Permit a CITY OF TIGARD BUILDING PERMIT
1 1 1 PERMIT #: BUP2006 -00595
' COMMUNITY DEVELOPMENT DATE ISSUED: 1/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 112 D C - 00100
SITE ADDRESS: 15705 SW 72ND AVE ZONING: I -L
SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG
Project Description: NIKE GOLF LAB.
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: F1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 2,000.00
Owner: Contractor:
PACIFIC REALTY ASSOCIAT FIRE SYSTEMS WEST INC
15350 SW SEQUOIA PKWY #300 600 SE MARITIME AVE #300
TIGARD, OR 97224 VANCOUVER, WA 98661
Phone: Contact #: PRI 360 693 - 9906
FAX 503 - 289 -2208
FEES Reg #: LIC 49732
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/19/2007 $62.50
[TAX] 8% State Surcha 1/19/2007 $5.00
[FLS] FLS Pin Rv 1/19/2007 $25.00
Total - .... " $92.50
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.
Issued By: Permittee Signature: A��/
Mir
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.
ISpb7S 70 5� Zo - o0 s
F e ro1iection System
Building Permit ADplicationRECEIVED ,(Hz OFFICI: ust :ONi.Y
City of Tigard DEC 2 1 2006 Received
. _ - _ -'Q‘ K�; • I A _ pd, "%o • 1
,
q 13125 SW Hall Blvd., Tigard, OR 9722 OF TIGARD PlanPlanReview
■ ' • Phone: 503.639.4171 Fax: 503.598.1 90 Date/B . Other Permit:
TI - n I ,I) Inspection Line: 503.639.4175 BUILDING DIVISION DateReadyBy: ® See Page 2 for /"
Internet: www.tigard- or.gov Notified/Method: iii= 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 d
t in 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 Comercial /industrial Valuation: $
m
El 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 5 C 1 f A.") 1 2 WV /tAtL3- New dwelling area: square feet c
City / State/ZIP: ( /, "4-0 OR- Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: Moore lr LAB 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.
1 Kr i rit L[_ S-PFE4 NI2L(gt -) i fJ &Art -) Valuation: $ a •
Existing building area: ` O . �. ( �,�st 1 6ar e feet
New building area: 2LLOO square feet
i v PROPERTY OWNER I ❑ TENANT Number of stories: / 7
Name: haw- Type of construction: 5
Address: oKl.r Bc w6...e___NAmysJ The,/ ih r Occupancy groups: 1 •
City /State/ZIP: ?raw"— ` b. 6 (L Existing:
Phone: (9 ) WC ) 4 V13 Fax: ( ) New:
1,1 APPLICANT ❑ CONTACT PERSON NOTICE
•
Business name: r ( 2 1 / � S1j - ' ' j Jt fl1 All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: ,SA Sv), / s el ,d under ORS 701 and may be required to be licensed in the
Address: (..co sir /l to i l s r A vi- ?00 jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: VlieJ Co: i1L/It- 1-4,1 f '&. / apply:
Phone: qt,o4y7ffot, Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: f (Please refer m fee schedule)
Permit fee: t o ) 5 D
Address:
• State surcharge (8% of permit fee): S
City / State/ZIP:
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.) 25,_�
CCB lic.: 41 ! 3 Z Total permit fees: �,5
Authorized si atur Amount received:
- tee. ‹. - This permit application expires if a permit is not obtained
Print name: jA Sovt s q�yrplg s Date: 1 2.11 -44.› within 180 days after it has been accepted as complete.
r • Fee methodology set by Tri- County Building Industry
Service Board.
I:\ Building\Pamits\FPS- PermitApp.doc 03/23/06 440-4613T(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:
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: 1 $
C.) Fire Alarm
Subinittal•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): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and Z 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 - PermitApp.doc 2
CIIY:QFTIGARD
BUILDING DIVISION PERMIT #: BUP2006-00 J95
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/19/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,
INSPECTION WORKSHEET FOR DATE: 1130/2007 TIME: 7:03AM PAGE: 40
SITE ADDRESS: 15705 SW 72ND AVE CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK III LOT #: 002 TYPE OF USE:
PROJECT NAME: NIKE
DESCRIPTION: NIKE GOLF LAB.
OWNER: PACIFIC REALTY ASSOCIAT, PHONE #:
CONTRACTOR: FIRE SYSTEMS WEST INC PHONE #: 360-693-9906
Inspection Request Scheduled For: Date: 1/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message _
999 Sprinlder final 042643 -02 360 -693 -9906 Y _-5
Corrections /Comments /Instructions:
.. e
.. , A..4. '
Wri "W
ASS 0 PARTIAL APPROVAL 0 CANCEL ❑ NO ACCESS
❑ FAIL w CALL FOR INSPECTION ❑ ADDITI' EES ASSESSED
��� ►'� •
Inspector: Date: 4 0 Phone #: (503) 718- `i(--2.)3