Permit Pk_ a CITY OF TIGARD BUILDING PERMIT
f) PERMIT #: BUP2007 - 00096
COMMUNITY DEVELOPMENT DATE ISSUED: 2/16/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136DD -03400
SITE ADDRESS: 11740 SW 68TH PKWY 100 ZONING: MUE
SUBDIVISION: TIGARD TRIANGE COMMONS LOT: 008 JURISDICTION: TIG
PROJECT: OMA
Project Description: FPS - Type I hood.
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: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 449 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: $ 995.00
Owner: Contractor:
PACIFIC NW PROPERTIES GUARDIAN FIRE PROTECTION
PO BOX 2206 1012 SW A ST
BEAVERTON, OR 97075 CORVALLIS, OR 97333
Phone: 503 - 626 -3500 Contact #: PRI 541 - 752 -2258
FEES Reg #: LIC 100355
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/15/2007 $62.50
[TAX] 8% State Surcha 2/15/2007 $5.00
[FLS] FLS Pln Rv 2/15/2007 $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
Ore 5 Itility 1 . • ation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
o ese rules or direc . ues ' • s to OUNC by calling 503.246.6699 or 1.800.332.2344.
, i ..MIII■
Issued By: i t /.■L Permittee - gnature: /1 / �/ �_
Call 503.639.4175 by 7:00 a.m. for an inspect on , -t business day.
This permit card shall be kept in a conspicuous place on the jo s site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I,
Fire Protection System
Building Permit Application rc)li 01:11C1:: 1; r: r)Nl.l •
City of Tigard �: 9 ° 1 0 7 Permit No.: , JP j90 �/I ��
'� q 13125 SW Hall Blvd. Tigard , ,lOR�° Plan Review
■ Phone: 503.639.4171 Fax: 503.598.1960 p��g . Other Permit:
- r 1 G A I: I
Inspection Line: 503.639.4175 FEB 15 2001 Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov g� Notified/Method Supplemental Information
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TYPE 8 NUV �'`l r 11�`Jl�►+"U
' r x .. ■ , A1 TQtTOI REQUIRED DATA: 1- AND 2- FAMILY DWELLING
atlew construction 1 01Oemolition 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 C ommercial /industrial Valuation: $ 795—
❑ Accessory building ❑ Multi - family N er of bedrooms:
❑ Master builder ❑ Other: Number of ms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: tD 1 7 LW .. . (,P/ t4-11/ New dwelling ar :. square :-
City /State/ZIP: ----' r n v� Garage/ : r : area: square feet
Suite/bldg /apt. no.: 7 Project name: OR R(- O j isc Cover porch area: square feet
Cross street/directions to job site: De' area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this applicalj\.
csse
4 4 0 y F: id f .5 5,,‘,.-. /,'-o --iy,af Valuation: $ / S
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:
XAPPLICANT O CONTACT PERSON
NOTICE
Business name:
u � c i r ,, / ..,, f=si1 t / ., All contractors and subcontractors are required to be
Contact name: tk , r u S p 1.--r---/ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: APO s 4 s i, jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: ae LO/Iii B2 F apply:
Phone: ('y /) 70-- >SV I F : ( ;1/ 753-' L/a.5f
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: C ruryt J Icy ,„ / €t1 /n f (Pleaserejertojeeschedulel
l r J Permit fee: 6A . 60
Address: `�(� S. �(i, �j - �T 4 State surcharge (8% of permit fee): 5, Od
City / State/ZIP: 6m (42 S ( ?' o ^ 7 3 3 / FLS plan review (40% of permit fee): U p
Phone: (5 ) 7 c.. _ -- Fax: (S' 1) 7V. -. It d... c9 (Due upon application.) '
CCB lic.: /(2) - 5 S _ Total permit fees: l eA . 50
4 Amount received: 9 . 56
Authorized signature:
This permit application expires if a permit is not obtained
Print name: P -" „v /- t. 7 . 1(S rt '•c/ Date: ?-- / 5= Q 7 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
1:\BuildingWamits \FPS- PermitApp.doc 0323/06 440 -4613T(II /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe w ork to be done:
1.) ❑ New 2.) Modification to sprinlder heads only
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required
❑ Repair
Number of sprinlder 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)
1 . 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 (8% 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- PermitApp.doc 2
CITY- OPTIGARD Fo
BUILDING DIVISION PERMIT #: ZQ^)`7 — 'qi=o
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 ��ii1J
Inspection Requests (24 Hrs.): (503) 639 -4175 _' R_ I
INSPECTION WORKSHEET FOR DATE: 2 7:3 ,CD 7 TIME: PAGE:
SITE ADDRESS: (l - KO Siso 66 COD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: N T'C t 2 e t so
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
Ad,
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[JPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR NSPECTION 111 ADDITI AL F ES ASSESSED
I nspector: Anigi A Date: Z 2-3 7 Phone #: (503) 718- 2-4 j:
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CITY - OIL TIGARD
BUILDING DIVISION PERMIT #: BUP2007-00096
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1612007
Phone: (503) 639 -4171 ,,a111'�
Inspection Requests (24 Hrs.): (503) 639 -4175 . J.W F L'—
INSPECTION WORKSHEET FOR DATE: J20/2007 TIME: /;09AM PAGE: 53
SITE ADDRESS: 11740 SW 68TH PKWY 100 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGE COMMONS LOT #: 008 TYPE OF USE:
PROJECT NAME: OMA
DESCRIPTION: FPS - Type I hood.
OWNER: PACIFIC NW PROPERTIES, PHONE #: J03 626
CONTRACTOR: GUARDIAN FIRE PROTECTION PHONE #: 541 - 752 - 2258
Inspection Request Scheduled For: Date: 2/20 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
9` �0 Suppression trip test 043573 503 - 4939 N
Corrections /Comments /Instructions:
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11.171 ,
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p PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL w CALL FOR INSPECTION ❑ ADDITI NAL F ES ASSESSED
ADI L Z 407
Inspector: MWM , . Date: Z Phone #: (503) 718
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