Permit ih, CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00247
� DEVELOPMENT SERVICES DATE ISSUED: 7/30/02
� {=-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06640 SW REDWOOD LN 2ND FL PARCEL: 2S112DA -01300
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 001 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: 2N : 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 7,455.00
Remarks: Fire sprinkler system. Work on floors 1 and 2.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY #300 -WMI 14795 SW 72ND AVE
PORTLAND, OR 97224 PORTLAND, OR 97224
Phone: Phone: 620 -4020
Reg #: LAC 64174
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT CTR 6/20/02 $120.10 27200200000 Sprinkler Final
5PCT CTR 6/20/02 $9.61 27200200000
FIRE CTR 6/20/02 $48.04 27200200000
Total $177.75
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 - 332 -2344.
Permittee
Signature • :I J..111:§Mvirt1 "--%-f. •
r
Issued - : / ,L4_, - . /2 - k_
Call 639 -4175 by 7 p.m. for an inspection the next business day
.42.0e. 7/ 0- Z
7 /2 Tituilding Permit Application
LtP' ' �� , City of T ar ECE1VED Date received —Oy Permit no.:g � . oo l
'� i � i g Project/appl.no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 JUN 2 0 2002 Date issued: B3rat I Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: CH uk liL3�1R.D 1 &2 family: Simple Complex:
Boom
TYPE OF PERMIT ''
❑ 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi-family 0 New construction ❑ Demolition
IlAddition /alteration/replacement Tenant improvement Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: "~ • `F� , farKA U.) i / i, ; Bldg. no.: 239 Suite no.:
Lot: I Block: (Subdivision: [Tax map /tax lot/accotmt no.:
Project name: Portland ACl i ni c
Description and location of work on premises/special conditions: Installation of Fire sprink s yste m ( �
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling: rte
City: (State: ZIP: Valuation of work $ d
Phone: (Fax: 1E-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Name: Michael Stewart Covered porch area (sq. ft.)
Mailing address: 14795 SW 72nd Avenue Deck area (sq. ft.)
City: Portland ( State: OR ( ZIP: 97224 Other structure area (sq. ft.)
Phone: 503-620-4021 Fax:620-1058 E -mail: Commercial/industriallmulti- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: Delta Fire, Inc. New bldg. area (sq. ft.)
Address: 14795 SW 72nd Avenue
City: Portland ( OR I 97224 Number of stories
State: ZIP:
Phone: 620 -4020 ( Fax: 620 -105$E -mail: Type of construction
CCB no.: 64174 Occupancy group(s): Existing:
New:
City /metro lic. no.: 1934 Notice: All contractors and subcontractors are required to be
ARCIIIT[C771)ESiLNER licensed with the Oregon Construction Contractors Board under
Name: Delta Fire, Inc. provisions of ORS 701 and may be required to be licensed in the
Address: 14795 SW 72nd Avenue jurisdiction where work is being performed. If the applicant is
City: Portland State: OR ( ZIP:97224 exempt from licensing, the following reason applies:
Contact person: Michael Stewar no.:
Phone: 620 -4020 Fax620 -1058 E -mail:
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.
attached checklist. All provisions of laws and ordinances governing this o Visa CI MasterCard
work will be complied with w t . er specified herein or no . Credit card number: / /
/ Expires
Authorized sl ature 41 , A116 V Date: Name of cardholder as shown on credit card
Print name: Il ,f (55a 13h1A 1 1 Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
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: Ot
Additional description of work:
Type of System (Complete A, B or C as applicable):
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $ ,t90
Permit fee based on valuation (see chart): $ Sao. i0
8% State Surcharge: $ 4,(0
FLS Plan Review 40% of Permit: $ 4.0
TOTAL: $ 5
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 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
c� CF1�BUP o — O 6 a q-
Received Date Requested / /a2 4 ( AM PM BUP
Location Le Co Lie) Suite MEC
Contact Person C 0 - Ph ( ) (02-e — 91) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation — ��
Drywall Nailing ��- �` a-
Fire wall ���� frn
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Other:
IAZIP PART FAIL
PLUMBING - 745 l�h.r �ti
Post & Beam / > J /
Under Slab G�l� f� �� /i> ,' -
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
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 f. r reinspection RE: 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