Permit ,� CITY OF TIGA FIRE PROTECTION SYSTEM PERMIT
` 2 '• COMMUNITY DEVELOPMENT Permit #: FPS2011 -00058
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/28/2011
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7204 SW DURHAM RD 300
Project: Consumer Cellular Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Relocate (6) fire sprinkler heads
Contractor: T & L COMMUNICATIONS INC Owner: PACIFIC REALTY ASSOCIATES
PO BOX 87387 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98687 -7387 PORTLAND, OR 97224
PHONE: 360- 737 -9725 PHONE: 503 - 624 -6300
FAX: 360 - 737 -9648
FEES
Description Date Amount
Specifics: Permit Fee - COM 04/28/2011 $91.44
12% State Surcharge - Building 04/28/2011 $10.97
Type of Use: COM Plan Review - Fire Life Safety - COM 04/28/2011 $36.58
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $138.99
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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 the 180 days. ATTENTION: Oregon law requires you • . •w the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -00 1090. ou may obtain a copy of the rules
or direct questio, to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / `/ `, „ ' , / Permittee Signature: �0Y.r[ — 7----,Air.LgiL..
ak Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Building Permit Application
Fire Protection System QG FF
FOR OFFICE USE ONLY Received
City of Tigard DatDate/By: /sO �/ T PermitNo.:� 1� % 5 i - " 13125 SW Hall Blvd. Tigard 0� j RED Plan Review
Phone: 503.718.2439 Fax: 50 5 6 ff Date/By: Other Permit:
TI CARD Inspection Line: 503.639.4175 p q g 2011 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov P F l\ !� Notified/Method: 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: 7204 SW DURHAM RD New dwelling area: square feet
City /State /ZIP: PORTLAND, OR 97224 Garage /carport area: square feet
Suite/bldg. /apt. no.: 300 Project name: CONSUMER CELLULAR 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.
FIRE SPRINKLER TENANT IMPROVEMENT Valuation: $$2,000.00
.a. t 1 (.0 \-14=0L-M. Existing building area square feet
W New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New
® APPLICANT ❑ CONTACT PERSON NOTICE
Business name: T &L COMMUNICATIONS All contractors and subcontractors are required to be
Contact name: Larry Bushaw licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: PO BOX 87387 jurisdiction in which work is being performed. If the
City /State /ZIP: VANCOUVER, WA 98683 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 737 -9725 Fax: : (360) 737 -9648
E -mail: OFFICE@TI, COMMUNICATIONS.COM
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: T &L COMMUNICATIONS
Permit fee:
Address: PO BOX 87387
City/State /ZIP: VANCOUVER, WA 98683 State surcharge (12% of permit fee):
FLS plan review (40% ofpermit fee):
Phone: (360) 737 -9725 Fax: (360) 737 -9648 (Due upon application.)
CCB lic.: 67787 Total permit fees:
Authorized signature: m fuzilitiv„1- Aount received: /(� , �! 9
This permit application expires if a permit not obtained
Print name: Larry s w Date: 4 -28 -11 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I: \ Building \Permits\FPS- PermitApp.doc 02/01/11 440- 4613T(11 /02/COM/WEB)