Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00526
DEVELOPMENT SERVICES DATE ISSUED: 1/9/03
F 13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
SITE ADDRESS: 15854 SW UPPER BOONES FERRYRD BLD.0 PARCEL: 2S112DD 00701
SUBDIVISION: OREGON BUS. PARK II 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: 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:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,500.00
Remarks: Addition of heat & smoke detectors for fire alarm system.
Owner: Contractor:
PACIFIC REALTY ASSOCIATES ADT SECURITY SYSTEMS
15350 SW SEQUOIA PKWY #300 -WMI 2815 SW 153RD DR
PORTLAND, OR 97224 BEAVERTON, OR 97006
Phone:
Phone: FAX684 -7297
Reg #: H3- 469 - 729644
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 12/6/02 $62.50 Final Inspection
[TAX] 8% State Tax 12/6/02 $5.00
[FLS] FLS Pln Rv 12/6/02 $25.00
Total $92.50
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) • -6699 or 1- 800 - 332 -2344.
Issued y: J4,4_,1 v , . -',, iii A
Pemiittee -
Signature: ` )Q a pp 7 (t ems`
Call 639 -4175 by 7 p.m. for an inspection the next business day
,
.
Fire Protection System
A.. Building Permit Application
RECEIVED received: /a (o e9 Permit no.: 4 /0 p ^�5'
tf �� �^: 1i y � / V_
City of Tigard P if
Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigat.OR 9 3�
Phone: (503) 639 -4171
Et; Date issued: By: I Receipt no.:
Fax: (503) 598 file no.: Payment type:
CITY OF TIGARD y
Land use approval: BUILDING DIVISION l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family ❑ New construction 0 Demolition
❑ Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: l • • E ;00N MTZ.' D, Bldg. no.: C Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: 'TOTAL ro uILDIN 01)UC7 1►s •
Description and location of work on premi es/special conditions: ,-)i ST \-'.- OF F - OZS 1 LA 5`f STE
WITH k_VEL 1 R e M Pt`-' I> svn0KE DETECT0.5.
' - OWNER : FOR SPECIAL INFORMATION, USE CHECKLIST
Name: ( Floodplain ,scpticcapacity,solar,etc.)
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
' CONTRACTOR Valuation of work $ I Soo
4 ► S u I T ' z, � C>E S Existing bldg. area (sq. ft.)
Business name: New bldg. area (sq. ft.)
Address: '� •
y: - e O IQ O .. Number of stories
Cit • ZIP:
Type of construction
Phone s MHO Fax: E -mail:
Occupancy group(s): Existing:
CCB no.: New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
' _.' - ARCHITECT /DESIGNER' licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: _ Fax: E -mail:
ENGINEER . s
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa ❑ MasterCard
work will be compl' with, wheth tried herein or not credit card number / /
� , /t i4 J jSL Expires
Authorized signatu 1[)/t J!(S Date: I 1 Neme of cardholder as shown on credit card
Print name: A • So i . — Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6400 /COM)
i
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Fire Protection Permit Check List
A.) ❑ New ❑ Addition ❑ Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:
Additional description of work:
Type,of System (Complete A, 13-or C as applicable): - • ,
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation I $
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes a
Cut Sheets
Fire Alarm Project Valuation: $ t S 00.00
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $
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 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST •
'BUP G S
Received "• ,Date Requested '' AM PM `SCUP
Location / 5 ' S /./l U _ U Suite rz -40Ju .c�/ MEC
Contact Person Ph ( ) ! / pQ �LM
7
Contractor Ph ( ) l' 9 7 -L SWR
BUILDING Tenant/Owner :`� / — ELC
ng ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: /9 711 SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
e A a5)
Susp Ceiling
Roof
Other:
Final
(� )
F tLJ BING PART FAIL
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 Hail, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA ( Approach/Sidewalk Date ` V I o Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
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Date Time Zone Operator Event Zone Comm EC Additional Information
1:1 Ei 03 03:45:47 ',/RT 22-44P/PT -C LEAR FM TT T01 RINESH Ol i
1/16/03 09:45:47 Comment: TEST:ALL
:•!' 1:1
1/16/03 09!45:47 Comment: LAST SET:011603 84424
1/16103 09:29:40 R466 2012-RE-RESTORE LN#12 E466 T R466 U99
,,";!:■,,'' f
:;•, 1/16103 09;28:01 E466 1752-SA-SVC ON PREMISES T E466 U99
1/16/03 09: 2000-RE-RESTORE SMOKE/HEAT DET T R110 C9
1/16/03 09;26:5E1 9 40-FA-FIRE ALARM SMOKE/HEAT DET T El 10 09
1/16/03 09:25:50 10 2000-RE-RESTORE SMOKE/HEAT DET T R110 C10
,' 1/16)03 09:26:41 11 2000-RE-RESTORE SMOKE/HEAT DET T R110 C11
1/16/03 09:26:30 10 40-FA-FIRE ALARM SMOKE/HEAT DET T E110 C10
'1) 1/16/03 09:26:22 11 40-FA-FIRE ALARM SMOKE/HEAT DET T Eli° C11
1/16/03 06:44:24
VRT 1999-OA-PIC HOLDER TOM RINESH
,.,.. 1116/03 08.44:24 VRT 126-IN-ON TEST BY VRT CAT: 3
1/16/03 08:44;24 Comment: 011603 944 011603 1644
1/16/D3 08:44;24 Comment: TEST:ALL ,•,y1
;
1/16/133 01:10:58 E502 20-IN-TIMER TEST E602 CO
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