Permit CITY OF TIGARD
1 DEVELOPMENT SERVICES BUILDING PERMIT c
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 F E TE I T S ° • ° DATE ISSUED: ° ° : 6 / 77 - 047
: 10/16/97
PARCEL: 19136DB -02600
SITE ADDRESS...: 11201 SW 72ND AVE
SUBDIVISION • ZONING:C —G
BLOCK • LOT • JURISDICTION:TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION —
CLASS OF WORK.:FPS FIRST • 0 sf N: S: E: W:
TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5N . ° °° 0 sf N: S: E: W:
OCCUPANCY GRP.:A3 TOTAL 0 sf ROOF CONST: FIRE RET ?:
OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..:
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 300
Remarks : Fire suppression system - No C of 0 required - no change in occupant
load - Bob P
Owner: FEES
MCDONALDS CORPORATION type amount by date reept
5000 SW MEADOWS ROAD, SUITE 230 PRMT $ 25.00 GEO 10/16/97 97- 300134
LAKE OSWEGO OR 07035 SPCT $ 1.25 GEO 10/16/97 97- 300134
PLCK $ 16.25 GEO 10/16/97 97- 300134
Phone #: 684 -9334 FIRE $ 10.00 GEO 10/16/97 97- 300134
Contractor:
CARBON DIOXIDE INC
3357 SE 21ST AVE
PORTLAND OR 97202
Phone #: 232 -6646 $ 52.50 TOTAL
Reg #..: 000639
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Framing Ins p
Tigard Municipal Code, State of Ore. Specialty Codes and all other I n s u l a t i o n Insp
applicable laws. All work will be done in accordance with Gyp Board Insp
approved plans. This permit will expire if work is not started S u s p C e i i n g Insp
within 180 days of issuance, or if work is suspended for Bore
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- 00101987.
You 'any obtain a copy of these rules or direct questions to OUNC
by calling (503)246 -1987.
' • Is sued D :
Permittee Signature: /,� .�......, , y• _
Age
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m• for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Fire Protection Permit Application Plan Check # 6 / C
;IT'Y OF1 IGARD Commercial or Residential Recd By 'T "..
13125 SW HALL BLVD. Date Recd 0 # _rr
TIGARD, OR 97223 Print or Type Date to P.E. rit I "',fi
.303) 639 -4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST !0 l' //
Permit # r _ L 0
Called (0 1 5 - 7
Job Name of Development/Project Type of System (Complete A or B as applicable)
Ae_boIsPtDS
Address Address
11ZO S)^) 72"'' Ave_ T c ARO,a2 A . ) Sprinkler Wet ❑ D ry ❑
1
Name 72 z3 Standpipes
M.O. � 6IJAL1> S CbRi:: .
Owner Mailing Address Hazard Group
57"' ) -CIO MeilbotoS / J W%TE Z3.r) Additional
City/State Zip Phone Information Density •
LA G 4c-,o a 9 7035. 6 8%-93j
Name A i N Design Area
Occupant Mailing Address K. Factor
City/State Zip Phone Al) Sprinkler Project Valuation $
Contractor Na B.) Fire Alarm
(Sprinkler or LA .EcNJ b l x)(1' D E
Alarm Company) Mailing Address ST - Submittal Shall Include Battery Calculations YES ❑
Prior to permit "3357 SE 21
issuance, a City/State Zip Phone Individual Component YES ❑
Copy Cut Sheets
of all licenses Pd RTLAND OR,. q 72c B.1) Fire Alarm Project Valuation $
are required if State Const. Cont. Board Licit Exp. Date
l ex database 63995 2 '15 Project Valuation Subtotal (A & or B) $ sc °
Name Permit fee based on valuation $
(see chart on back)
Architect Mailing Address 1 5% Surcharge t
City /State zip Phone FLS Plan Review 40% of Permit $ ' f
Describe work A.) New X Addition 0 Alteration 0 Repair 0 TOTAL . $ ,/
to be done:
B.) ion to sprinkler heads only: Plans required: Submit three sets of plans, including a vicinity map and
1. 1-10
1. 1 -10 heads= No plans required
2. 11 += Plan review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application, that the information given is
Number of sprinkler heads: correct. that 1 am the owner or authorized agent of the owner, and that plans submitted
are in compliance with Oregon State laws.
Additional Description of Work:
goo / 'E- 6i 416E2EL /IQE SvffRessio,0
S V f-v/2_ (/ pp 6 1 gNeE S Si lure n
Agri Date
/9/
A.) In Existing Building New Building
(3 i / lU 9 7
Building ontact Person Name Phone
Data B.) Commercial ❑ Residential ❑ SV SA 1 - BRADyy _ (503) Z3Z - lci/G
FOR OFFICE USE ONLY:
No. of stories: Plat # MapfTL#: //__ ��
' Sq. Ft: l l Ve D 6'' ! 0. 06
Notes
I Occupancy Class Type of Construction
is \firesupr.doc
CITY OF TIGARD
BUILDING PERMIT FEES
TOTAL
•
STATE BUILDING
VALUATION OF PERMIT F.L.S. TAX PERMIT
PROJECT FEES (40 %) (5 %) FEES
1 -1500 25.00 10.00 1.25 36.25
1,501 -1600 26.50 10.60 1.33 38.43
1,601 -1,700 28.00 11.20 1.40 40.60
1,701 -1,800 29.50 11.80 1.48 42.78
1,801 -1,900 31.00 12.40 1.55 44.95
1,901 -2,000 32.50 13.00 1.63 47.13
2,001 -3,000 38.50 15.40 1.93 55.83
3,001-4,000 44.50 17.80 2.23 64.53
4,001 -5,000 50.50 20.20 2.53 73.23
•
5,001 -6,000 56.50 22.60 2.83 81.93
6,001 -7,000 62.50 25.00 3.13 90.63
7,001 -8,000 68.50 27.40 3.43 99.33
• 8,001 -9,000 74.50 29.80 3.73 108.03
9,001- 10,000 80.50 32.20 4.03 116.73
10,001- 11,000 86.50 34.60 4.33 125.43
11,001- 12,000 92.50 37.00 4.63 134.13
12,001- 13,000 98.50 39.40 4.93 142.83
13,001- 14,000 104.50 41.80 5.23 151.53
14,001- 15,000 110.50 44.20 5.53 160.23
15,001- 16,000 116.50 46.60 5.83 168.93
16,001- 17,000 122.50 49.00 6.13 177.63
17,001- 18,000 128.50 51.40 6.43 1.86.33
18,001- 19,000 134.50 53.80 6.73 195.73
19,001- 20,000 140.50 56.20 7.03 203.73
20,001- 21,000 146.50 58.60 7.33 212.43
21,001- 22,000 152.50 61.00 7.63 221.13
22,001-23,000 158.50 63.40 7.93 229.83
23,001- 24,000 164.50 65.80 8.23 238.53
24,001-25,000 170.50 68.20 8.53 247.23
25,001- 26,000 175.00 70.00 8.75 253.75
26,001- 27,000 179.50 71.80 8.98 260.28
27,001-28,000 184.00 73.60 9.20 266.80
28,001- 29,000 188.50 75.40 9.43 273.33
29,001-30,000 193.00 77.20 9.65 279.85
30,001-31,000 197.50 79.00 9.88 286.38
31,001- 32,000 202.00 80.80 10.10 292.90
32,001- 33,000 206.50 82.60 10.33 299.43
33,001-34,000 211.00 84.40 10.55 305.95
34,001- 35,000 215.50 86.20 10.78 312.48
•
35,001- 36,000 220.00 88.00 11.00 319.00
36,001- 37,000 224.50 89.80 11.23 325.53
37,001- 38,000 229.00 91.60 11.45 332.05
i:\firesupr.doc
•= CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: f A.M. ° /� // 7 P.M. MST:
Location: 1124 I S W 2 Af A J 1/"8 BUP: q7.-- 0 4 ? V
Tenant: \M ` Gv∎.- -2r.....K G S Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING 4f:. ' • AL ELECTRICAL SITE
Site Post/Beam Post/Beam • o 1 : eam aver /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In , 4/ • i _ Water Line
Slab Framing Top Out Gas • Rough -In UG Sprinkler
Foundation Insulation Sewer dip II t 6 , • Reconnect Vault
Bsmt Damp Drywall Storm urnace �� Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved . • pproved Approved Approved
Appr /Sdwlk Not Approved Not Approved of v Not Approved Not Approved
FINAL FINAL FINAL FINAL
c - 3 - 04..,_-- //c__ / c-tti__I"AA F.,:se--e vv■-4.4-- s L4LA "s v,„.. j
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• -
hi re -x,w 12_ - .../1.- - N \ z .._......_ k-
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•
O Call for reinspection O Reinspection fee of $ ( requ• ed before next inspection O Unable to inspect
Inspector: C.// `
/ Date: ‘ 7.../ 6 i — ( Page of