Permit \ BUILDING PERMIT
CITY OF TIGARD
71 m ° PERMIT #: BUP2008 -00396
COMMUNITY DEVELOPMENT DATE ISSUED: 12/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: DIANA HARRISON CPA
Project Description: Add (1) sprinkler head, relocate (4) and plug (1).
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: 2N : 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: $ 1,253.00
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: Contact #: PRI 503 - 620 -4020
FAX 503 - 620 -1058
Reg #: LIC 64174
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/19/200€ $62.50
[TAX] 12% State Surch 12/19/200€ $7.50
Total $70.00
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 rul s or dir- • ques '•ns to OUNC by calling 503.246.6699 or 1.800.332.2344.
/ /
Issued By. �' /l am1L �� .
_i Permittee Signature: d i 1/ 11,4 �.64
r /
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.
' B;�ildiog Permit Application
11 • Protection System FOR OFFICE USE ONLY .
City of Tigard Dace / / / 9 0 D (74,-)..b / /dM Permit No.:
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Da[eBy: Other Permit:
T 1 G A R D Inspection Line: 503.639.4175 Dare Readyaty: Junr ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: " /i Supplemental Information
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 (rolnded to the nearest dollar) of all
AAddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION • work indicated on this application.
ID 1- and 2- family dwelling /4 Commerciallindustrial
Valuation: S
Accessory building Number of bedrooms:
❑ ry g ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 35o /� ( Oo nuo New dwelling area: square feet
City/State /ZIP: cJ dirk 1 0 p, 1 1 (4 Garage /carport area: square feet
Suite/bldg. /apt.no.:#. Projectname:Diap,A. NA.tcl, CPA. Covered porch area square feet
Cross street/directions to job site: � Deck area: square feet
Other structure area: square feet
.REQUIRED DATA :,.COMMERCIAL- USE,.CIIECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value rotnded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
lyrical 1. 3pr;nv�tter , ) )local e , y 696n NPX I
herxd, and vu i {)elniNer lilerA 40 pithydie, Existing building area square feet
ea1ef . Tr - New building area: square feet
u PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: •
City /State /ZIP: Existing:
Phone: ( ) Fax:( )
New:
X APPLICANT ❑ CONTACT PERSON .
NOTICE ..
Business name: l _ , . P 1 All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:
HP- Carl:::,m under ORS 701 and may be required to be l in the
Address: 1/.17 Fl 5/ 6 7Qnd Ave_ jurisdiction in which work is being performed. If the
City/State /ZIP: Or-Viand 91 as applicant is exempt from licensing, the following reasons
n^ apply:
Phone: (505 CoaC) 4O9 Fax: 4 ) c 9 �_ /mg
E -mail: h s:, ptcAYe,, corn
•
CONTRACTOR BUILDING PERMIT FEES*
Business name: ,�� ire, F (Please refertofeescheddulel
� ' j C�S 5 ,, 7 !� n nn.
� Ave- Permit fee: �� •
Address: I
State surcharge
t�n �� - 1 r.1.11� o� � aa u review (12 %of per f ee):
Al
City /State /ZIP: Pt 69� — 4 0 9 r _ 6 � _ 106g FLS plan ue upon ap cit
n pl o Al Phone: � Fax: ( - 7 (Due upon application.) ,�!
CCB lic.: 17tj Total permit fees: 70,Op
Authorized signature: Amount received:
fiT
• This permit application expires if a permit is not obtained
M coz
Print name: Heidi G f `,�,� ate: al I lc 10 within 180 days after it has been accepted as complete.
V►� ' �t,J (�J • Fee methodoloD' set by Tri -County Building Industry
Service Board.
I', Building \Permits\FPS- PcrmitApp.doc 03/23/06 440.4613T(I1i02 /COMJWEB)
It
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information + +
•
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
21. Addition Z. 1 -10 heads: No plan review required.
.Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: C9
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
15g, Wet ❑ Dry
Additional Standpipes /VA
Information: Hazard Group
Density �Q
Design Area le,00
K. Factor 5.64- n
Sprinkler Project Valuation: $ 1ld , 0Q
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ MA
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ , V J
•
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: A', sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 1 ,0(�
Permit fee based on project valuation (see fee schedule): $� w
Permit fee based on square footage (see D above): $ /VA
State Surcharge (12% of permit fee): $ 1.
FLS Plan Review (40% of permit fee): $ 1tJ
TOTAL: $ 70.0 0
Plan review requires a completed application and 2 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.
I: \ Building \Permits \FPS- PermitApp.doc 2
•
CITY OF TIGARD 410
•
BUILDING DIVISION -
itto PERMIT #: BUP2008-00396
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2
Phone: (503) 639-4171
Inspection Requests (24 Hr.): (503) 639-4175 -
„
INSPECTION WORKSHEET FOR DATE: 1/ 7/2O / 1/7/20i:) TIME: 7 PAGE 37
SITE ADDRESS:
15350 SW SEQUOIA PKWY 190 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: DIANA HARRISON CPA
DESCRIPTION: Add (1) sprinkler head, relocate (4) and plug (1).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: 603.620-4020
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 079430-01 603-620-4020
Corrections/Comments/Instructions:
•
•
•
•
AP in ARTIAL APPROVAL 0 CANCEL 7 NO ACCESS
FAIL //CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED •
Inspector: Date: / 7 0 7 Phone #: (503) 718-