Permit C ITY OF TIGARD BUILDING PERMIT
PERMIT I BUP2005 - 00370
. �1�� DEVELOPMENT SERVICES DATE ISSUED: 8/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 2S112DD - 01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 130 ZONING: I -P
SUBDIVISION: PACIFIC CORP. CENTER LOT: JURISDICTION: TIG
Project Description: Relocate (1) sprinkler head.
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: NONE sf N: S: • E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 29 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: $ 396.00
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: 503 - 624 - 6300 Phone: 503 - 684 - 2928
Reg #: LIC 64077
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/3/2005 $62.50
[TAX] 8 %State Surcha 8/3/2005 $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- 0100r m- • •btain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: � Permittee Signature., . /`i Arv,
it
I
Call 503 - 639 -4175 by 7:00 a.m. for an inspection at business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project. ,
Approved plans are required on the job site at the time of each inspection.
•
Fire Pioteeition System
Building Permit Applic n IVED FOR OFFICE USE ONLY x
„City of Tigard I RDeacteiveyd3 _3 0r Permit No.' k:Z? j_ISUJ � % 6 ,
13125 SW Hall Blvd., Tigard, OR 9' = =3 t 200 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 L IV Date/By: -
inspectior. Line: 503.639.4175 _ t Date Ready/By: Jut 0 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGA Notified/Method: 7 supplemental Information
BUILDING DIVISION
- • . TYPE OF WORK:` . .. • REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New onstruction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition'alteration'replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
• CATEGORY OF .CON work indicated on this application.
❑ 1- and 2- family dwelling om Valuation: $
1:1 Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
• -- ` �M
• JOB SITE INFORMATION AND LOCATION .. ;' : - Total number of floors:
Job site address: 19c S A O ( IN pv�� . New dwelling area: square feet
City /State/ZIP: uc V (Ia.., Garage/carport area: square feet
J
Suite/bldg. /apt. no.4* 12/ ) Project name: MC/ QG -Nei • Covered porch area: square feet
J
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
Re it :(F WO WO
h ' . • work indicated on this application.
eit loco Te. Y e s p 14 -e. ' haft, Gt �� Valuation: $ • a v ,
Te wr %Iwi- (f,Ntpov4 tw. n 111CJt h Existing building area: square feet
li�V v'," l 1, 1 G New building area: square feet
❑ PROPERTY OWNER -I - _ - ❑ TENANT '.' • - Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ❑CONTACT PERSON NOTICE
Business name: IS•efei COnTragrOi2►) All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name:
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State'ZIP:
_ apply:
Phone: ( ) Fax: : ( )
E -mail: _ •
- D CONTRACTOR i -, _ w • • - •. ' '
Business name: Vv U u t- -Pi re. l Ir lJ 1€t i'h OIV ' J N / l / - BUILDING PERMIT FEES*
Address: 6 615 .s V Please refer to fee schedule.
8V rN -4 u
'r 1
City State•ZIP: . 1- .54.6 , 4 4 I oe 4.l 2_ L3 - SO
�n , Fees due upon application
Phone: (6)05 ) tl/ . ` 2„, I Fax: (903 Vg4 . VS1
Amount received
CCB lic.: 0401
Date received:
Authorized signature: G This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete. ■
I Print name: wirNl I l 1V I Date: 04 O, i b5 • Fee methodology set by Tri County Building Industry
Service Board.
■ 9�...i. , Pc —•s FPS•Pe:rn::. c., . -.- 440.:613T1:1 G2 COMWE.t1)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Mod' cation to sprinkler heads only:
❑ dition 1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Ad, itional description of work:
PODC1z -f irs P
5 h Ni kle42. 1-1-€/ rt>
-Type of System (Complete‘A; B,,C or D as applicable):
A.) Commercial
J ❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
• B.) Type I - "Hood Fire System: ,' ; �K_:;� •:;; : • =. .
Hood Project Valuation: $
•' spa,, �f. ('-'•'F'f '7 3
C.) Fire Alarm � �.: ;,��: � - -. _ _�:.:_�,:.,�,-; -�� r�` *�..,,.... .. ... _ _
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand AloneSysfem).r _ -
Square Footage: Permit Fee: y;:'ra'. -'
0 to 2,000 $187.50
2,001 to 3,600 $232.50 ' t
3,601 to 7,200 $292.50
. -w- r:
7,201 and greater $381.50 :` � °s`
Sprinkler Project Square Footage: , sq. ft.
Project Valuation Subtotal (A, B & C): $ G< <Q
Permit fee based on valuation (see attached chart): $ kpZ • 50
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ , . Q 0
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ (i SC7
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 Building\Forms\FPS Checklist.doc 12/29/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 00370
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/312005
Phone: (503) 639 -4171 gi lll
Inspection Requests (24 Hrs.): (503) 639 -4175 :.�
INSPECTION WORKSHEET FOR DATE: 8/18/2005 TIME: 7:06AM PAGE: 98
SITE ADDRESS: 15575 SW SEQUOIA PKWY 130 CLASS OF WORK:
SUBDIVISION: PACIFIC CORP. CENTER LOT #: TYPE OF USE:
PROJECT NAME: MCPC INC
DESCRIPTION: Relocate (1) sprinkler head.
OWNER: PACIFIC REALTY ASSOCIATES. PHONE #: 503 -624 -6300
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 - 684 -2928
Inspection Request Scheduled For: Date: 8/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 013773 -01 503-684 -2928 N
Corrections /Comments /Instructions:
5POEJUkLE PJ
ASS c .te-----2----
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSP =CTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /
ir,` Date: - IF -0 S P hone #: ( ) 503 718 -
,_