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Permit
CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00357 l4. DEVELOPMENT SERVICES DATE ISSUED: 7/27/2004 c�' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15230 SW SEQUOIA PKWY 100 PARCEL: 2S112DA -00300 SUBDIVISION: ZONING: I -P BLOCK: LOT: 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: 5N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 201 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: $ 8,000.00 Remarks: Fire sprinkler TI, add (1) new, relocate (77) heads. 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 7/22/2004 $120.10 Sprinkler Final [TAX] 8% State Surchari 7/22/2004 $9.61 [FLS] FLS Pln Rv 7/22/2004 $48.04 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 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling ( 5 8 - - -•. •9 or 1- 800 - 332 -2344. Issu -d By: . ■ , ' 1 / �'KX. 0 ' Permitte ,� Signature: \‘ - Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection System . Ruilaing Permit A n cation FOR OFFICE USE ONLY Received wilding 7� ' _ ` Date/By: 7 l/Y e No.: ;151 2 �! �a,3�5 7 City of Tigard ` Planning Approval Other �� Plan Review Permit No.: \ 13125 SW Hall Blvd. 0 Plan Review ,t Other Tigard, Oregon 97223 V � Date/By: ?' 'Z. i f 5 Permit No.: Phone: 503- 639 - 4171' Fax: - 5 98 -10 , 4 7 ) , ' j1 Post-Review Case d Noe w Int ww.ci.tigard.or.us� N ._.. _�trt See Page 2 f Contact 24 -hour Inspection Request: 503,q3 -OR 55 Name/Method: ) ' Cr Supplemental Information • . ... .. . -. TYPE`OFWORKc J : r, R .a: Y, > -�' % - - - -, . ;�a;• -:v , ..- e ,• UIItED ;DATA - =? ::s, • :-.•-• . °s. � ; - ❑ New construction ❑ Demolition . . ' Q ,,. : • l : ` & ,� -, - , ; " .: �ti,;,�;- FAIVVIQYDVi�ELLING_''s, .;t• },. 1 Addition/alteration/replacement ❑ Other: - CATEGORY OT CONSTRUCTION ?Y : Note: Permit fees' are based on the total value of the work performed. Indicate \ ❑ 1 & 2- Family dwelling ® m 1 Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, 1N overhead and profit for the work indicated on this application. ilk ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation $ '' -`- .: JOB' SITE INFORMA'TION'and LOCATION '' - . "":;' , No of bedrooms: No of baths: Job site address: 15230'i.) fbt1OIA PK-LO V Total number of floors Suite #: 1 DO k BCCDI are Apt. #: 14 New dwelling (( ft Garage /carport area (ss q. ft.) Project Name: 4(YUSE( r'u1w1 1 PG- G p u ,(Z,9 Covered porch area (sq. ft.) Cross street/Directions to job site: I Deck area (sq. ft.) Other structure area (sq. ft.) `'REQUI RED`DATAir•' _; P-,,- ti 1' ,.^- , ; : .,: . • :COMMEIRCI USE.CHECKLI , Subdivision: I Lot #: - .... -, s, h. . Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate °sDESCRIpTION:OF,VYORK.: _ :, . the value (rounded to the nearest dollar) of all equipment, materials, labor, k overhead and profit for the work indicated on this application. A,teL I Spei►\lcisz.e 1n.ead. 9- oc -e -in ` 42lYlk�2e. VIonAs Valuation $ ‘g( O Existing building area (sq. ft.) New building area (sq. ft.) Number of stories ®: PROPERT.Y:OWNER:._.' '':. ") . I ' ® _TENANT =. ': . -- . •-:, . , Type of construction Name: p 3 c -•1- Occupancy group(s): Existing: New: Address: 153•0 51a 14 1 q PKU3y City/State /Zip: POI7n A-ti `)b i o e_. 0l"12zi-t Phone:( )( Fax(5517; ( - - I 75S NOTICE: All contractors and subcontractors are required to be APPLICANT • licensed with the Oregon Construction Contractors Board under -0 CONTACT PERSON.'. ; , ' provisions of ORS 701 and may be required to be licensed in the Business Name: Fl l -p C, , jurisdiction where work is being performed. If the applicant is exempt Contact Name: 3( e J - 013 from licensing, the following reason applies: Address: Pr ft 2,7,D 5LIS City /State /Zip: -rG- 412_, , 0 9_, °11281 -OS4j Phone:(503)jc2o - (o l t D Fax :(93=5) IdZO- 6141 . _ - E -mail: - . BUILDING PERMIT FEES r E : :1-::',... • CONTRACTOR .. • Please= refer to fee se tedule.': � • . Business Name: FI -ETDP CD . ' 11 ?S Fees due upon application $ Address: Q t3 oxc 2_7 City/State /Zip:IlE,p z f]e_- 9-1242,1 - bS �S Amount received $ Phone( )(dlO - 1 LtC Fax() 620 -.LA 4.I Date received: CCB Lic. #: (o3gl{ to Authorized • Signature: j 41 All 2te: �'IlA( ©(l Notice: This permit application expires if a permit is not obtained within , 1 . 180 days after it has been accepted as complete. ' [ F I a Li , ' C)l Z 41 pe_e *Fee methodology set by Tri -County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms\BldgPermitApp.doc 01/03 Fire Protection Permit Check List Describe work to be done: A.) ❑ New B.) Modification to sprinkler heads only: (r Addition ❑ 1 -10 heads: No plan review required. Alteration . 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: — 7$ Additional description of work: "Rej ate SPizlY1le_LL2 kQS cutcL I 5p 21 Y1 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: $ 5cCjn°" B.) Type l - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire-Alami 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): $wce- Permit fee based on valuation (see attached chart): $ 12_0.10 Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ C1.10( FLS Plan Review 40% of Permit Fee: $ 4.01.1 TOTAL: $ rni 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 BUIieDING Inspection Line: (503) 639 -4175 MST INSPECTION LISION Business Line: (503) 639 -4171 OU 3.3 BUP �‘ Received Date Requested AM PM BUP ?Oi q -00..33 7 Location C � a` 3 Suite 1 MEC Contact Person Ph ( ) 32_ d - 30 / PLM Cont artnr Ph ( ) SWR Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Fire All 're Sprinkler arm Susp'd Ceiling << Roof �� O -r: � 1 = / P. SS PART FAIL �/ • • - BING fr Post & Beam Under Slab Rough -In \ 1)■ ( Water Service 41tk Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan • Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Dampers PART FAIL y RICAL 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: 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