Permit BUILDING PERMIT
- CITY OF TIGARD PERMIT #: BUP2008 -00009
COMMUNITY DEVELOPMENT DATE ISSUED: 1/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 350 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: DELTEK
Project Description: Plug (2) sprinkler and relocate (3) heads.
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: sf N: S: E: W:
OCCUPANCY GRP: 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: $ 1,155.00
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 1/11/2008 $62.50
[TAX] 12% State Surch 1/11/2008 $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 by calling 503.246.6699 or 1.800.332.2344.
i
Issued By: il j ` . _ Jr Permittee Signatures i,e ' 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.
Fire Ptrotection System EC I` ED
Building Permit ApplicaR
iot>r G1 V FOR OFFIci, usi•: ONLY
City of Tigard JAN 11 2000 Received / i o ,
° 13125 SW Hall Blvd., Tigard, OR 97? C prl Plan Review ' Permit • : bi . 40 x01.0
Phone: 503.639.4171 Fax: 503.59 Q` T�A Date /B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 BuiwiN GENtstoN Date Ready/By: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: En 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 (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.
❑ 1- and 2- family dwelling ® Commercial/industrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12909 SW 68 Parkway New dwelling area: square feet
City/State/ZIP: Portland, OR 97224 Garage/carport area: square feet
Suite/bldgJapt. no.: #350 Project name: Tigard Triangle - Deltek 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: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Plug 2 Fire Sprinkler Heads and Relocate 3 Fire Sprinkler Heads Valuation: $$1,155.00
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Delta Fire, Inc. All contractors and subcontractors are required to be
Contact name: Heidi Scarbrough/Eric Loewer licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 14795 SW 72 Ave. jurisdiction in which work is being performed. If the
City / State/ZIP: Portland, OR 97224 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -4020 Fax: : (503) 602 -1058
E -mail: heidis@ deltafire .com/ericl @deltafire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Delta Fire, Inc. (Please rtjertoleeschedule)
Permit fee:
Address: 14795 SW 72 Ave
City/ State/ZIP: Portland, OR 97224 State surcharge (8% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 620 -4020 Fax: (503) 620 -1058 (Due upon application.)
CCB lic.: 64174 Total permit fees:
Authorized signature:
This Amount received: 2
s permit application expires if a permit is not obtained
Print name: Heidi Scarbrough Date: 1 -11 -2008 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I: \BuildmglPermits \FPS- PermitApp.doc 03 /23/06 440- 46I3T(II /02/COM/WEB)
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 ® 1 -10 heads: No plan review required.
® Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 5
Additional description of work
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes NA
Information: Hazard Group Ord. Group II
Density 1500
Design Area 0.10
K. Factor 5.62
Sprinkler Project Valuation: $ 1,155.00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $ N/A
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ N/A
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: N/A sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 1,155.00
Permit fee based on project valuation (see fee schedule): $ 62.50
Permit fee b ed on square footage ee D above): $ N/A
t State Surcharge (N's of permit fee): $ 7.50
FLS Plan Review (40% of permit fee): $ N/A
TOTAL: $ 70.00
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.
http: / /wwwcitigard.or.us /city_ hall /departments/cd/docs /FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION _. PERMIT #: SUP20t: 00009
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/11/200f3
Phone: (503) 639 -4171 14'111
�
Inspection Requests (24 Hrs.): (503) 639 -4175 :•. !.
INSPECTION WORKSHEET FOR DATE: 214/200 TIME: 7 :01AM PAGE: 36
SITE ADDRESS: 12909 SW 68TH PKWY 350 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: plug (2) sprinkler and relocate (3) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: J03.62U - 4020
Inspection Request Scheduled For: Date: 2/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 064975 -01 503-620-4020 N
Corrections /Comments/ Instructions:
40 :ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL . LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: AMP Date: 2 / `f U_ Phone #: (503) 718 - v
CITY OF TIGARD A , _
BUILDING DIVISION w PERMIT #: Bl)P2009 -00009
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 1/11/200;
Phone: (503) 639 -4171 s mu �
Inspection Requests (24 Hrs.): (503) 639 -4175 ..' �I I..
INSPECTION WORKSHEET FOR DATE: 2/1312008 TIME: 7:01AM PAGE: 4
SITE ADDRESS: 12909 SW GOTH PKWY 350 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: DELTEK
DESCRIPTION: Plug (2) sprinkler and relocate (3) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: DELTA FIRE INC PHONE #: 50-610 - 4020
Inspection Request Scheduled For: Date: 7/13/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
'.- '°°° :4
910 SprinFdc3r rough -in /test 0E1969-01 503-956-6290
Corrections /Comments/ Instructions:
1
41111trriliall■ mf.
RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I1, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ∎_ - ■ Date: dv Phone #: (503) 718 -
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