Permit a C 11 O F T I G D BUILDING PERMIT
• PERMIT #: BUP2008 -00257
°,` COMMUNITY DEVELOPMENT DATE ISSUED: 7/24/2008
T1GARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135AB-00900
SITE ADDRESS: 10200 SW GREENBURG RD 150 ZONING: C -
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: CORVEL
Project Description: Add (1) new head to storage room.
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: A 39 W .
Owner: n Contractor:
SHORENSTEIN REALTY SERVICES PACIFIC FIRE SPRINKLERS
ONE SW COLUMBIA ST #300 17273 S STEINER ROAD
PORTLAND, OR 97258 BEAVERCREEK, OR 97004 -9653
Phone: 503 412 - 4800 Contact #:
Reg #: LIC 41650
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/24/2008 $62.50
[TAX] 12% State Surch 7/24/2008 $7.50
Total $70,00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issua -, • 1 • is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Or: •on Utility Notifica '•n Cent- Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -01 e e You may obtain a copy
o' these rules or direct q - ons. • OUNC by calling 503.246.6699 or 1.800.332.2344.
I k I- ued By: 1' � � / Permittee Signature: "! .7 _
Call 503.639.4175 by 7:00 a.m. for an inspection that b in ss day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
-4____ -
Building Permit__. plication
Fire Protection System Cir. � ti,s ,11+ � aFO ROFFICE'USEONLI #*L t^+ ' -
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Received
,:; Clty of Ti 5 ; , Q Date/By: 7 P( 6g6 Permit No.: 0 [Q 8 -OQa
° 13125 SW Hall Blvd., Tig. 't, e 7223 4�00o Plan Review
l q Other Permit:
Phone: 503.639.4171 Fax: 503.59$i u ® DateB
TIR D Inspection Line: 503.639.4175 J� P� A� Date R /Meth eady/By:
od: 1 °� ®See Page 2 for
Info ation
.,.5 > : z ' Internet: www.tigard or.gov ON. � o *'" �,S�CS NNotified/Meth o. Supplemental rm
TYP1fIr�1� R R REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ��LL ❑ 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 CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling Commercial /industrial Valuation: $
ID Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: l
ilp 20 8 5't cJ -(7 yet p ,,,.- New dwelling area: square feet
City /State /ZIP: Qvc.J l OW- Garage /carport area: square feet
Suite Idg. /apt. no.: / �0 Project name: C0✓.,ve / Covered porch area: square feet
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.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
n / / DESCRIPTION OF WORK . work indicated on this application.
,4 / / ! 4.e.a.d 1 in. "jet,/ S d1/2.01t VI"- R00 V Valuation: $ 3����v
]
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT • Number of stories:
Name: .5 7, pp K cj� l ' Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON NOTTCE .
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES* ' .
� t (Please refer tofeeschedule)
Business name:
// 12c i��iG r% S/t -r&AS ' ' Permit fee: (oa so
Address: 7 0 y i2 6, t •evz.el C7
City/State/ZIP: //t � �A � O� G 7 � ‘r State surcharge (12% of permit fee): '� , � a�
7 , ,,t / 7 FLS plan review (40% of permit fee):
Phone: ( 503 ) .7)0 - i to ( i h Fax: (5 0) j) 37T _ d ?3- (Due upon application.)
CCB lic.: /-0 / it 0 Total permit fees:
Authorized signature: Amount received: `'O �°
This p ermit application expires if a permit is not obtained
Print name: d � e, w by 07-%.- Date: ?...,24/ --e)3'-' * within 180 days after it has been accepted as complete.
Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1 I /02 /COM/WEB)
.- -
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -1 0 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 as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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: $
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.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 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: \ Building \ Permits \ FPS- PcrmitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 131./P2008-002.57
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 124 /20013
Phone: (503) 639 -4171 'JL
Inspection Requests (24 Hrs.): (503) 639 -4175 - °:_...
INSPECTION WORKSHEET FOR DATE: 7/2500108 TIME: 7:00AM PAGE: 38
SITE ADDRESS: 1 0200 SW GREl= NESURC RD 150 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: CCORVEL
DESCRIPTION: Add (1) new head to $1.oracg ± roorn.
OWNER: SI REALTY SERVICES, PHONE #: E:0.;4112 - 41300
CONTRACTOR: PACIFIC FIRE SPRINKLERS PHONE #: .
Inspection Request Scheduled For: Date: 7/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
899 Sprinklff final 073189 -01 503 110 -664€i N
Corrections /Comments /Instructions:
34 C`c�c� e \ ■ 1 .v il CoL J CHA 1 y
C-C. vko. l
►�� 'ASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 7 5s Date: ,25-Tu1 y o£( Phone #: (503) 718- 2 Y