Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00198
`^• Ih DEVELOPMENT SERVICES
o
SER9 ICES -639 -4171 DATE ISSUED: 6/1/2006
Hall
PARCEL: 2S112DD -01601
SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 001 JURISDICTION: TIG
Project Description: Add or relocate (11) sprinkler heads.
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: 18 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: $ 3,200.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES WESTERN STATES FIRE PROTECTION
15350 SW SEQUOIA PKWY #300 -WMI 13896 FIR ST STE B
PORTLAND, OR 97224 OREGON CITY, OR 97045
Phone: 503 - 624 -6300 Contact #: PRI 503 - 657 -5155
FAX 503 - 657 -5182
FEES Reg #: LIC 104570
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/8/2006 $81.70
[TAX] 8% State Surchari 5/8/2006 $6.54
[FLS] FLS Pln Rv 5/8/2006 $32.68
Total $120.92
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
95201010 thxough OAR 952 - 001 -0100. You may obtain a copy of these or direct questions to OUNC by
c ling 503 - 246 -6•: • • - 800 - 332 -2344. -.—
Is ued By :,' , � ",L P ermittee S nature : -_ L ,., 7gz. (9--( ,
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.
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Fire Protection System
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Building Permit Applie4jon� FOR OFFICE USE ONLY
City of Tigard � �U '� I •�' Received 3 r �
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DateB : -�� - +
� Permit � ���
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
�� 1 Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ��. ";�, 8 2ggp � � � Date/B : I
Inspection Line: 503.639.4175 ■ I� Date Read : y. 114 ® See Page 2 for
Internet: www.ci.tigard.or.us CITY Notified/Method: � - Supplemental Information
OF TIGARD
RIM DIkir D •..
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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: 15755 SW Sequoia Parkway New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 100 Project name: BRIDGEPORT IMAGING 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: 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: $$3,200.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: ' if
Phone: ( ) Fax: ( )
New:
® APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: Western States Fire Protection Co. All contractors and subcontractors are required to be
Contact name: Darrell Fluit licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 Fir Street, Suite B jurisdiction in which work is being performed. If the
City/ State/ZIP: Oregon City, OR 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 Fax: : (503) 657 -5182
E -mail: darrell.fluit @wsfp.us
CONTRACTOR
Business name: Western States Fire Protection Co.
BUILDING PERMIT FEES*
Address: 13896 Fir Street, Suite B
Please refer to fee schedule
City/State /ZIP: Oregon City, OR 97045
Fees due upon application
Phone: ((503) 657 -5155 Fax: (503) 657 -5182
CCB lic.: 104570 Amount received
Date received:
Authorized signature: - This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: /3/-7 / ii /T I Date: May 5, 2006 * Fee methodology set by Tri- County Building Industry
Service Board.
i: \Building\Permits \FPS- PermitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist,
Page 2 - Supplemental Information
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: 11
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 Light
Density 0.10
Design Area n/a
K. Factor 5.6
Sprinkler Project Valuation: $ 3,200
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
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): $ 3,200
Permit fee based on valuation (see attached chart): $ 81.70
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ 6.54
FLS Plan Review 40% of Permit Fee: $ 32.68
TOTAL: $ 120.92
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.
C:\My Data\Drawings\292661 - Bridgeport Imaging TI\FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2006- 00198
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7 :00AM PAGE: 51
SITE ADDRESS: 15755 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 001 TYPE OF USE:
PROJECT NAME: BRIDGEPORT MRI
DESCRIPTION: Add or relocate (11) sprinkler heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503-6246300
CONTRACTOR: WESTERN STATES FIRE PROTECTION PHONE #: 503.657-5165
Inspection Request Scheduled For: Date: 8/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 035621 -01 971- 563 -3699 Y
Corrections /Comments /Instructions:
•
. N l , I 4.1110- �
.- - , �,��� j
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
1 7 1 c,fi f � 1 Inspector: Date: 6 J ` .rte Phone #: (503) 718- `' ` 25
CITY. OF
BUILDING DIVISION PERMIT #: 6U 0/5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 F.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ) s7.-CS J'el IA O I Pi- c 3 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: '
OWNER: t � PHONE #: G9 1— S193-3659
CONTRACTOR: Pe l"� ' PHONE #:
Inspection Request Scheduled For: Date: I0 9 g ' D ( Pour Time:
Code # Inspection Description Confirm # Contact # Message
c ) ID 3..ft-P-1,,A,Le.,6 ,
Corrections /Comments /Instru o -
t 1 v
0
AI M i'f
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL PI CALL FO^ INSPECTION ❑ ADDIT *NAL F ES ASSESSED
► �►
Inspector: AMI■ — Date: I L° I 41 ° Phone #: (503) 718 -Z�