Permit A 1
A tITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00143
Il DEVELOPMENT SERVICES DATE ISSUED: 4/15/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16150 SW UPPER BOONES FERRYRD BLDG. C PARCEL: 2S113AB -00600
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
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: 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: $ 1,400.00
Remarks: Relocate (9) sprinkler heads & add (3) sprinkler 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 3/31/04 $62.50 Sprinkler Final
[TAX] 8% State Surcharl 3/31/04 $5.00
[FLS] FLS Pln Rv 3/31/04 $25.00
Total $92.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: '�� L������r —
Perm ittee
Signature: 9 Call 639 -4175 by 7 p.m. for an inspection the next business day
/�Nel7� cionnS�yste .
'Bu ermit Application FOR OFFICE USE ONLY .
Received Building / �
/�
�� �® Date/B : /JI /L
Q Permit No 1,__ I / t
City of TigardBECE Planning Approval
Date/n Re view Other Other No .
13125 SW Hall Blvd. Pla Other �
Tigard, Oregon 97223 200 Date/B . -/2 -0 AMA Permit No A ti ,,
v e „ - a 9 0'
Phone: 503 -639 -4171 F
MM . 03 -59& ""e t,$ . ?\ Post - Review Land Use
TIu��' Date/B - Case No
Internet: www.ci.tigard.060Y OF 10 Contact E /� G ® See Page 2 for
ur
24 -ho Inspection RecpistS NO Y� Name/Metlo& y
,i,. _ I�� Su . demental Information
y p�J - 1-
. - T„YP:E Ole WODDlc - : . - - 1 :1_ r k]: _ - ^ol ' Z LL J am - . !
•., - ,. . -., �,.:. ; :: . .: rt ,�., .a , . _- - _ QiIIREDDATAc;.�:;,.,: �.�:.,;; J: ^� L
F
New construction ❑ Demolition 2 DWELLING ri' '' ` - �
Addition/alteration/replacement ❑ Other:
::CATEGORY OF`CONSTRUCTION -- Note Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling .Commercial/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 $
'. :r: INFORIWATIONtiiiiE OCATION`' . No. of bedrooms: No. of baths:
Job site address: 16150 SO lIPRER PDIJES ro (Z. Total number of floors
Suite #: Bldg. /Apt. #: C_... New dwelling area (sq. ft.)
Garage /carport area (sq. ft.)
Project Name: 11,40010G-1 C DOCePrt S , 11)G Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
RE IJIRED, DAT 3; ,:''.,;:,... ..; •k Y a ;
Subdivision: • T , 1 COMMERCIIAL USE CHECKLIST. >::.,:�' '-; ' Ii -'' ,
Lot #: - ,(
Tax map /parcel #: Note Permit fees* are based on the total value of the work performed. Indicate
''- -` " .":`-<[' • : MSCRIPTIOPCOP,W,ORKr" - _ the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
I249.i DC a4-c. ` , (ZIYLIcit a - 11 1 l
446%. 3 C :ptc.-L list .P� `
, Yl v JJ S Valuation $ I400
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories ,.
g •PROPERT;Y'OWNER =- '_,"-, ;4, ®; 'rEKANT -.z' - ':.,: -'_;, _ Type of construction
Name: Rlem ti-r Occupancy group(s): Existing:
New:
Address: I5350 10 f— a_mol4 Pkitl # 30D
City /State /Zip: Pi-r3 , .E, 9 - 12 t-I
NOTICE: All contractors and subcontractors are required to be
Phone 1,1„ - , A mp Fax ■+b —11 licensed with the Oregon Construction Contractors Board under
CI APPLICANT-• :r -' ❑ •',CON[ ACTPERSON `' • provisions of ORS 701 and may be required to be licensed in the
Business Name: 6 2ES LO jurisdiction where work is being performed. If the applicant is exempt
Contact Name: P n e5t*.) from licensing, the following reason applies:
Address: Pty 23054s
City/State/Zip:—V6 ael r h' q -721 tt-c
Phone 620- — 1 Fax: y . -
• BUILDING PERMIT r " ` - • „': ` .:
E -mail: - -
CONTRACTOR S - , ` Please refer,to, fee, scpecl ile :,--
Business Name: �ISTrAP .. ... $ p
CO lJ Fees due upon application.... .... .
Address: . c2Q exix 7 3OSU S .
City /State /Zip:--1-16A_ems D- 1 Z- -i s Amount received.. .. $
Phone ) 670_ („1(„14) , Fax:(9 620 - 6(l. { Date received
CCB Lic. #: (0?3$t4
Authorized ..
Signature. d . C1 . j V L .4 • 4 .r 3/Z��61(/ Notice: This permit application expires if a permit is not obtained within
,U , n CJ 1 180 days after it has been accepted as complete.
ati , i —ems =Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i \Dsts \Permit Fomu \BldgPermitApp doe 01/03
.
■ ..: . • 1 - 1 , '1 , ' • • - '
. .
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Fire Permit Check List .
Describe work to be done:
A'.) ' •CjI New B:) Modification to sprinkler heads only:
Addition Li 1-10 heads: No plan review required.
'1-1 Alteration )4 11+ heads: Plan review required.
CI R4>aii
Number of sprinkler heads: (2,2:Loca..te_ 9
Additional description of work:
•.:-
, . .
. • : , ., - - . •
Type of System (Complete A, B, C or D as applicable):4 , . Y. .,
A. COrninerCiar,SPrinkler .'-'.'• `,..: -' 1. ''' ' -, .- . '''. '.: • '' ''',?..,':-: ' :-.: - , - .:- ' '.:
• ... ,VVet L ' ' Dry 'ED •
Additional Standpipes --::, . , __ -- :-, ,--', • , „
Information: Hazard GroUP' • ' •
..
•
Density - , . . ,.
Design Area
K. Factor
Sprinkler Project Valuation: $ 1400
:B.) :TYPe'l L HiiititUFite;siiiipeo'sibii.soterii;
,-- Hood Project Valuation: I $
-,-. - :c3s - -' - .F.1 - W,Araltiti'... - ,-_ : :: : ' ''''•:: ,,!,! _.: .. ',..'. J •,..,,, 1 , i: :_. . - . . , ..,
" '1 Submittal Battery Calculation - : • . - Yes 'CII • , '
include: Individual Component Yes CI
" Cut Sheets 71
Fire-Alarm Project Valuation: $
• )
, .
IN ReSidential-Speinkler.(Starid Atone System) -: 1 . -- .'' ' • , • : ‘. - : ' i ,' ' -;
i
Square Footage: Permit Fde:
0 to 2,000 $187.50 ' ' I' • i.j ',.:',.;.`-;',,,, •;,,: .
2,001 to 3,600 , • $232.50, - !'-',,''g-'i.:,e.':i''':::::':-',...':':"-:',;:::-.;:l.'i.:-.' .•
3,601 to 7,200 ., ' . : .$292:501 , . , 1,?.
7,201 and greater z ,,:, ,, $381, - , - '•'-.,'Z''' _:::„'7..:,.i..
Sprinkler Project Square Footage: ' ' ' - 's'ci ft.
ProjectValuation SubtotaF(A,B 8,' c) '.V 1400 '
Permit fee bas'e.d 06:valuation (see attached chart): i$. •G
Permit fee 'based on square footage (D) (see fees above) ,.'.- ”$:,
,
State Sbechaegfd':8_.% of Permit Fee:- '$'„ :. 5. W ,
FLS'Plan Review 40% of Permit ;;;Fee:: $" 2.5. co
„TOTAL,v $,
- 4 _
Plan review requires a completed application and 3 sets of plans at submittal.
Plan review fees are required submittal.
,
"New" fire protection systems require that plans bear the original seal of an Oregon
licensed fire suppression engineer, or NICET level.t`37 technicians..
iMstsVorms\FPSchecklist.doc 02/28/03 ,
- ' „