Permit tI TY OF TIGARD PERMIT
PERMIT #: BUP2003 -00655
11�A DEVELOPMENT SERVICES DATE ISSUED: 11/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15860 SW UPPER BOONES FERRYRD B -15 PARCEL: 2S112DD -00500
SUBDIVISION: OREGON BUSINESS PARK 1 ZONING: I -L
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: 5N : 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: $ 2,120.00
Remarks: Fire sprinkler TI, add (9) new heads & relocate (8) heads.
Owner: Contractor:
PACIFIC REALTY FIRESTOP CO
15350 SW SEQUOIA PKWY #300 9384 SW TIGARD ST
PORTLAND, OR 97223 TIGARD, OR 97223
Phone: 503 - 624 -6300
Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 11/18/03 $72.10 Sprinkler Final
[TAX] 8% State Surchari 11/18/03 $5.77
[FLS] FLS Pln Rv 11/18/03 $28.84
Total $106.71
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001- 001111h3ugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
cal • g (503) 246-669 1-800-332-2344.
Is ued By: U I CAD/A33kil
Perm it e I
Signature: ; ' • ISAIIMIII lB•k-�\--•
11 •
Call 639 -4175 by 7 p.m. for an inspection the next business day
/SfGQ t w Of Pet 1100Ncv
Fire Protection System
BuildiIIgi. rmit Application FOR OFFICE USE ONLY ,
•9 Received O Building D
City Date/By / � r ' b Q 3 l ' Permit No �u �
.9"VO&J E � Planning Approval Other MM'' // l
y of Tigard i . `�1 ��� a0 Date/By. Permit No :b1.4 � - - G[/(f/ �
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 \I 1 a ! Date /By. , 1 -26 .0 ., 3 z 0)y Permit No..
Phone: 503- 639 -4171 Fax: 503 -5 Q 966 !$' ' l ej Post- Review / � - M Land Use
i • > L .I I' Date/By ti D at e /B p, , ZO a J ( \3s -rb
Internet: www.ct.tigard.or.us Of - ' �'
-:: J Case No
Contact A/ hi ® See Page 2 for
24 hour Inspection Request: 503 6 ♦� D' Name /Method / r V 1 Supplemental Information
TYPE OF WORK REQUIRE—
EQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY.DWELL•ING . • '
Addition/alteration /replacement ❑ Other: -
CATEGORY OF CONSTRUCTION. . Note. Permit fees' are based on the total value of the work performed Indicate
❑ I & 2- Family dwelling I Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, matenals, labor,
overhead and profit for the work indicated on this application
❑ Accessory Building ❑ Multi - Family
❑ Master Builder ❑ Other: Valuation ........ ........... S
JOB•SITE INFORMATION - and LOCATION . No of bedrooms No of baths:
Job site address/1(,D u�P es Fit p(j j24otal m... ........ ..
ew d ber area of floors. (sq. ft.). ... •
Suite #: Bldg. /Apt. #: / S Garage /carport area (sq ft.) ...
Project Name: 012.E../ Al I'L rzEpS , IIoG, Covered porch area (sq ft )
.............
Cross street/Directions to job site: Deck area (sq ft )..... . . .. .. ..
O IC, Dp ,� , , ^ /� 5 n�ede- ( Other structure area (sq. ft.)
• (� l ' REQUIRED DATA: . -
'COMMERCIAL.- USE CHECKLIST - . - • •
Subdivision: Lot #:
Tax map /parcel #: Note Permit fees* are based on the total value of the work performed Indicate
• - DESCRIPTION OF WORK __ _ the value (rounded to the nearest dollar) of all equipment, matenals, labor,
A elegy � 2- t 1 �l O �Gt 5 overhead and profit for the work indicated on this application
i2� ca
_1/41-e_, C-`1-� S . Valuation ` —
Existing building area (sq. ft.)
New building area (sq. ft.) ...........
Number of stones /
- Mt PROPERTY OWNER : • 1 I■ TENANT , - Type of construction... .. ....... ... ............. .... I/
Name: pikel-rieu S i Occupancy group(s): Existing:
Address: i53.50 SO �ti UD /H MakAy 41 3Pfo New.
City /State /Zip: Po 2._L_A -o tr 9722
Phone(fj) (a2 -( Fax:(933)(02(}-77Sc; NOTICE: All contractors and subcontractors are required to be
Dif APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: Fi/2 rQP CO - jurisdiction where work is being performed If the applicant is exempt
Contact Name: a it_j .['_ pErt -ejot3 from licensing, the following reason applies:
Address: C )3gL/ S I,J 71 ,A - P_I 577
City /State /Zip: - ( -, Ael) / rip__ 9 '722.3
Phone �,2D- 4D Fax:(sJ3) _lo /Lll - -
-
• ' BUILDING PERMIT FEES*
E -mail: — - -
- Please refer to fee schedule.'
CONTRACTOR .
Business Name: t—/ ae sTr P C D _ Fees due upon application . S /4,
Address: 9 3R 3,L) 7-1& 41a-D ST'-
City /State /Zip: • T[7 AE I, De 372Z3 Amount received.... .... S
Phone:( ' bZj) -(,/ Li I Fax:( .P L7 D-(, it Date received.
CCB Lic. #: (o 3 $ Li t
Authorized `
•
Signature: ,6 I1 a3 Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
Of A F 5
77P [ z-i D *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i \Dsts \Permit Forms \BldgPermitApp doe 01/03
•
Fire Protection Permit Check List
Describe work to be done: iJ
A.) ❑ New B.) Modification to sprinkler heads only:
a Addition ❑ 1 -10 heads: ,No.plan review required.
fil Alteration - 11+ heads: `Plan review required.
❑ Repair
Number of sprinkler heads: 1
tion of work: 1
Additional description ►4d °I 5 Pa�c..rt_�.� lids
Qao cap -e_
Type of System (Complete A, B, C or D as applicable):
- ° 'Coinrrieicial_:Sprinklet _� - � .
Wet ❑ Dry ❑
Additional Standpipes •
Information: Hazard Group • '
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 2120'1?
- B•) TYPe , Hood =Fire Suppression':System� -� • " ,
Hood Project Valuation: $
Fire . Alarm :? � ;j" .�•i�,� ; 'e. °a:.���. , 7,1.. „ -., : L C
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
• ' Fire Alarm Project Valuation: $ •
•
• D:) : Residential Sprinkler(Stand �Alone`System)�� ��� ,����> 1 °:;'
Square Footage: Permit Fee: } , ; ; ` ,1
0 to 2,000 $187.50 7 , r;;;; a .u ,:
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): $ 2(20"G9...
Permit fee based on valuation (see attached chart): ,$ '1 2. ID
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ ; --11
FLS Plan Review 40% of Permit Fee: $•
TOTAL: $ [ 0 —1 I
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.
is \dsts \forms \FPSchecklist.doc 02/28/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received 02- 1 / pate Requested 0 AM PM BUP
Location / . f &(-) / C / =cite 4I / /S MEC
Contact Person 61,0,ce pf 0A -4(/)-{ Ph ( ) ,} — 2 7 PLM
Contractor �-4- Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation AJU T_
Drywall Nailing
F e Spri /� C seP&i �� /�v2 q/ .
Susp'd Ceiling .
Roof 6 /9 /A / P C P®T /d't/ q, 609 j
(�
Other:
inal
',. PART FAIL
P ' BING
Post & Beam
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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 1 ' ) L Inspector ` Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL