Permit JI ` CITY OF TIGARD + BUILDING PERMIT
PERMIT #: BUP2005 -00068
c.illl DEVELOPMENT SERVICES DATE ISSUED: 2/23/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO PARCEL: 1S136DC 04500
SUBDIVISION: PP1995 -013 ZONING: C -G
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: : sf N: S: E: W:
OCCUPANCY GRP: M 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: $ 997.00
Remarks: Sprinkler heads relocated (3)
Owner: Contractor:
WAREMART INC A- PROFESSIONAL FIRE SYSTEMS CO
BY BURKE + NICKEL 12273 SOUTH STEINER RD
3336 E 32ND ST #217 BEAVERCREEK, OR 97004 -9653
1LSA, OK 74135
one. Phone: FAX - 632 -4835
503 - 632 -4353
FEES Reg #: LIC 41650
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/23/2005 $62.50
[TAX] 8% State Surchari 2/23/2005 $5.00
Total $67.50
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: ` ��jeC1 ,J
Perm ittee INI41111r
Signature: ^,_ (1
Call 639 -4175 by 7 p.m. for an inspection the next business day
,f Fi Protection System \ ‘,
Bu?1din Permit Appli ip • FOR OFFICE USE ONLY
City of Tigard ,, , DateeB
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 FEB ' y ,',1' � ,i Date/B : Review/
2 3 Other Permit:
Inspection Line: 503.639.4175 L .� � I J '! Date Ready/By: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental information
CITY OF TICA
xS'-" ^` - °Y:^,' ' ", ,fieSa R�5 'ti t'�,�- �.?4 -_!v. :a-n =3�,?sa+;. �- ",{�'.. f:„4!T::ira. :;; :� 'x :.1 s '.w >ro aas._. c k w " = N ...;;;.t•,.. : + w . ; _ _
. .a. > " . y; . ;si�AT Riig. `F": �u:` °` Pt.5 :s ` ' 3 � H ::1�V a 's-�Si'•f�•;,,�.�.ty��c . x... - . ! f y'.,:' - -
ir' k . , - ` . > , Er -, - s „ V • a. ;l;REQUIRED.DAT 2 =FA .
e. .� • ; "�•" :�. -�.,_ :..���.. � ' ?., - �..,rnr;_, � • � � , s „�� A MI Y °DWE'
.s, ,'t':5� >��s....,'r�`�Yw. ,,.,.s -e.x.� .a n. N.,:'��#+ e�`�__,.�. .. s,r��.�:�..., -r ..,.�.x, -., `5'.:u�c�,n..,.,.,. ::=..4•c�a;�h:,� -. .�...�. -a �_... _. �.,....;_ _ _., �� - .. .. ..
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
1Z Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
z•, x; N'.1 ;,: : i 4.i7Va. ;,; _vx,:ff 4 c r.; u; . ._ $ work indicated on this application.
«' �:: CATE:GQ1tY, :OF . , i _ PP
�.'inT�;? ��.;:- �:""'`* '�.,.s;�, v�G(QN, _� i:; rl`�'�� F ., a'�;`��.��'3
... - _., .,,, -a*,.� , - � . s, ar� - ..... - < ;ate rx+^Es^' .A��r�n:.: .v..: ... ,o. m.,. ,,�..,: t�"�.�.� .. .. .s. ;'", u..m. _ . _.. - ..�. 4_,.
Valuation:, ' $
❑ 1- and 2- family dwelling Commercial /industrial
❑ Accessory building El Multi-family Number of bedrooms:
ED Master builder ❑ Other: Number of bathrooms:
k , t . ° x0 „ :-4 £' ii -_; ::::, :.2 •:,§ �*d -.; ; ...,: Total number of floors:
.,, , 4. } .=,h,.; ' JOB iSTTEINFORIVIA'TI01V .S AND ; 'I OCATION ;1 , w > ; `' ..,
'SY ° . �t�•Y.��e`Ti °..,.:Yw.^..TI' : a.....v x_ n ,., is rv:n . ; ...5: _.t':•:. A.T!M'::. A..,��k. s..�a. _ - ,. a .. .+'.aFF.' �. f!'mli) .. .. .. Wr ,..
Job site address: / Scz.) •ACZTtiAe)v -n4 RD New dwelling area: square feet
City/State/ZIP: — 1 16p(Z.{7 pie. , Garage /carport area: square feet
Suite/bldg. /apt. no.: r 00 Project name: I .40 Covered porch area: square feet
Cross street/directions to job site: � Deck area: square feet
— 7 2 4 0 I op.1 q �+ T NIOVTA �,,, Other structure area: square feet
" 116N-ft.—Di ( R , PAly c..4d�t -�N4 ✓ ":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
r ° = '�`�. : ' work indicated on this DESORIPTIO ':�t�:� = :; '. application.
�x . . __;.� ^`,h.�< = ' <, - ' w „° <a� .,r•. ..!...,..,4 ..'r.ze• . •na:,�n. >,• ... .. ^'.•:s: -'; .,», � i r w. ., , - ., .. .. '
"RELocpx8 3 S7 / IN �, t rV— _ V. Valuation: $ C197'
0--ANgH ( � L9
i4S O” D der Existing building area: square feet
•--rt: pa' , F ` r)g f�, c yy L C� New building area: square feet
Vi` _ -,. E . •. O t-.-'. ” :.:1 ' - r , Number of stories:
:��� , �t�y ./ ��PROP RTY.; W1VER;�` _. ���: _;;. . . °: TE1VAlYT,':^' -�,�: �
Name:G Fitip2S Type of construction:
Address: 'Fri,. 6:s )Q 14 1b Occupancy groups:
City/State/ZIP: •..,/40bD5ore.1 , 9•767 I Existing:
Phone: ( ) Fax: ( ) New:
w'.;;';`f' ;V V i .. -_> rox•: -zs °IVf, i#-�r:11f�w .,f..r w. « , q . -
:."1° r.. +:e, r..4: 'e..`'� s > ,•f._.:E,:•. °; , � 4' ;*„ i M , -; ', Y _
R; * : 14 . .�z 1 : :. r ^ ' w .,,, ® `CONTAC P :., , :i ., =k
,: : r
- � e._ e.� < _.a _ ,.. � `� f^:�- a ._•x� :. . .. r�_:, >...� .•,._a,...,:. e_ _ � .; mo . � +� �:: . :;:� '.- n��: `a:�^ - Y� �NOTICE - .
Business name: pe— iet,F S‘or,9it„L Rites s.1/41savis C • All contractors and subcontractors are required to be
Contact name: �� ^�R' licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: il-z.. J a5 , STEiµe Z.- fz,13, jurisdiction in which work is being performed. If the
City/ State/ZIP: IbEANJETzcifFEK 1 (#2.., ciloOLP applicant is exempt from licensing, the following reasons
apply:
Phone: (r'3) 152 4.353 Fax: : ('j@3) �p 4 D$3 S •
E -mail:
Xt°,, S tg ng - v:s i .
„�. 4:. yk':•.5 3'v^,+ L [ J ` ; � ; 4.:_i . t.,.::. �.{� _h'. 1:
;,.r�,� =;',s. • � ,� : . •�i ,•. ��, =i R •• . �h_'"= x�'-'- �` .=' ,�;t. > 7
. ; i z »:;�
' p F._
•
«tra:s�;:.��x3c•:`:�;. -;m; w..„: r.:�a t�:a,;...., � :�_ e �s;:,��:.,t.�- ,._;..s.s: :.�Y : ._ -......, .,.., M. ��:.�§ -` - . _
Business name: A- 1 ' 'ss' I;t9t44. T-1t 9-6 s C6 ;
°K ` BI
JILDING:,EERIYIricy.KES*
Address: ` j�41�/t 1 = < : >:,.... -.•.M: . .
Please refer to fee schedule.
City/State /ZIP:
Fees due upon application
Phone: ( ) Fax: ( )
CCB Iic.: ( ! Amount received
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
` Print name: I kt ‘ - 7 - 4. - M M �, Date: ?, r (8 i 0 * Fee methodology set by Tri-County Building Industry
/ Service Board.
1 :\Building\Permits \FPS- PerrrutApp.doc 12/03 • 440.4613T( I1 /02/COM/WEB)
Fire Protection Permit Check List
aY ,...- .... ,V''U'0... .e+..,e S= n.... '. k " tz ':,,`..g 55ci; .::..Y- .'.-'. �..� � qy {w f,: ..AT �•A�: ";4i..�.ry .,�« - "
-E `sS L'. -.n•v� -." "''. .";` .,9 '.T':
�Describe�wor .to be e.�r_. �:•�
1.) M ❑ New 2.) Modification to sprinkler heads only:
❑ Addition - 1 -10 heads: No plan review required.
Js Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
..
N. Wet ❑ Dry
Additional Standpipes
Information: Hazard Group et+2XJ i l •
Density '
Design Area
K. Factor rz itip
Sprinkler Project Valuation.: $ . a '
B `:T' e I .HoodFire >Su `ressi'ori`S` stem"
Hood Project Valuation: $
•
' Submittal shall Battery Calculations • Yes , ; •
include: Individual Component • '❑ Yes •
Cut Sheets , • •
Fire Alarm Project Valuation: $ —
D );'`'Res dent al Sprii kler'(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 `� �- ••y:� -`...
Sprinkler Project Square Footage: • 8-- '\, , sq.. ft.
Project Valuation Subtotal (A, B & C); $- ; - q� j •, •
Permit fee based on valuation (see attached chart): $ 6240 -
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ 5,149
FLS Plan Review 40% of Permit Fee: $ _.
TOTAL:
•
Plan review requires a completed application and 3 sets of plans at submittal. Pl
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\Forms \FPSchecklist.doc U/24/03 •
CITY ,O TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00069
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2312005
Phone: (503) 639 -4171 Apt U � 1 � Inspection Requests (24 Hrs.): (503) 639 -4175 -_..
INSPECTION WORKSHEET FOR DATE: 4/18/20055 TIME: 7:14AM PAGE: 54
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO CLASS OF WORK:
SUBDIVISION: PP1996 -013 LOT #: TYPE OF USE:
PROJECT NAME: WNCO
DESCRIPTION: Sprinkler heads relocated (3)
OWNER: WAREMART INC, PHONE #:
CONTRACTOR: A- PROFESSIONAL FIRE SYSTEMS CO PHONE #: FAX-632-4835
Inspection Request Scheduled For: Date: 4/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 004708 -01 503 - 539 -1246 N
Corrections /Comments /Instructions: M _,i 01)1
'WP ENIFE811111111,141
, ,..., , - . -
•
...,
_.
SS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITI AL FE S ASSESSED
Inspector: Aiij Date: te hone #: (503) 718 -