 3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2006 >00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/200G
Phone: (503) 639 -4171 Arts uy +QA\
I nspection Requests (24 Hrs.): (503) 639 -4175 ' I �..
INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7 :00AM PAGE: 5
SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 00 TYPE OF USE:
PROJECT NAME: BRIDGEPORT MRI
DESCRIPTION: T.I. Walls- (MRI space).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FORTIS CONSTRUCTION, INC. PHONE #: 603 - 459 - 4477
Inspection Request Scheduled For: Date: 8/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 03562101 971 - 563 -3699 Y
Corrections /Comments /Instructions: il_sT
A,
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1_,., ay "
MI` _ ....,
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
Inspector: 61/41k) Date: 6 , A _• Phone #: (503) 718 -Z°3
•
CITY OF' TIGARD
BUILDING DIVISION PERMIT #: BUP2006-00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2006
Phone: (503) 639 -4171 A.o - '� A
Inspection Requests (24 Hrs.): (503) 639 -4175 , 'I i..
INSPECTION WORKSHEET FOR DATE: 8125/2006 TIME: 7 :16AM PAGE: 33
SITE ADDRESS: 15756 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: BRIDGEPORT MRI
DESCRIPTION: T.I. Walls - (MRI space).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FORTIS CONSTRUCTION, INC. PHONE #: 503 - 459-447/
Inspection Request Scheduled For: Date: 8/25/2006 Pour Time: X v
V
Code # Inspection Description Confirm # Contact # Mss g
0
299 Final inspection 035540 -01 971- 563 -3699 Y
Corrections /Comments /Instructions: .
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1\13-ft FAQ S „.‘ \e-e__&' D arc
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too ;1 '4 &> /( ,,. z 2 o9' vz
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 6 6
Inspector: Date: v 1 h K Phone #: (503) 718 - /24
CITY OF TIGARD ..'
BUILDING DIVISION PERMIT #:49.006 0013.2--
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 I � I ,
Inspection Requests (24 Hrs.): (503) 639 - 4175 , _
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / c. 7 S__c CLASS OF WORK:
SUBDIVISION: LOT # • � TYPE OF USE:
PROJECT NAME: j 6 0
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 6-19 o " Pour Time:
Code # Inspection Description Confirm # Contact # Message
2 g — / SAS-62,ycz6,/ 4 -0 - 2_ 97/- SZ3_3C9?
Corrections /Comments /Instru ��eoZ
\ 1
4111 "A , —14 fri - .in..-
.,.. ( D , _
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F■R INSPECTION ❑ ADDITIONAL F ES ASSESSED
' 4
A tp,■
Inspector: Date: 0 Phone #: (503) 718 - ZAv✓
CITY „OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19!2,X5
Phone: (503) 639- 4171j�l+�
Inspection Requests (24 Hrs.): (503) 639 -4175 F. ..
INSPECTION WORKSHEET FOR DATE: tiii /200f; TIME: 7:0' 4 1,NI PAGE:,
SITE ADDRESS: 16Th6 SW ` IT:01001A PKVIV 100 CLASS OF WORK:
SUBDIVISION: PAGii : CORPORA t:' CENTER LOT #: 001 TYPE OF USE
PROJECT NAME: BRIDGEPORT RT M }d
DESCRIPTION: TA, Watl;; - (WI Epsp ;z).
OWNER: PACIFIC REALTY '?; OCIATE$, PHONE #:
CONTRACTOR: FORTl5 0ON5 - F f 010N, INC. PHONE #: 50.3-451-4177
5N'- 'ii17'
• Inspection Request Scheduled For: Date: 6, Pour Time:
Code # Inspection Description Confirm # Contact # M sa e s
She wali;:J nchors 0;i006 6-01 91 I ~.;3•3t,.:'& Y
Corrections /Comments /Instructions:
C .. . 6 eAr't S 4-• � �� 4/V/ 4A1
PL4.JJ 4-es t •
•
t!/. •
❑ PASS =* TIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
o , .
Inspector: X Date: / 0.11 6 Phone #: (503) 718 - ' Z
CITY QF TIGARD ,�.
BUILDING DIVISION PERMIT #: I3!JP200' 001..52
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: +'1/1°3/200':.
Phone: (503) 639 -4171 m Inspection Requests (24 Hrs.): (503) 639 -4175 F_ ..
INSPECTION WORKSHEET FOR DATE: 5/2602006 TIME: 1;00AM PAGE: I
SITE ADDRESS: 157f') SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORA FE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: BRIDGEPORT MRI
DESCRIPTION: 11 . Walls - (MRI space).
OWNER: PACIFIC REALTY ASSOt;IA1ES, PHONE #:
CONTRACTOR: FORTIS CONSTRUCt1ON, INC. PHONE #: fia.1-'l59 F1i ft
Inspection Request Scheduled For: Date: 5/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 insulation 030687-01 0/1 563 Y
Pe+Pv Sttaw - cA1'e -v la', bb
Corrections /Comments/ Instructions:
. i...• r r �� ,l
IINATfraial i All
ire IA ife
_ - --- .
PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: i) Date: J J le, bL Phone #: (503) 718- 19 '-3
■
CITY Q.F TIGARD ..
BUILDING DIVISION PERMIT #: E3UP2006.00132
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19,000 :1
Phone: (503) 639- 4171����
Inspection Requests (24 Hrs.): (503) 639 -4175 W'
INSPECTION WORKSHEET FOR DATE: 5/25/2006 TIME: 7:03AM PAGE: 76
SITE ADDRESS: 16755 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CLNTER LOT #: 001 TYPE OF USE:
PROJECT NAME: RRIDGEPOR'f MRI
DESCRIPTION: 1.1. - (MRI space).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FORTIS CONSTRUCTION, INC. PHONE #: 503459 -4477
Inspection Request Scheduled For: Date: 5/25/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 030541 -01 971.563.3699 Y
Corrections /Comments /Instructions:
P S i,.,u w— �a u 1 J
Dr W t, N e3 () et y
Impvier
sf
- . CO
a
j7(2_tag- y [1)0
❑ PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ' LL FOR INSPECTION ❑ ADDITI {Z G J22 AL FS ASSESSED
Inspector: / Date: Phone #: (503) 718-
_ 6
C1.71` OF TIGARD - BUILDING DIVISION PERMIT #: B!JP200;■d;01:t2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/200:
Phone: (503) 639 -4171 i..�11 jG ill
Inspection Requests (24 Hrs.): (503) 639 -4175 ... _,.. "__..
INSPECTION WORKSHEET FOR DATE: 5/1B/2006 TIME: 7 :01AM PAGE: 57
SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: BRIDGEPORT MRI
DESCRIPTION: Ti. Walis (MRI space).
OWNER: PACIFIC REAL lY ASSOCIATES, PHONE #:
CONTRACTOR: FORTIS CONSTRUCTION, INC. PHONE #: S03 -159 -4177
Inspection Request Scheduled For: Date: 5/113/2008 Pour Time: 2 00
Code # Inspection Description Confirm # Contact # Message
270 Reinforcing steel (mbar) 03001401 971-563.359q N
Corrections/Comments/Instructions:
, Ail
111" A ,A _ .1
/ ,
r ASS ❑ PARTIAL APPROVAL . ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 41dbA. Date: CT ' i� Phone #: (503) 718 -2-AZ3