Permit - CITY OF T I GA R D BUILDING PERMIT
PERMIT #: BUP2001 -00466
-
DATE ISSUED: 12/26/01
, DEVELOPMENT E SERVICES 1639 -4171
�
SITE ADDRESS: 15705 SW 72ND AVE PARCEL: 2S112DC -00100
SUBDIVISION: OREGON BUS. PARK III ZONING: I -L
BLOCK: LOT: 002 JURISDICTION: TIG
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: 3N . sf N: S: E: W:
OCCUPANCY GRP: F2 TOTAL AREA: 0.00 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: $ 3,177.00
Remarks: Modification of 5 fire sprinkler heads.
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: Phone: 620 -4020
Reg #: SIC 64174
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 12/26/01 $81.70 27200100000 Sprinkler Final
5PCT CTR 12/26/01 $6.54 27200100000 '
MISC CTR 12/26/01 $32.68 27200100000
Total $120.92
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe mi itte - r
Si . ure: %�.t` «r %� �
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Call 63 • • 175 by 7 p.m. for an inspection the next business day
' A Building Permit Application
Date received: /A WO/ Permit f" /fA6
.- ;' • l iy'� City of ° Citf Tigard
= Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
7YPE OF PERMIT
0 1 & 2 family dwelling or accessory lCommercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement lir improvement Ur sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: 0 fi. .4.../M a Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
•
Project name: a . r [. A _.!
r
Description and loc. tion � t - �of work on premises/special conditions: QL1.t� -vLt . • . 4 _ •
_ _a e ' • II )41 // '
-- �l ' i /F
r
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplaiii, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
1 [G Covered porch area (sq. ft.)
Mailing address: a} . .-ffiffallINIM Deck area (sq. ft.)
MIMIIIMy ZIP 9 a Other structure area (sq. ft.)
Phone: ,_� ,d , Fax • �p - pr E -mail: Commercial industrial /multi- family:
CONTRACTOR Valuation of work $ ,3,1 7 7
Existing bldg. area (sq. ft.)
L New bldg. area (sq. ft.)
Address: .47- "- JO= Q
Number of stories
_ ` ZIP: ". ,F)-Wal Type of construction
Phone: evr • , ci i, • ,m E -mail: Occupancy group(s): Existing:
CCB no.: i 7 New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
FIESNMr provisions of ORS 701 and may be required to be licensed in the
Address: 7"
� - _ LAff. Q jurisdiction where work is being performed. If the applicant is
�, State:0 ,_ ZIP: • _ exempt from licensing, the following reason applies:
Contact person: fr / �,-, i1 Plan no.:
Phone: ,90 -go, J Fax. ,,.y - () , E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied wi ? , whether , - cified herein or not. Credit card number: Expires /
Authorized signatu tr/' �4( Ord _ •. Date: 1 "� 1 N ame of cardholder as shown on credit card
Print name: - ((` sicr t4 $
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/coM)
Commercial Plan Submittal
Requirement Matrix -
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3 **
Mechanical 2
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
i:\dsts \forms \COM- matrix.doc 9/24/01
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
.r -w - BOP -o6i1 oz 6
Date R equested / 7 AM PM BLD
Location l S 7 C) S 7€ d 41/Y2 -Suite = MEC
Contact Person Ph ,)-D ( ZZj i PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes: - ._—
Slab IT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
7
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler r 11
1 ,, „, L-
Fire Alarm
Susp'd Ceiling
Roof F Ps
Mi.:
di allik RT FAIL '
'G
Post & Beam
Under Slab ',..\./
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL •
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA r
Approach /Sidewalk Date / d Z Inspect Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
ITY OF TIGARD BUILDING INSPECTION DIVISION -
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
Date
/r Requested I;2 — 2 7 AM PM BLD
Location [ J 70,s Suite MEC
Contact Person Ph 6;--6 414 22) PLM
Contractor Ph SWR
‘44,41.111NG ) Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
/ Fire Sprink
Susp'd Ceiling
Roof -
Misc: (_
Fi
.y PART FAIL
- ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire '
ADA
Approach /Sidewalk
Other / Date / 7 / `Z 7 IK '\ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.