Permit C ITY OF TIGARD BUILDING PERMIT
r PERMIT #: BUP2008 -00349
1 ° ' COMMUNITY DEVELOPMENT DATE ISSUED: 10/16/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-00900
SITE ADDRESS: 10200 SW GREENBURG RD 700 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: Relocate (6) 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: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 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: $ 948.00
Owner: Contractor:
SHORENSTEIN REALTY SERVICES PACIFIC FIRE SYSTEMS LLC
ONE SW COLUMBIA ST #300 6704 RIVERIA CT
PORTLAND, OR 97258 WEST LINN, OR 97068
Phone: 503-412-4800 Contact #: PRI 503 - 710 -6646
Reg #: LIC 180140
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/16/200E $62.50
[TAX] 12% State Surch 10/16/200E $7.50
Total $70
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 Utilit Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of the ules or .i -ct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
i
Iss d By: . - },- ,
` � d
� 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.
O l i..R .
g
Buil"di Permit Application
Fire Protection System FOR OFFICE USE ONLY '
V, City of Tigard Received R, I (5 bQ Permit No 6 4 ° S.bO q y:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
': C • Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
Ti GA R D Inspection Line: 503.639.4175 Date Ready /By: fur. ® See Page 2 for
. ' Internet: www.tigard- or.gov Notified/Method: I Supplemental Information
- - TYPE OF - WORK • � • � ' • � . REQUIRED DATA:`!- 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
. • C ATEGORY. ' OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling 14 Commercial /industrial Valuation: $
❑ 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: 4 New dwelling area: square feet
City /State /ZIP: ' O cu,„1 / D Garage /carport area: square feet
ar th ldg. /apt. no.: 7 [ R Project name: r cut 444 { 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.
_� Valuation: $ I ( 18 " �''
ke /OC 4/ �G s�xl kl ,�..J_s
Existing building area: square feet
•
New building area: square feet
'❑ PROPERTY OWNER . ' - ❑ . Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
, ❑ : APPLICANT , ••• • , , • • . " . ❑ CONTACT ' PERSON . NOTICE:
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR ' • : BUILDING PERMIT FEES*
(Please refer tofeeschedule)
Business name: p c c?�i4, �' ,f2•e 5 / 5 -7 -� Permit fee: (_p, 5 0
Address: 670 q /./).//' 6 — f'
City/State/ZIP: / 1 /, State surcharge (12% of permit fee): 7 . So
Cit
y �>g' l..t KK C�/ 1( 9 7 0 `8' FLS plan review (40% of permit fee):
Phone: (5 ) 710-44 yL Fax: ( 6, 6 5) 37 7 _ 7 G g 5 (Due upon application.) -- t9 -- '
CCB lic.: / re) / y a Total permit fees: b ?O ,
Authorized signature:
Amount received: f 70 .°)
This permit application expires if a permit is not obtained
Print name: C Date: ` -/G -05 within 180 days after it has been accepted as complete.
4,7 ..„,..0 mss^ * Fee methodology set by Tri- County Building Industry
Service Board.
I \Budding \ Permits \FPS- PermitApp.doc 03/23/06 440- 4613T( 1 1/02 /COM/WEB)
/!' -
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe'work"to..be done:.. 4 s _
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 a licable
PP )�
Commercia i
l Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
1B), Type I - :Hood:Fire Suppression System - ��-
Hood Project Valuation: $
C) Fire Alarm Y - r - ¢`
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 (12% 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.
I: Buildin \Permits \PPS- PemvtApp.doc 06 /25/08 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: B
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/16/2006
Phone: (503) 639-4171 PERMIT
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/4/2008 TIME: 7 PAGE: 5
SITE ADDRESS: 10200 SW GREENBURG RD 700 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: Relocate (6) heads.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: PACIFIC FIRE SYSTEMS LW PHONE #: 503-710-6646
Inspection Request Scheduled For: Date: 11/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 077634-01 503-710-6646 N
Corrections /Comments/ Instructions:
14 3
i iic Arrive() QICI 4 A-5
C4,5.e._
/ 00KASS fl PARTIAL APPROVAL n CANCEL 0 NO ACCESS
fl FAIL fl CALL FOR INSPECTION H ADDITIONAL FEES ASSESSED
Inspector: ---S Date: 5/ /liai , e.K4 Phone #: (503) 718- 2( 42 3
, ,
....
CITY OF TIGARD 'I, , ,
.
BUILDING DIVISION PERMIT #: BUP2008-00349
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 101161200R
Phone: (503) 639-4171 erip01#
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10117/2008 7:02AM 37
SITE ADDRESS: CLASS OF WORK:
10200 SW GREENBURG RD 700
SUBDIVISION: LOT #: TYPE OF USE:
LINCOLN CENTER/FIVE LINCOLN
PROJECT NAME:
FARMERS INSURANCE
DESCRIPTION:
Relocate (6) heads. .
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: PHONE #:
PACIFIC FIRE SYSTEMS LLC 503-710-6646
Inspection Request Scheduled For: Date: Pour Time:
10/17/2008
Code # Inspection Description Confirm # Contact # Message
910 Sprinl4er rough-in/test 076830-01 503-710-6646 N
Corrections/Comments/Instructions:
foe locA.4:0 d)ri I-lead s
PASS fl PARTIAL APPROVAL 0 CANCEL 7 NO ACCESS
I I FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Z3_ Date: (7C- Phone #: (503) 718-