Permit • BUILDING PERMIT
CITY TIGARD PERMIT #: BU P2003 -00651
� DEVELOPMENT SERVICES DATE ISSUED: 11/12/03
A--- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 06650 SW REDWOOD LN 220 PARCEL: 2S112DA -01400
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : 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: $ 1,060.00
Remarks: Fire protection: Relocate 6 sprinkler heads and add 4.
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
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 11/12/03 $62.50 Sprinkler Final
[TAX] 8% State Surchart 11/12/03 $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 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
i
Issued By: Al! ., , / .J _ .1 .._:/
Permittee (A ,
Signatures ff A (, all 639 -4175 by 7 p.m. for an inspection the next business day
Fire-Protection System
• U
Building Permit Application FOR OFFICE USE ONLY
Building
- Date/By: !.(7 � p j Permit No () ?C7O 3 O�/
J
c
City of Tigard Planning Aprov/a1 Other
`J g 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 ` Ii �l l Post - Case and Use
Inte www.ci.tigard.or.us Contact C e No ® See Page 2 for
24 -hour Inspection Request: 503 -639 -4175 Name /Method: .414:
7 �` f Supplemental Information
TYPE OF WORK REQUIRED DATA: .
•
❑ New construction ❑ Demolition . I & 2 FAMILY DWELLING
IR Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees" are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling gCommercial/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 • No. of bedrooms: No. of baths:
Job site address: (oloSO 5) La'bo3DD D LA-/3E Total number of floors
/A t. #: New dwelling area (sq. ft.)
Suite #:
A.oS0 e p I �n Garage /carport area (sq. ft.)
Project Name: C S B S,r,- rns Covered porch area (sq. ft.)
Cross street/Directions to job kite: Deck area (sq. ft.)
Other structure area (sq. ft.)
PRC-I % LC CDR—POP—Alt
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: I 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.
`� tQr 01 Valuation $ ( 0 (00°2
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
J°-' PROPERTY OWNER I ❑ TENANT . Type of construction
Name: 2 \ C r12 us-r Occupancy group(s): Existing:
New:
Address: 153(=> 5i0 S .LbIIt Pko 3CC
City/State /Zip: 7 _s 2. 6 1? tt,J_
Phon': t35) ( _ 3 D Fax ( ) � 91 �S NOTICE: All contractors and subcontractors are required to be
ID p 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: }--1 (_. i-'p p e jurisdiction where work is being performed. If the applicant is exempt
Contact Name: - ,i J C p -5o,3 from licensing, the following reason applies:
Address: GI 3(64 5 TI A - J) '•
City/State /Zip: T6 f t> 12, q 7 Z23
Phone(9,o)1„2„0- (,lLM Fax t ) ( 4 ,20-61 U 1 BUILDING PERMIT FEES*
E -mail: — Please refer to fee schedule.
_ CONTRACTOR
Business Name: *i..1 S` c _ Fees due upon application $ co
Address: q 37 5 ID TIG -14 '5T-
City/State /Zip: —77 --, 1) t2 6/77_2_,3 Amount received $
Phone(y ,2j _ ( 11/7 Fax( .p) b21)- L i ct I Date received:
CCB Lic. #: (03 Sl(6 -
Authorized - ii Notice: This permit application expires if a permit is not obtained within
Signature: � , , / 4. AI. . . /,' L
A i -- e: i � 3 180 days after it has been accepted as complete.
f )// • 0 1i ' .4 ` ) ZE ET =Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
is \ Dsts \Permit Forrru\BldgPetmitApp.doc 01/03
Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) edification to sprinkler heads only:
Addition 4- 1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work: rZ,Qk� I &cLe-
a L{
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet ❑ Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ i g p °—
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: $
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.
Project Valuation Subtotal (A, B & C): $ N DT._
Permit fee based on valuation (see attached chart): $ ( ,CE
Permit fee based on square footage (D) (see fees above): $ —
State Surcharge 8% of Permit Fee: $ 5.00
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ . Sp
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
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: ' 639 -4171 MST
Received D e Requested / / 3t /(23 -, M PM , BUP
Location ('&7 S7) /ea e1c) 0 Suite MEC
Contact Person Ph ( ) PLM
Con r Ph ( ) SWR
I N Tenant/Owner ELC
Foo 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
F.041113r44127 e S rink
Fir
Susp'd Ceiling
Roof
,•• • --r:
J . ART FAIL
P • = NG
Post & Beam
Under Slab
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 for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA - t ''
Approach/Sidewalk Date / 2 ( 11 / u (� ) Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL