Permit 1CITY OF TI GA R D BUILDING PERMIT
PERMIT #: BUP1999 -00436
lr i DEVELOPMENT SERVICES DATE ISSUED: 10/12/1999
cal 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15575 SW SEQUOIA PKWY 180 PARCEL: 2S112DD -01600
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: . BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,600.00
Remarks: Fire suppression system
Owner: Contractor:
PACIFIC REALTY ASSOCIATES DELTA FIRE INC
15350 SW SEQUOIA PKWY P.O. BOX 4010
STE 350 TUALATIN, OR 97062
TIinonD, OR 97223 Phone: 620 -4020
Reg #: LIC 00064174
• FEES .. REQUIRED INSPECTIONS
Type By . Date Amount Receipt Sprinkler Rough -In •
FIRE BON 09/30/1995 $31.10 99- 318745 Sprinkler Final
PRMT BON 10/12/1995 $77.75 99- 3190007
SPOT BON 10/12/1995 $6.22 99- 3190007 OR I GI N A L
Total $115.07
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 folio - rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through eAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Permitee 1 . ,
Signature: 0
I / ��
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application Plan Check # 7 $ - 7C
CITY OF TIGARD Commercial or Residential Rec'd By
13125 SW HALL BLVD. Date Rec'd j— 3 6 -
TIGARD, OR 97223 Print or Type Date to P.E. P-5
(503) 639 -4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST do - L R '
q q ✓ Permit # A " Y .' //
gOe ! I --&-,.a (s L,Cr> Iii aped a �2-Q - t
Job ame -d (� Qf De elopr,�en Trol� , • I . O _ l i ‘ ype of System (Complete A or B as applicable)
Il , g
Address Address iw A.) Sprinkler Wet A Dry E]
rainimaimm Standpipes
Owner • ailing Address Hazard Group
S CO � w , ",...4. A 5c 30 Additional
? - ty/ - te % ip Phone Information Density
A o 6
N -me Design Area
l/2 LX -1 co vY kiz
Occupant Mailing Address K. Factor
City/State Zip Phone A.1) Sprinkler Project Valuation $ 4
Contractor Name B.) Fire Alarm
(Sprinkler or 1 • t& v?
Alarm Company) Mailing Address _ Submittal Shall Include ■
Prior to permit -r
)'7 e t S SW 7 2 A., D /1-1.4._
issuance, a City/State Zip Phone Individual Component ■
Cut Sheets
of all licenses ( U 2 j4�4 c 4- - ` 1 127 � )VZD a . 6 B.1) Fire Alarm Project Valuation $
required are State Const. Cont. Board Lic.# Exp. Date
expired in COT
database Lr J L/ Project Valuation Subtotal (A & or B) $
Name Permit fee based on valuation $
Mailing Address (see chart on back)
Architect 7% Surcharge $
City/State Zip Phone -2 10 $ 1 i ,
FLS Plan Review 40% of Permit
Describe work A.) New 0 Addition , Alteration ¶. Repair 0 TOTAL $
to be done:
B.) Modification to sprinkler heads only:
1. 1 -10 heads= No plans required Plans required: Submit three sets of plans, including a vicinity map and
2. 11 += Plan review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application, that the information given is
Number of sprinkler heads: (y correct, that I am the owner or authorized agent of the owner, and that plans submitted
Additional escription of Work: _.
are compliance with Oregon State laws.
• - f ( .)��� )�� ature f Own N�lgent / Date
A.) In Existing Building New Building ❑ ( 7rT
r
Building . Contact Person -Name Phone t'
Data B.) Commercial N' Residential ❑ (0g0 ^7oao
FOR OFFICE USE ONLY:
No. of stories: Plat # Map/TL #:
Sq. Ft:
Notes
Occupancy Class Type of Construction
- . ,
0 614 4,
i:\dsts\forms\firesupr.doc 7/2/99
02/17/2000 Activities for Case #: BUP1999 -00436
3:26:52 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level • By Updated Notes
BUPC005 Application received 09/30/1999 GEO RECD No Hold BON 10/05/1999
•
BUPC008 Permit created 10/05/1999 BON DONE No Hold BON 10/05/1999
BUPC012 Plans routed to Plans Examiner 10/05/1999 BON DONE No Hold BON 10/05/1999
BUPCO24 Plans Approved by CPE 10/06/1999 RDP DONE No Hold RDP 10/06/1999
BUPCO22 Plans Approved /Routed to DSTs 10/06/1999 RDP DONE No Hold RDP 10/06/1999
BUPC783 Sprinkler Rough -In 10/06/1999 10/06/1999 No Hold RDP 10/06/1999
BUPC784 Sprinkler Final 10/06/1999 10/06/1999 02/01/2000 TLP PASS No Hold AKJ 02/01/2000
BUPCO29 DST Post Review Completed 10/12/1999 GEO DONE No Hold GEO 10/12/1999
BUPC090 (F) Ready to issue 10/12/1999 GEO DONE No Hold GEO 10/12/1999
BUPC100 (F) Issue permit 10/12/1999 BON DONE No Hold BON 10/12/1999
BUPC960 Case Finaled 02/01/2000 AKJ DONE No Hold AKJ 02/01/2000
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BU 1 99 — rz� L/C
Date Requested ( AM PM BU I_ • 3
Location / c c ) S S i ( . U � l% r ite Ig 0
LO On -- 00
— 51
Contact Person Il/25 Ph 7D9 S2?) PLM
Contractor Ph SWR
GILDIN
Tenant/Owner 11111”11." , , - -- mC C
Retaining Wall f I cn Mtf1 PATH ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain Inspection Notes: n /� D �, v U^ t_ l _ i'��
Post & Beam
� � ` j � �� SIT C �('
Ext Sheath/Shear C"v`C fJ'1 64/qq / "oo 3-f g
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
•
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
ASS PART FAIL
P LUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P RT FAIL
ECHANIC L
Post & Beam
Rough In
Gas Line
Smoke Dampers
PART FAIL
` ___ RICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / - 0 v Inspector 0 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.