Permit ,
C ITY OF TI CARD BUILDING PERMIT
PERMIT #: BUP2004 -00439
1"il& DEVELOPMENT SERVICES DATE ISSUED: 9/14/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135A6 -03400
SITE ADDRESS: 10260 SW GREENBURG RD 190
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 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: : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 1,000.00
Remarks: Add & relocate (4) fire sprinkler heads for new tenant.
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST WYATT FIRE PROTECTION INC.
ONE SW COLUMBIA ST #300 9095 SW BURNHAM
PORTLAND, OR 97258 TIGARD, OR 97223
Phone:
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 9/14/2004 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 9/14/2004 $5.00
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 -I! ! • ough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli . (503) 246 -6. or 1- 800 - 332 -2344.
• 4110
Iss -d By: '
Permittee
Signature: X
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
• • Blinding Permit Application ROR OFFICE' USE :ONLY=
Received ` D' Building P
. Date/By: 7 / Permit No.: "A,,. , •
City of Tigard Planning Approval Other
y Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax 503 - 598 -1960 --- � „� ly j � a Post - Review Land Use
. J l '' Date /By: Case No.
Internet: www.ci.tigard.or.us ' Contact �I,uds El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: / I (o. Supplemental Information
•
TYPE OF WORK; ..-.,A: �': _..'- - - , -,_�:� •
REQUIRED D ATA:
n New construction ❑ Demolition , & 2 F AMILY. DWELLING
® Addition/alteration /replacement ❑ Other:
"CATEGORY OF CONSTRUCTION::: , -, - - ,:, :' - :4, Note: Permit fees* are based on the total value of the work performed. Indicate
n 1 & 2- Family dwelling J1 Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOBSITE INFORMATION and LOCATION r. No. of bedrooms: No. of baths:
Job site address: 1 e7 2, 6 p S,v, , C91ZEFANS6 RD. Total number of floors
New dwelling area (sq. ft.)
Suite #: VI C) Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: k .t_.La( S iC�5 Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
• '.' ' REQUIRED.DATA .'-
COMMERCIAL—'USE CHECKLIST ' "'=
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK • the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
L I 1 .i _ ii
1V'.1 tO P ��
.T NI �N t Z(`itP�W�M�h(,1 Valuation $ /DOD
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER ❑ TENANT- .,:;',, ,r,, .. ,:,,, ,-,_• . : ; , , Type of construction
Occupancy group(s): Existing:
Name: New:
Address:
City /State /Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
❑ APPLICANT ❑ CONTACT PERSON
provisions of ORS 701 and may be required to be licensed in the
Business Name: Ste Co NI R jurisdiction where work is being performed. If the applicant is exempt
Contact Name: • from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: I Fax: •
tBUILDING PERMIT FEES *. ':*--±:,,-: '-
E -mail: _ : Please" refer to fee schedule. .
CONTRACTOR . • ._..... . e - �
Business Name: U )V n Po T1014 Fees due upon application $ (I ,
Address: /O /c . 5,t4), c
City /State /Zip: Tj_GpsfL, ()2 { Amount received S
Phone: &e24-z Fax: &e4_ Lp 6,st Date received:
CCB Lic. #: b .i.p :i
Authorized / Notice: This permit application expires if a permit is not obtained within
Signature: r _ _ Date: / y (l`f'V ISO days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
■ P1 :.:se print name)
i:AI)stsAPermit Forms : :l;:.•.'I'•..n. rll.'03
Fire Protection Permit Check List .
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition 0 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ 'Repair
Number of sprinkler heads: 4
Additional description of work:
Type of System (Complete A, B, C or D as applicable)
A.) Commercial Sprinkler
Wet n Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ t 000
B.) Type I - Hood Fire Suppres System°:. ' >. , _ ,,
Hood Project Valuation: $
.
C.) Fire Alarm ��F.:, -:� -:,
Submittal shall Battery Calculations Yes '
include: Individual Component . Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand:Alo' a : System):' :``_ .............
; r
Square Footage: Permit Fee:
0 to 2,000 $187.50:a''t >:_.
2,001 to 3,600 $232.50 "_,
3,601 to 7,200 $292.50 ;.4 ;_:=: _ ;.• v.
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B &.C): $ \ poo
Permit fee based on valuation (see attachedtchart): $ Z ,v
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ 5:2%
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ G`7, So
Plan review requires a completed application and 3 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.
is \dsts \forms \FPSchecklist.doc 02/28/03
•
CITY OF TIGARD 24 -Hour
ZUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP ..266 e-( -'6v ` � 3 l y
Received Date Requested — / 7 AM PM BUP
Location / d a` 6 A u Suite MEC
Contact Person Ph ( ) (� �7 `��` PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing a _
�
Firewall �i l i(j
ire • arm
Susp'd Ceiling
Roof
O er:
4i jI'
i
A ART FAIL 7'111111.r
9 =NG �.
Post & Beam
Under Slab
Rough -In I . qt ,=
Water Service
Sanitary Sewer /
Rain Drain
Catch Basin / Manhole
Storm Drain a,
Shower Pan
•
Other:
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE - Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL