Permit v CITY OF TIGARD BUILDING PERMIT
'PI PERMIT #: C OMMUNITY DEVELOPMENT DATE ISSUED: 6/12 2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 113AA - 01000
SITE ADDRESS: 16570 SW 72ND AVE B9 ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK I LOT: OOC JURISDICTION: TIG
PROJECT: SERVICE MASTERS
Project Description: Fire sprinkler alteration, add (3) heads, relocate (19) 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: 3N 7,500 sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 7,500 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 75 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: $ 2,500.00
Owner: Contractor:
PACIFIC REALTY ASSOCIATES FIRESTOP CO
15350 SW SEQUOIA PKWY #300 -WMI 7000 SW HAMPTON ST #105
PORTLAND, OR 97224 TIGARD, OR 97223
Contact #: PRI 503 - 620 - 6140
Phone: FAX 503 - 620 -6141
Reg #: LIC 63846
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 5/17/2007 $72.10
[TAX] 8% State Surcha 5/17/2007 $5.77
[FLS] FLS Pin Rv 5/17/2007 $28.84
Total $106.71
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
Oreg i i •tification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of t se rules or di ; ct . .e '.ns to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss e d By: ! a j s Permittee Signature:
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.
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Building Permit Application 7° 5(47a
Fire Protection , System 15) .1. FOR OFFICE USE ONLY
Daceived 2D /� DatDate/13 : �� Permit No.: / /) " O I City of Tigard
° 13125 SW Hall Blvd., Tigard, OR ddd"' c 1 B ; Plan Revie ��� : II. Phone: 503.639.4171 Fax: 503. 8.1�9 1 J L O Date M bpIM % Other Permit:
T 1 G n It D Inspection Line: 503 tv lr P�p Date Re ® See Page 2 for
Internet: www.tigard- or.gov a " Sal Notified/Method: .. a jil , O Supplemental Information
CO TYPE OF W 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
X 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 kCommercial/industrial Valuation: $
El 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: / 625-71, 5 e, j — 72 5ti 4 f t9 New dwelling area: square feet
City /State /ZIP: 17 0L 1 7 2-Z3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: c g, wlAr _ Covered porch area: square feet
Cross street/directions to job site: 7Z4 f Ill, cil 8 00n r. y /1j j , 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.
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.
Ab6 3 61R S'piQl/Vf�C 4-,n►D , c(oe,X (9 Valuation: $ 2.S00°.-1 a I'ci7n/G �� Fu o1 nce TrAi / i Aim vter Existing building area: square feet
New building area: '7''. square feet
X PROPERTY OWNER ❑ TENANT Number of stories:
Name: Mel-RUST I �f Type of construction: e/.. 13
Address: S3 S S W - Y q A May 7/30 0 Occupancy groups:
City /State /ZIP: Existing:
Phone: ( 43 ) 474- 6300 Fax: ( 43 ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: ) All contractors and subcontractors are required to be
&2Ue� �
Contact name: � �1JA/ licensed with the Oregon Construction Contractors Board
� under ORS 701 and may be required to be licensed in the
/.
Address: O, 30,1 z_ j0S 4S' jurisdiction in which work is being performed. If the
City /State /ZIP: 774,4- I Di_ em apply ant is exempt from licensing, the following reasons
Phone: ( col) 804 - S Z7 Z I Fax:: ( ) a
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: f .� 01a tom-( /
(Please refer to fee schedule)
�( Permit fee: - 7 'Z 1 .
Address: 7000 W - // typbe o�J 7� . �O
ro �� O � � State surcharge (8% of permit fee): s' 4
City/State/ZIP: 77 72-23
/ FLS plan review (40% of permit fee): 2 Q $
Phone: ( S'03) (0 20 -6 14 Q Fax: (5-b 3) ( .. (, 14 f (Due upon application.) L (J
CCB lic.: 63g4,4, Total permit fees: (0 b,1
Authorized signature Amount received: 106'
This permit application expires if a permit is not obtained
Print name: 13QvC6 A. ?Edi io Date: 5714107 within 180 days after it has been accepted as complete.
/ • Fee methodology set by Tri -County Building Industry
Service Board.
1: \Building\Permits\FPS- PermitApp.doc 03/23/06 440- 4613T(11 /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
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): $
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 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.
I: \Building \Permits \FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00267
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/12/2007
Phone: (503) 639 -4171 ■■'' ��I
Inspection Requests (24 Hrs.): (503)639 -4175 ,' °
INSPECTION WORKSHEET FOR DATE: 8/23/2007 TIME: 7:OOAM PAGE: 15
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTERS
DESCRIPTION: Fire sprinkler alteration, add (3) heads, relocate (19) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOP CO PHONE #: 503-620-6140
Inspection Request Scheduled For: Date: 8/23 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 054534 -01 503- 320 -8601 N
Corrections/Comments/Instructions:
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/ ' / PASS li IAL APPROVAL CANCEL 0 NO ACCESS
❑ 'AIL % • ' LL FOR INSPECTION ❑ ADDITION . FEES ASSESSED
Inspector Date: e ; 0 Phone #: (503) 718 -2&
CITY OFTIGARD r "
BUILDING DIVISION •
PERMIT #: BUP2007 -00267
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/1212007
Phone: (503) 639 -4171
Alk
Inspection Requests (24 Hrs.): (503) 639 -4175 . F '_ L�
INSPECTION WORKSHEET FOR DATE: 8/7 /2007 TIME: 7:03AM PAGE: 52
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTERS
DESCRIPTION: Fire sprinkler alteration, add (3) heads, relocate (19) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOP CO PHONE #: 503 -620 -6140
Inspection Request Scheduled For: Date: 8/7 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 053514 -01 503- 320 -8601 N
Corrections /Comments /Instructions:
_ r . LE_ Lem, L S - -- 5 L LA-- S
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ( Phone #: (503) 718- 7 2-1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2007 -00267
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611212007
Phone: (503) 639 -4171 / 1t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/18/2007 TIME: 7:01AM PAGE: 10
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK( LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTERS
DESCRIPTION: Fire sprinkler alteration, add (3) heads, relocate (19) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOP CO PHONE #: 503 - 620 -6140
Inspection Request Scheduled For: Date: 7/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 052270-02 503-320-8601 N
Corrections /Comments/ Instructions:
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❑ PASS /OR IAL APPAO ' L ❑ CANCEL ❑ NO ACCESS
❑ FAIL UU • , • - INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector:
` Date: 6 0 Phone #: (503) 718- Z-6 9
CITY OF TIGARD . „-y-
BUILDING DIVISION PERMIT # BUP2007 -00267
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED 6/12/2007
Phone: (503) 639 -4171 " '� 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:OOAM PAGE: 39
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK I LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTERS
DESCRIPTION: Fire sprinkler alteration, add (3) heads, relocate (19) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: •
CONTRACTOR: FIRESTOP CO PHONE #: 503 - 620 -6140
Inspection Request Scheduled For: Date: 7/10/2007 Pour Time:
Code Inspection Description Confirm # Contact # Message
295 Misc. insp • ction 051711 -01 503- 804 -8272 Y
Corrections/ en s /Instructions:
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❑ PASS `j∎ 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �7Z.;(` (1Z„.........._. Date: ° ?fL 07 Phone #: (503) 718-
---,.
CITY OF TIGARD - .._
BUILDING DIVISION PERMIT #: BUP2007 -00267
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/12/2007
Phone: (503) 639 -4171 I�I'�
Inspection Requests (24 Hrs.): (503) 639 -4175 R:_..
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 93
SITE ADDRESS: 16570 SW 72ND AVE B9 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK! LOT #: OOC TYPE OF USE:
PROJECT NAME: SERVICE MASTERS
DESCRIPTION: Fire sprinkler alteration, add (3) heads, relocate (19) heads.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: FIRESTOP CO PHONE #: 503- 620 -6140
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
295 Misc. inspection 050086-01 503- 804-8272 Y
Corrections /Comments/ Instructions:
.,..iit■.
❑ PASS "if " ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • • ' FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ `L Date: ; / 0 Phone #: (503) 718- kci
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