Permit 51 a CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00389
..
COMMUNITY DEVELOPMENT DATE ISSUED: 12/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 190 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL
Project Description: Relocating (1) sprinkler head.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 675.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Contact #: PRI 503 - 620 - 4020
Phone: FAX 503 - 620 -1058
Reg #: LIC 64174
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/8/2008 $62.50
[TAX] 12% State Surch 12/8/2008 $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 rules or direct questions to OUNC b calling 503.246.6699 or 1.800.332.2344.
/�
Issued B / . . „ / Permittee Signature: f 1 (JA k ' ,1)-
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.
v CITY OF TIGARD BUILDING PERMIT
' E ISSUED BUP2008-00389
COMMUNITY DEVELOPMENT
DATE ISSUED: 12/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 190 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL
Project Description: Relocating (1) sprinkler head.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 675.00
• 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 12/8/2008 $62.50
[TAX] 12% State Surch 12/8/2008 $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 rules or direct questions to OUNC b calling 503.246.6699 or 1.800.332.2344.
` /�
Issued B ` / .„4111111 P=PFPermittee Signature: k
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.
7 a CITY OF TIGARD BUILDING PERMIT
' , 2 COMMUNITY DEVELOPMENT PERMIT #: BUP2008 -00389
DATE ISSUED: 12/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 190 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL
Project Description: Relocating (1) sprinkler head.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 675.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phane:
Contact #: PRI 503 - 620 -4020
FAX 503 - 620 -1058
Reg #: LIC 64174
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/8/2008 $62.50
[TAX] 12% State Surch 12/8/2008 $7.50
Total $70
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 b calling 503.246.6699 or 1.800.332.2344.
ejtSZ/J
Issued B ` 'j / _ _ Permittee Signature: j&L/
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.
:111 CITY OF TIGARD BUILDING PERMIT
11 ar PERMIT ISSUED BUP2008
COMMUNITY DEVELOPMENT
DATE ISSUED: 12/8/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 190 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL
Project Description: Relocating (1) sprinkler head.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 675.00
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 12/8/2008 $62.50
[TAX] 12% State Surch 12/8/2008 $7.50
Total $70
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 b calling 503.246.6699 or 1.800.332.2344.
/ � iiii Issued B `'j� / iliz,k- Permittee Signature: ,l
--...
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.
Building Permit Application
, Fire Protection System FOR OFFICE USE oN 1.1
Ci of Ti and Received � G i
Aft `� g DateBv: O/ UC Permit No.: l 1
11 • 13125 SW Hall Blvd., Tigard, OR 97223 a MOO Plan Review ,
C Phone: 503.639.4171 Fax: 503.598.1960 (� C O D 11.• Date/By: Other Permit:
T 1 G A K D Inspection Line: 503.639.4175 V� Date Ready/By: turfs: ® See Page 2 for
Internet: www.tigard- or.gov ri4 1 . i4 1► 4; ..fied/Method: D Supplemental Information
TYPE OF WORK 101.1 REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rotnded 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.
❑ I- and 2- family dwelling *Commercial/industrial Valuation: S
A ccessory building Number of bedrooms:
❑ g ❑ Multi - family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND. LOCATION Total number of floors:
Job site address: , 2,09 ft, ( ,„.,t PQ clh New dwelling area: square feet
City /State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: '90 Project name:T T • o c f y2 . Covered porch area square feet
Cross streeddireaions to job site: LAPP— Deck area: square feet
Other structure area: square feet
REQUIRED DATAc,COMMERCIAL- USE,CAECKLIST
S ibdivision: 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.
`PjP.US rx4 , oru, r►tp. .bi tniAlex hPoa Valuation: S 75.0
Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: •
City /State /ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
A APPLICANT ❑ CONTACT PERSON
NOTICE .
Business name:
(�Q ._c... I� All contractors and subcontractors are required to be
Contact name: Ke1�'t�J r licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be lcensed in the
Address: 1147g 5I 1 3 T j qQ . jurisdiction in which work is being performed. If the
City /State /ZIP: o4-�la� /@ (� 8 u applicant is exempt from licensing, the following reasons
n� 0 R ` apply:
Phone: )WOt) _ /.10 i 0 Fax:: 633) 6040 KEA
E -mail: he:int i `760della((P. (OM
CONTRACTOR BUILDING PERMIT FEES*
Business name: tp � 4 rF i e ( (Please refer to lee schedule
C/ ti-� ` � ` f � � t C f n A.Q �� A , ' Permit fee: 6,A, a, 5 O
Address: Ili ri t 71 - Tae _
j� State surcharge (12% of permit fee):
City /State /ZIP: TV *ir yid, O R 1 (� -7 � �, O
a ? FLS plan review (40 % ofpermit fee): A/
Phone: t16 Fax: S) ) t9O 105 ' /Due upon application.) !V
CCB I ic.:(t / /7g Total permit fees: $ 7C) . Ad
Authorized signature: ��DD,, Amount received: `K
.IXM� This permit application expires if a permit is not obtained
H 1 within 180 days after it has been accepted as complete.
Print name:
�P id l S CaflOfav CS Date: / ' fog * Fee methodology set by Tri -County Building Industry
Service Board.
I Building\PermitsFPS- PermWpp.doc 03/23/06 440 4613T(I 1i02,COMVWEB)
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 IS 1 -10 heads: No plan.review required.
Alteration ❑ 11+ heads: Plan review required.
Repair
Number of sprinkler heads: j -
Additional description of work:
Type of System (Complete A, B, C or. D as applicable):
A.) Commercial Sprinkler
Wet ❑ Dry
Additional Standpipes Al P
Information: Hazard Group L.r
Density • . • Io
Design Area 1 00
K. Factor
5 .0g-
Sprinkler Project Valuation: $ 6 15.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ iJ,A
C.) Fire Alarm .
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ /U
D.) Residential Sprinlder (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: I r sq. ft.
Fire Protection Permit Fees •
Project valuation subtotal (see A, B & C above): $ (075. QO
Permit fee based on project valuation (see fee schedule): $ ( Do
Permit fee based on square footage (see D above): $ A)fi
State Surcharge (12% of permit fee): $ '1. -
FLS Plan Review (40% of permit fee): $ AA
TOTAL: $ 76.00
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.
L`,Biaid :K \ Permits \FPS -Peer irApp.doc 2
CITY OF TIGARD ,_.___
BUILDING DIVISION PERMIT #: BUP2003 00399
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: -12j800013 W,
Phone: (503) 639 -4171 , �11' 9 .
Inspection Requests (24 Hrs.): (503) 639 -4175 . �!�!+� ! L.
INSPECTION WORKSHEET FOR DATE: 12/18/ 408 TIME: 7:01AM PAGE: 9
SITE ADDRESS: 12909 SW 68TH POW 190 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: BENEFICIAL
DESCRIPTION: Relocating (1) sprinlder head.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: 503-620 -4020
Inspection Request Scheduled For: Date: 12118/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 079109 -01 503- 956-6290 N
Corrections /Comments /Instructions:
•
0 PASS 111 ' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL /// ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
_ .a ,
Inspector: Date: / Z /0 ig Phone #: (503) 718