Permit CITY TIGARD BUILDING PERMIT
PE RMIT #: BUP2005 -00325
���r DEVELOPMENT SERVICES DATE ISSUED: 7/11/2005
' c " - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S113AD -01800
SITE ADDRESS: 16798 SW 72ND AVE B14 ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK I LOT: 011 JURISDICTION: TIG
Project Description: Modification of (3) fire sprinkler heads for TI.
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: 23 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: $ 1,915.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: 503 - 624 -6300 Phone: 503 - 620 -4020
FEES Reg #: LIC 64174
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/11/2005 $62.50
[TAX] 8% State Surchari 7/11/2005 $5.00
Total $67.50
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 -I e -0010 throe • h OAR 952 - 001 -0100. You may obtain a copy of these r .: or direct questions to OUNC by
cal ' ng 503 - 246 -6699 or -: • I- AP -2344.
Is .ued By: \ ` � A �,..!,,[ f Permittee Signature: .
CaII 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.
F FAr,eP,rotection System
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Received permit No.: /,
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permi
�
Inspection Line: 503.639.4175 �..'' F�' ' I I Date/By:
Ready By: lur • ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: 1 e Supplemental Information
' :TYPE'.OF . ` -... • .. REQUIRED. DATA I A 4D'Z.FAMILYDWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
a r Addition /alteration/replacement ❑ Other: equipment, materials. labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION ".::'.-•'•:•.••;;• _ , work indicated on this application.
Valuation: $
❑ I- and 2- family dwelling 1.4r ommercial /industrial
L l ❑ Accessory building I ❑ Multi- family
Number of bedrooms:
❑ Master builder l ❑ Other: Number of bathrooms:
JOB SITE"INFORMATION'AND •LOCATION• Total number of floors:
Job site address: 1(, i `j g s c 3 -- Z, d . New dwelling area: square feet
City/State /ZIP: I:),.,-,r-id--1.0,,,,,j_ , j Z c 2 Gy Garage /carport area: square feet .
Suite/bldg./apt. no.: Project name: C k..... c ,, v , ,,,0 - 0, ��,` Covered porch area: square feet
Cross street/directions to job site: 3 tt e - ,.;?,u -k Deck area: square feet
Other structure area: square feet
,REQUIRED DATA COMMERCIAL -tJSE CHECKLIST-•
Subdivision: Lot no.: 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
- DESCRIPTION-OF `S ORIE7 - + - 4- =' work indicated on this application.
Valuation: $ 1 1
I CAL- b cet /ku, 3 .S r `n P- 1 kic.a, Qv
.
3 Existing building area: square feet
New building area: square feet
L ❑ PROPERTY OWNER ' .. TENANT , " - •?..; ‘':''• Number of stories:
Name: C ()Bison COt�` �,/ _ o ~Mc SS ---. Type of construction:
Address: 1 (,1 it SI.J - 71,1- c , Occupancy groups:
City /State. Z1P: r 6 U `1'7 Z 2 Existing:
Phone: t ) I Fax: ( ) New:
APPLICANT . ❑ CONTACT PERSON :
NOTICE' ,
Business name: .--t. e. 0,,,,,,..
F. Vi In c.
_ All contractors and subcontractors are required to be i
licensed with the Oregon Construction Contractors Board I
Contact name: ei j' iZe under ORS 701 and may be required to be licensed in the t
Address: I t•{ 151 b 4 7 Z,,,, A, ilt e. jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State /ZIP: d r4-6tit i 1f 1121,11 apply:
Phone: t.„3a3 ) K, 20_g6 2.o Fax: : (5d3) (o l IOC
E-mail: _ I
CONTRACTOR '
Business name: ,-4tk. F; �� T, f BUILDING PERMIT FEES*
.address: )(,/ -1 ¶ S 5A l Zrij , Ave Please refer to fee schedule.
Cary %State ZlP�drtin4 i, 2Z Fees due upon application
Phone: (SZ, 3) ( Z,) Fax: (bZ ) ( Zv_t 6S$ Amount received
CCB lie.: 6y1`](
i r �� Date received:
Authorized signature: / This permit application expires if a permit is not obtained
/ within 180 days after it has been acce red as In complete.
Print name: m1 a' �1'l Date: b / 21 l o 3 Fee methodology set by Tri- County Building p dustry
L 111 Service Board.
1a0 -- 761 }T(11 /02 /CON/WEB)
Iimldme Panics FPS- PcrmitApp doe I_03
CITY OF TIGARD l►
BUILDING DIVISION a.......,.
#: BUP2005 -00325
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED• 7/11/2005
Phone: (503) 639 -4171 � " lbII $.1(11,
Inspection Requests (24 Hrs.): (503) 639 -4175 —N I— `___
INSPECTION WORKSHEET FOR DATE: 7/13/2005 TIME: 7:10AM PAGE: 44
SITE ADDRESS: 16798 SW 72ND AVE B14 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: COOKSON
DESCRIPTION: Modification of (3) fire sprinkler heads for TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: DELTA FIRE INC PHONE #: 503 - 620 -4020
Inspection Request Scheduled For: Date: 7/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 011319 -01 503-620-4020 N
Corrections /Comments /Instructions:
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3N - • ....
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_Magri - NAM,
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'PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6 Cik. Date: —7 / 1370 Phone #: (503) 718 -
CITY QF TIGARD .. .
BUILDING DIVISION PERMIT #: BUP2005.00325
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2005
Phone: (503) 639 -4171 A bs !
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:_. ° �`
INSPECTION WORKSHEET FOR DATE: 7/12/2005 TIME: 7:0GAM PAGE: 62
SITE ADDRESS: 16798 SW 72ND AVE B14 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: 011 TYPE OF USE:
PROJECT NAME: COOKSON
DESCRIPTION: Modification of (3) fire sprinkler heads for TI.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503 -624 -6300
CONTRACTOR: DELTA FIRE INC PHONE #: 503 - 620 -4020
Inspection Request Scheduled For: Date: 7/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 011212 -01 503 -620 -4010 N
Corrections /Comments /Instructions:
411t
. Ci • ' _ �-, . Ada;
c.,. ;PP .... t 0 r
( FW \ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDIT ONA FEES ASSESSED
Inspector: ow I � P Date: `hone #: (503) 718-