Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2001 -00199
� DEVELOPMENT SERVICES DATE ISSUED: 6/6/01
---41 6 I 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07257 SW KABLE LN 300 PARCEL: 2S112D6 -00300
SUBDIVISION: SOUTHERN PACIFIC TIGARD IND. ZONING: I -
BLOCK: LOT: 005 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: 3N : sf N: S: E: W:
OCCUPANCY GRP: B 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 10,100.00
Remarks: Tenant Improvement
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 6/1/01 $148.90 27200100000 Sprinkler Final
5PCT CTR 6/1/01 $11.91 27200100000
FIRE CTR 6/1/01 $59.56 27200100000
Total $220.37
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 -3 - 4.
Pe rm ittee ` �`
Signature: �,
Issued By: V/04//0//A J Ib
Call 639 -4175 by 7 p.m. for an inspection the next business day
Building 1
F . , . ‘
---11-(17,-ci L 5 -7- L i ved: 6 h /0 ( Permit no 07 Gf?J - 7 (pk. F .0
x >ili Ci ty of TigaL _ J ' :_ . Project/appl. no.: Expire date: City q/ Tigard Address: 13125 S W Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt
' Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: ) 0 0 ( — 0 0 (,- 2i 1 &2 family: Simple Complex:
TYPE OF PERMIT
Li 1 &. 2. family dwelling or accessory ❑ Commercial /industrial ❑ Multi-family ❑ New construction U Demolition
®Addditi alteration/re lacement > I Tenant improvement ❑ - ire s nnkl _
_ alarm ❑' Other: ' - \
• P P P - - - -
JOB SITE INFORMATION
'Job' faddy _ iZ5`1 ILA I5 L. L 4E
;�address: Bldg. no.: Suite no.:
Lot: I Block: ISubdivision: I Tax map /tax lot/account no.:
Project name: TINE AF o 96111 IMANT �d►� pI2pi6 NT
Description and location of work on premises /special' conditions: APO t'ZO 5 ?�tkeg V (' ow a� 1N S ✓SP�e.
c.4ttain • , to 4e- z i fur,- ilAr • t..,. , 1 -- ' f u a 191i , 7z-caw • f3
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: p ,4L i 9- i i t (Floodplain, septic capacity, solar, etc.)
Mailing address: 1!-& 2': family dwelling:
City: T( ., -) [State: 6(4 [ZIP: 51`2Z? i Valuation of work $
Phone: (p3oo [Fax: I.E -mail,: -- - No of bedrooms /baths
Owner's representative: i 'Total number of floors - - -- - -
Phone: . Fax: _ . E- mail - : , New dwelling area (q ft)
APPLICANT 'Garage /carport .area (sq. ft:) - - - -
Name: • , Covered overed porch area (sq. ft:)
Mai ling address: I _ Deck area (sq. ft.)
City: State: I; ZIP: 'Other structure area (sq. ft.)
Phone: Fax: Email: Commerciallindustrial /multi family:
CONTRACTOR Valuation of work $ (0 100, '
'Existing.bldg, area (sq. ft.) _ _ . •
Business name c-(12C, Srop co
Address: N e w bldg._ area (sq. ft.)
3 � _'_ i ((� 1� 5;(" Ne b stories
City: 'r ( (� 1 State t41Z, I ZIP: 91 ZZ3
Type o_ f constructio
Phone: (07:0 -�(p,j L (�- [Fax: 04-4(411,E-mail: E- mail: Occupancy Existin
CCB no.: ;,g (p P Y g - -
New
City /metro li 5 $g,l Notice: All contractors and subcontractors are required to be
ARCHIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under ,
Name: / provisions of ORS 70 -1 and:may be required to he licensed�in the
Address:Zj (- ov(7t Ave jurisdiction where work is `being performed. If the applicant is
City: ,� b ZIP: 001.0 exempt from licensing, the following reason applies_
Cit � State:
'Contact person: Plan nno.: - '
Phone: 'j cA V 11 ,, Fax 0 , 4 % 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. .
ed checklist. All provisions of 1 ws and ordinances governing this ❑Vis ❑ MastetCard ., ' will be c .ith, whether � ecfied herein or not: credii card namber
1
work
Expires,
Authorized signature. �`- Dat (e /b',0/ Name of cardholder as shown on credit card ,
a /s ,y, .
' Printrn`ame:_ 73 t i PF /� /fjy) J . P `'
Cardholder $ Amount
Notice: This permit application expires if a permit is¬ obtained' within 180 days after it has been accepted as complete. 440 -4613 (6100 /Cora)
Fire Protection Permit Check List
A.) ❑ New ❑ Addition 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: 6u' 5 (t9
Type of '.S.yst'em (Coompl,et'e,, B ass,app
A.) Sprinkler Wet' Dry ❑
Standpipes '
Additional Hazard Group (Age{
Information Density 10
Design Area
K. Factor i. 6
Sprinkler Project Valuation: $ (0 (o t -
B.) Fire Alarm
Submittal shall Battery Calculations Yes ❑ '
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $ .—
Project Valuation Subtotal (A;& B): $ (0 t (00
Permit fee based on valuation (see chart): $ I (
8% State Surcharge: $ t j cil
FLS Plan Review 40 % of Permit: $ s
• TOTAL: $ 220 -1
r`6 I
is \dsts \forms \FPSchecklist.doc 10/04/00
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
. BUP ( ° / 97
Date $requested /■' AM PM BLD
Location 7 J- S 7 j Q�� -erg / Suite 366 MEC
Contact Person Ph Zv - 6 / PLM
Contractor Ph SWR
KI Tenant/Owner ELC
Re'di ' all
ELR
ting
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
Fire Sprinkler
Fire Alarm
Susp'.d Ceiling
Roof
Misc:
/ in-
,PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
el° •
PASS PART FAIL
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
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
Approach /Sidewalk /� I V ' ( Other Date l Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.