Permit CITY OF TIGARD BUILDING PERMIT
a
. COMMUNITY DEVELOPMENT DATE E ISSUED: 3/13 2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 200 • ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: ACE INSURANCE
Project Description: Relocating (1) fire sprinkler head and adding (2) new sprinkler heads.
REISSUE: Fr' FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: A11' FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: UNK 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: 700.00
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 Contact #: PRI 503 - 620 -4020
FAX 503 - 620 -1058
Reg #: LIC 64174
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/13/2008 $62.50
[TAX] 12% State Surch 3/13/2008 $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 by calling 503.246.6699 or 1.800.332.2344. ,
r" _ /
Issued By> , T — Permittee Signature: / / / Air / `J /,
Alio
/ I
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 OFFICF.:USE ()NIA
City of Tigard ^
City Ka„„C"I'. _ DateBv: ed 3 / 3 Q O Permit No.: G
% • • 13125 SW Hall Blvd., Tigard, OR 97223 ,
' a Phone: 503.639 Fax: 503.598.1960 1 1 ` Al � � 1 Other Permit: dti� y t g
Inspection Line: 503.639.4175 A V'"" `
Ins
T I G A R D p M Dat R Juris: ® Page 2 for
Internet: www.ti ard -or. ov ''�� t. y�
g g WI � " ,��S Supplemental Information
TYPE OF WORK 5 1041 4 , 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
p a Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling cs,Commercial/industrial Valuation: S
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I 909 c j A 6 is I J y New dwelling area: square feet
`-�(' �
City/State/ZIP: r O R 41 7
Y Garage /carport area: square feet
Suite/bldg./apt. no.: Project name:T` T i le - �.Ce. 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: I 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.
Retoca4e 1 fire, rIprinINIer Vu'. a" Arta 9- Valuation: $ 9W ()
net 3pc'inititer h'rtcS. 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: ( ) I Fax: ( ) New:
A APPLICANT ❑ CONTACT PERSON
NOTICE .
Business name: � e 1itt f fe Mc. All contractors and subcontractors are required to be
Contact name: e b? �i-L �P.l�t `D�Q {1/L, licensed with the Oregon Construction Contractors Board
-rand, under ORS 701 and may be required to be licensed in the
Address: 11.47 Of 5w 7a1 , i l . jurisdiction in which work is being performed. If the
City /State /ZIP: 'RD c 6R. 97 tau applicant is exempt from licensing, the following reasons
�� n ^ / apply:
Phone: (5Q' l & ct V - tip 0 Fax: (50: l l 0
E-mail:; Se4 de cut. /hetdif16?clet Qtfe.cjln
CONTRACTOR BUILDING PERMIT FEES*
Business name: 70e1-1-c. rife �nG (Pfeasereferwfeeschedule)
Address: ' L' 79 5 SW 7g 1d Ave . Permit fee: W
City /State /ZIP: po and l ik ci7 � State surcharge (12 % of permit fee):
f `_ FLS plan review (40% of permit fee):
Phone: 3) ( _ (R Fax: F03 & Qo _ (1Q 10 (Due upon application.)
CCB lic.: 6 Gi 1 `Ti Total permit fees: 7- 50
Authorized signature: pigt Amount rece ived: 7 ) _ G v
This permit application expires if a permit is not obtained
Print name: Hc 1 ( )C .c.l.r trwoc) I Da : ? / / '2 V /6 �( within 180 days after it has been accepted as complete.
L V • Fee methodology set by Tri- County Building Industry
Service Board.
1 Budding‘Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02 /CONLWEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
g i Addition ®; 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, .0 or D as applicable): •
A.) Commercial Sprinkler
A , Wet ❑ Dry
Additional Standpipes
Information: Hazard Group L•1 (j�(�7r
Density k 0
Design Area , 5 OOO
K. Factor 5, ( a
Sprinkler Project Valuation: $ g00, )
B.) Type 1 Hood Fire Suppression System
Hood Project Valuation: $ /v
C.) Fire Alarm •
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ 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): $ 9004
Permit fee based on project valuation (see fee schedule): $ (
Permit fee based on square footage (see D above): $ a
State Surcharge (12% of permit fee): $ 7 F
FLS Plan Review (40% of permit fee): $ Jll
TOTAL: $ 10.00
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.
1: \Building \Permits \FPS -Per niLkpp.doc 2
CITY OF TIGARD-
BUILDING DIVISION PERMIT #: 1311P2008-00075 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/20013
Phone: (503) 639 -4171 - Atvr i
Inspection Requests (24 Hrs.): (503) 639 -4175 ` __..
INSPECTION WORKSHEET FOR DATE: 3/17/2008 TIME: 7:01AM PAGE: 43
SITE ADDRESS: 12909 SW 613TH PKWY 200 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: ACE INSURANCE -
DESCRIPTION: tRelocafing (1) firm splinlder head and adding (2) new sprinkler heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: 503624 -6300
CONTRACTOR: DELTA FIRE INC PHONE #: 503-620 -4020
Inspection Request Scheduled For: Date: 3117/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
- 299 Final inspection 066767 -01 971-235-0149 N
Corrections/Comment/Ins ructions: p � s ■ � �
ktv a G -,�Y` s)
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k PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 - 7 /0 Phone #: (503) 718 - t .-J-1