Permit =n
•, ' � :�_ � �� OF �I BUILDING PERMIT •
° ' PERMIT #: BUP2008 -00299
COMMUNITY DEVELOPMENT DATE ISSUED: 8/29/2008
TIGAID 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
, - PARCEL: 2S101AD - 00100
SITE ADDRESS: 12725 SW 66TH AVE 207 ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT: 034 JURISDICTION: TIG
PROJECT: CRAWFORD CLAIMS
Project Description: Relocating (6) sprinkler heads for TI.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: 0560 n o
Owner: Contractor:
EXECUTIVE CENTRE LLC METRO SAFETY & FIRE INC
1590 NW 117TH CT PO BOX 33650
PORTLAND, OR 97229 PORTLAND, OR 97068
Phone: 503 - 526 - 1331 Contact #: PRI 503 - 231 -2999
FAX 503 - 256 -4691
Reg #: LIC 63651
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/29/2008 $62.50
[TAX] 12% State Surch 8/29/2008 $7.50
Total $70
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 -0 00. 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: �
/�_ i, _ , rte Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that 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.
i ailding Permit Application
Fire Protection System � FOR OFFICE USE ONLY
CI of Tiand `� Received / /
`J g �� D ateB : ` Permit No.: /+ .! ,0. i —
13125 SW Hall Blvd., Tigard, OR •'' -- ^Q Plan Review
Phone: 503.639.4171 Fax: 503.59: ' . (� ,� (, Date/By: Other Permit:
C
I" I G A R D Inspection Line: 503.639.4175 P\ V Ki o Date Ready /By: Juris ® See Page 2 for
Internet: www.tigard or.gov ` rk otified/Method: 6 Supplemental Information
`1 °IM �` \
TYPE OF WO) `` O � REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ 1 olliittion 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: $
❑ 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: ( 2 7 2 5 S W 6 6 4 j e New dwelling area: square feet
City /State /ZIP: it-74 • J e R 17137 Garage /carport area: square feet
Suite/bldg. /apt. no.: t t-7 Project name: 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
keJe 4te &-,x S AC, f K) e r k e A.4 i n 5 u i. -- 207 Valuation: .F ""y $ coo, oe
'to P v;)t.. Crn11( T L p (` T i , Pro i. ,(+- Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
❑ APPLICANT �� '':.(47.- ❑ CONTACT PERSON NOTICE
Business name: Ad ro 5l re 4y ' +na All contractors and subcontractors are required to be
Contact name: vq 1 K,J d; r tk A licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: p 6OX 31 6 0 jurisdiction in which work is being performed. If the
City /State /ZIP: Pd I # t ..... applicant is exempt from licensing, the following reasons
apply:
Phone: (50 9 ) z 3 ! - 2 yqy Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: 54) fi e
Permit fee:
Address:
City /State /ZIP: State surcharge (12% of permit fee): 7 5Z)
— FLS plan review (40% of permit fee): r
Phone: ( ) Fax: ( ) (Due upon applrcatiom)e
CCB lic.: 63 6S' I Total permit fees: 7c �
LJ
Ajiii--..—..--- �_ Amount received:
Authorized signature: This permit application expires if a permit is not obtained
Print name: 'ct n (fQ exit' ✓1 Date: g-2.1-06 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(11 /02/COM/WEB)
r _
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 -10 heads: No plan review required.
Z I 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 El 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.
1: \Buil ding \Permits \FPS- PermitApp.doc 06 /25/08 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 13(JP200i300299
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: f3 /2a'2..00rs
. Phone: (503) 639 -4171 !'"` t
�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,,, .'I_
7
INSPECTION WORKSHEET FOR DATE: 9/3/:''08 TIME: 7:01AM PAGE: 30
SITE ADDRESS: 12725 SW 66TI1 AVE 207 CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 034 TYPE OF USE:
PROJECT NAME: CRAWFORD CLAIMS
DESCRIPTION: Relocating (6) sprinlder heads for TI
OWNER: EXECUTIVE CENTRE LLC, PHONE #: 503526.1331
CONTRACTOR: METRO SAFETY & FIRE INC PHONE #: 603 - 231291
Inspection Request Scheduled For: Date: 9/3/2.008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
9E9 Sprinkler final 074976 -01 503 -626 -1331 L;,00 to
Corrections /Comments /Instructions:
•
•
!9 11 PARTIAL APPROVAL ❑ CANCEL Ii NO ACCESS
❑ FAIL MI CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ , , v .
Inspector: \ Date: k fill Phone #: (503) 718-