Permit CITY OF TIGARD BUILDING PERMIT
PE RMIT #: BUP2004 -00488
�A DEVELOPMENT SERVICES DATE ISSUED: 10/7/2004
s `� ��J �I 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 15575 SW SEQUOIA PKWY 150 PARCEL: 2S112DD -01600
SUBDIVISION: PACIFIC CORP. CENTER 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: : 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: 470/00 O. oO
Remarks: Add (2) fire sprinkler heads and relocate (6) fire sprinkler.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES WYATT FIRE PROTECTION INC.
15350 SW SEQUOIA PKWY #300 -WMI 9095 SW BURNHAM
PORTLAND, OR 97224 TIGARD, OR 97223
Phone:
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 10/7/2004 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 10/7/2004 $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 -0010 through OAR 952- 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (5 46 f •9 or 1-800-332-2344.
Issu d By: 1, /'
1•
Permitte
Signature: y de ",/f e. .„....- #. :-
Call 639 -4175 by 7 p.m. for an inspection the next business day
i :-N i re Protection System
Buii'�df�tg Permit Application . ,
Received ra FOR OFFICI USG ONLY
Building /
Date/By: � 4 7 4 Permit No.: .i rfte) ola) .
City of Tigard Planning Approval Other
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 - h { Post - Review Land Use .
e .i i ( DateB : Case No.
w
Internet: ww.ci.tigard.or.us Contact Ju CI See Page 2 for
24 - hour Inspection Request: 503 - 639 - 4175 Name/Method:�p, Supplemental Information
•
TYPE OF WORK , 7'. 'REQUIRED - . -
1=i New construction ❑ Demolition ° ` i & 2 FAMILY DWELLING ! - ,
®' Addition/alteration/replacement ❑ Other:
` r• • CATEGORY OF CONSJRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling ommercial/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: t�jlCj - QVOU A p f- - Total number of floors
New dwelling area (sq. ft.)
Suite #: i 50 Bldg. /Apt. #: Garage/carport area (sq. ft.)
Project Name: Co, T4 ( M\ 1716G6 • O 6T 1 t4Y Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
`t" ;'. % > ft. � ..W. REDDA_ TA: - • , - •
�.{ O VIMEI(
IAIs ='U CHK - . ; i'�' � � u7a �, •. - ECLLST _ _ �. -.
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,
v - � -����a overhead and profit for the work indicated on this application. -p1
Q
��� � `�I Y � �4-��
AND RekC/ S1 cl YPrS NY-\ Valuation $ � � COO '
- ` Existing building area (sq. ft.)
µ�Aro 5 �pY 1,��YDve.�/lpjN New building area (sq. ft.)
Number of stories
❑ PROPEI f OWNER I TENANT . , Y'`� Type of construction
�J I J) e Occupancy group(s): Existing:
Name: 1 tit,(. New:
Address:
City /State /Zi :
Phone:.5D 7 j ( Ail / 3jO p I NOTICE: All contractors and subcontractors are required to be un der
Fes' licensed with the Oregon Construction Contractors Board der
❑ APPLIC r . ❑ CONTACT- ERSON. r .1'> provisions of ORS 701 and may be required to be licensed in the
((p Business Name: CnNi ri utO 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 , : 'YTk°.+t w r;K: .�.,. • } �.
Fax: :','.4`1,'".`,4p; .. a ,. 4 n 'B," tI (► + FEE',.S« .. , `` r y ; ,i-: ..
E -mail: i , .�1Ai , , r 1w ` eiii
',iedul ; -; � �';� .. ..
rr�� yy ++ 3 Ire
:. C ti -.':' -r: ri:. . ' " -'. � -ir s 4, ,T M1. /1d ' • , , �. - •...00' ot ' irll ` - .:,,'A.�'s ' _ J . . - -
CONTRACTOR '. ;
Business Name: \NI*At} re, ?YtI€ � �NCG Fees due upon application $
Address: 4°45 cJW .EjfljU $
City /State /Zip: Tu c.,i D — grIZZ� Amount received
Phone: (GAS) . 1,417 Fax: (ye) l0A• eI (p Date received:
CCB Lic. #: (p4.011 ,
Authorized / . /� Notice: This permit application expires if a permit is not obtained within
Signature: Dat /0/7/ 180 days after it has been accepted as complete.
R \C' )4t' .0N 1Z 'Fee methodology set by Trl- County Building Industry Service Board.
(Please print name)
is \ Dsts\Permit FomuV3ldgPermitApp.doc 01/03
_ 's
• •
• Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only: _
• ❑ Addition -'1 -10 heads: No plan review required.
..Alteration ❑ 11+ heads: Plan review required.
❑- 'Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D a s applicable):
A.) Commercial Sprinkler., •
Wet ❑ • Dry ❑
Additional Standpipes
Information: Hazard Group
Density • ,
Design Area
K. Factor
Sprinkler Project Valuation: $ 1 000 . o0 •
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: $
Q
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): $ 1 ) c00.
Permit fee based on valuation (see attached chart): $ (02 . SO
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ ( 5a
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. •
i:\,nsis,`crms\F°5checkiist.doc 02/28/03
CITY 0: TIGARD 24 -Hour
Bt tPING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP i .0c) oo cfg?
Received Date Requested / / _ '?"-- AM PM BUP
Location 1 S ,C 7 u-e'c— — Suite /-5 MEC
Contact Person Ph ( ) g a / a FC 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
Firewall
I S rink1er
Fire Alarm L„1
Susp'd Ceiling
Roof
Other:
air _ MINI
PASS PART FAIL jwel ri/ t
PLUMBING I
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 0 Please call or reins • ction RE: 0 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