Permit • BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2001 -00251
,:il�. DEVELOPMENT SERVICES DATE ISSUED: 7/10/01
- 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 15957 SW 72ND AVE BLDG -A PARCEL: 2S112DC 00701
SUBDIVISION: OREGON BUS. PARK III ZONING: I -P
BLOCK: LOT: 038 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: 5N : sf N: S: E: W:
OCCUPANCY GRP: M 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: $ 500.00
Remarks: Adding sprinkler drops below suspended ceiling. (5) heads.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 9384 SW TIGARD ST
PORTLAND, OR 97224 TIGARD, OR 97223
Phone: Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 7/10/01 $62.50 27200100000 Sprinkler Final
5PCT CTR 7/10/01 $5.00 27200100000
Total $67.50
•
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 -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 mt ittee \ ` / 1c� ` �'7 " C
Signature: A I'
Issued By: • / lj/f� , ,6�.GG2 "1/L)
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
1 ' Building Permit Application
Daterece f f 4 Permit no.. / .0 _
,a.Mt.,. iy City of Tigard
° :_ Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 972
Phone: (503) 639 -4171 I t7 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1&2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory l "Commercial /industrial 0 Multi - family 0 New construction 0 Demolition
0 Additio alteratio , - placement Ga"I'enant improvement FtFr a spr inkle alarm 0 Other:
JOB SUIT INFORMATION
Job address: 5 1 S _ N • Z. • • ` Bldg. no.: Suite no.:
Lot: Block: Subdivision: , tee, • p • Tax map/tax lot/account no.:
Project name: . ��LV1
Description and location of work on premises/special conditions:
OWNElt FOR SPECIAL INFORMATION, USE CHECKLIST
EIMMIL
(Floodplain, septic capacity, solar, etc.)
Mailing address: / 1 0 z - 6. , 1,4 • '• 3(b I & 2 family dwelling:
State: OR ZIP: '] 2 Valuation of work $
Phone: .. -11 fl 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.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial/multi- family:
CONTRACTOR Valuation of work $ 5..
01)
Business name: ZE 'TO 1 0 Existing bldg. area (sq. ft.)
Address: )tj' %;/ % e 5' New bldg. area (sq. ft.)
Number of stories
City: '( c i /k-(Z • State: Pg.. ZIP: • 72. Type of construction
Phone: , • - 611 4b Fax: (aZu' 6141 E -mail: Occupancy group(s): Existing:
CCB no.: ' 3e , , New:
City /metro lic. no.: 5 066 Notice: All contractors and subcontractors are required to be
A RC! 11TECT /DESIGNER licensed with the Oregon Construction Contractors Board under
IMEICIMET t provisions of ORS 701 and may be required to be licensed in the
Address: /S 3 'p 5 .1 , i(.I// 30 jurisdiction where work is being performed. If the applicant is
HEINFMENZEIMIMEIENM ZIP: Z , exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: ) ' . Il 1 Fax: 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 ❑ Visa ❑ MasterCard
work will be complied w' , whether speci ed herein or not. Credit card number:
Expires
k Authorized signature: Date: (t 6 Name of cardholder as shown on credit card
\ Print name: ' u lI Imo(/} Nit $
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 (6IOOICOM)
Fire Protection Permit Check List
A. ❑ New ❑ Addition a Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:
Additional description of work: Hp 'pRcnrlde?- pooh e0,4
Type of System (Complete A or B as applicable):
A.) Sprinkler Wet Dry ❑
Standpipes
Additional Hazard Group , ef141 n)Aai)
Information Density • 15 •
Design Area 1) 6 it Mir Pdtf fD
K. Factor S•b
Sprinkler Project Valuation: $ 500 , z`r(
• B.) Fire Alarm N/A
Submittal shall; Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $ ADO • ° c )
Permit fee based on valuation (see chart): $ ( . �O
8% State Surcharge: $ 5 , o c)
FLS Plan Review 40% of Permit: $
TOTAL: $ CP ? •
is \dsts \forms \FPSchecklist.doc 10/04/00
//. /Lfr
CITY OF TIGARD BUILDING INSPECTION DIVISION ~ MST
24- Hour-inspection Line: 639 -4175 Business Line: 639 -4171 ?
!: BUP (
Date Requested 7 - 1 / AM PM BLD
Location / ) 9 7 Sw 7Z -td I - P Suite '4 MEC
Contact Person Ph C zri -G/ c D PLM
Contractor Ph SWR
ci 1l. DJNG Tenant/Owner ELC
Retaining WaII 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
Firewall
rink
Fire Alarm
Susp'd Ceiling
Roof
u isc:
• Fin
PART FAIL
BING
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 I /�
Approach /Sidewalk Date ` v Inspector 6O Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.