Permit IN a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00263
COMMUNITY DEVELOPMENT DATE ISSUED: 8/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113AC - 00101
SITE ADDRESS: 16655 SW 72ND AVE 800 ZONING: I -P
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: 029 JURISDICTION: TIG
PROJECT: COPYTRONIX
Project Description: Add (19) sprinkler heads & relocate (3).
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: 141 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 5,285.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI PO BOX 230545
PORTLAND, OR 97224 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 804 -8272
FAX 503 - 620 -6141
Reg #: LIC 63846
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/29/2008 $91.10
[TAX] 12% State Surch 7/29/2008 $10.93
[FLS] FLS Pln Rv 7/29/2008 $36.44
Total $138.47
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 Ilini546.6699 or 1.800.332.234 r
Issued :I- "� �i Permittee Signature:
�J
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.
Builft Permit Application
Fire Protection System FOR OFFICE USE ONLY
RECEIV 0 /�
City of Tigard Date/B A ! p
; en Permit No.: ;W 3— o ' 3
11 1 0 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev �� ftd i,
Phone: 503.639.4171 Fax: 503.598.1960 JUL 2 9 2008 DateB / CVO) other Permit
T I G A R 1 Inspection Line: 503.639.4175 Dare Rea - / Wrp ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Note. , 4 �s l� — Supplemental Information
■ a _ . . k . x 41.; , 9.
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.
12 f 1- and 2- family dwelling Commercial /industrial
Valuation: $
13 Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORnTION AND LOCATION Total number of floors:
Job site address: !6,6 SS' Q .- Tel All 1_ New dwelling area: square feet
City /State /ZIP: A 2 rtf4- D / 02 '7224 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: t0/3/4/ T/2o N 1 X 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: 1 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 WORK work indicated on this application.
4eb /Q /ige ftaii/✓Kl s ,Floe 3'ni . Valuation: $ rZ g °D
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name: 00 Pi/ P2 GN /x Type of construction:
Address: I64,ss gto 77/11A k Occupancy groups:
City/State/ZIP: ,o/1j(47 0 7 2z4 Existing:
Phone: ( ) Fax: ( ) New:
ix APPLICANT CONTACT PERSON NOTICE
Business name: .•f / yr I/ 0 9 to , All contractors and subcontractors are required to be
Contact name: i3evZ PO472.10 A licensed with the Oregon Construction Contractors Board
n - 1 under ORS 701 and may be required to be licensed in the
Address: ' 7( ) oo get - - /� •arew I (/ 0� 4 jurisdiction in which work is being performed. If the
City /State /ZIP: T/4412-1) P2 273 applicant is exempt from licensing, the following reasons
, apply:
Phone: ( 43 7 ^ B2 I Fax: : (J 03) 620 , / 4
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: f; i2t �f/ ep (ease �wfa�rr schedule) d
Address: A* O. 1.30.x. 1.30.x. 23054 Permit fee: 11 /....°
City /State /ZIP: / / 4 ,-, 0 2 g ? 2i I State surcharge (12% of permit fee): l� 4
t FLS plan review (40 /o of permit fee): 4 4
Phone: ( ) Fax: ( ) (Due upon application.) 3(„
CCB lic.: 43g¢4 Total permit fees: 1 3$47
Amount received: 1 .k, (47
Authorized signature:
This permit application expires if a permit is not obtained
Print name: BRv e c b . Pe rdN Date: 7/20"S within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits\FPS- PcnnitApp.doc 03 /23/06 440- 4613T(11 /02/COM/WEB)
•
ti
City of Tigard: Fire Protection Permit Checklist • -
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
El Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
El Repair
Number of sprinkler heads:
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
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm •
•
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
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 \Pemvts \FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200& 00263
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/13/200€3
Phone: (503) 639 -4171 awl, „�1��ii
Inspection Requests (24 Hrs.): (503) 639 -4175 ___..
INSPECTION WORKSHEET FOR DATE: 0/00/7008 TIME: 7:02AM PAGE: 12 • SITE ADDRESS: 16655 SIN 72ND AVE 800 CLASS OF WORK:.
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: 029 TYPE OF USE:
PROJECT NAME: COPYTRONIX
DESCRIPTION: Add (19) sprintler heads & relocate (3).
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOR co PHONE #: 503
Inspection Request Scheduled For: Date: 8/20/7000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Spuin rough-in/test rough- in /te t 074408 -01 503- 804 -8272 Y 7 )R� -�
Corrections /Comments /Instructions:
1.'
ir- ?d r. AlLowidory t Ai lib. IP i/ i i , ,
A / / •••""-- 4 .0. V
i_.
'ff PASS . • PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
r
%) CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `y� Date: 6 Phone #: (503) 718-
lb