Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00493
Y D
13125 EV WL PM E NT r SERVICES O -639 -4171 DATE ISSUED: 9/26/2005
PARCEL: 1 S 126DC -04400
SITE ADDRESS: 09430 SW CORAL ST 200 ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 007 JURISDICTION: TIG
Project Description: Relocate 1 and add 1 sprinkler head.
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: 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: $ 650.00
Owner: Contractor:
MARTIN, ROBERT CLARE T & L COMMUNICATIONS INC
THELMA M PO BOX 87387
BY JO RENE M MOODHE 2800 NE 65TH AVE SUITE A
w�ERWOOD, OR 97140 VANCOUVER, WA 98661
Phone Phone: 360- 737 -9725
FEES Reg #: LIC 67787
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/26/2005 $62.50
[TAX] 8% State Surcharp 9/26/2005 $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 -ore irec questions to OUNC by
calling 503 - 246 -6.P• or 1- 0- 332 -2344. /
Issued By: ' Permittee Signature: 2�
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.
1' Fire Prgtection Syste
Building Permit ApprilZGEI FOR OFFICE USL ONLY
City of Tigard Received p
SEP
Date/0 . r 0140 i OS P Permit No.., 4 1 - s� _ 'B
13125 SW Hall Blvd., Tigard, OR 97223 6 2U Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 �J �f'�"'-%'4:tth�j� Date /By: Other Permit:
Inspection Line: 503.639.4175 C r Ttr _ Date Ready/13y:
Ein
® See Page 2 for
Internet: www.ci.tigard.or.us 1 d OF Tic,_ ..WARD Notified/Method: Supplemental Information
$U� ,DING nWISI ®N .
. , . - 'TYPE OF WORK .„ - REQUIRED DATA I =.AND2= FAMILY`DWELLING ` _ '
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
►4ddition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
: , CATEGORY. OF-,CONSTRUCTION "' work indicated on this application.
__ . Valuation: $
❑ 1- and 2- family dwelling commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- JOB SITE .INFORMATION AND,4OC -ATION ., r Total number of floors:
Job site address: G c4 3 O sk.() c ( ' New dwelling area: square feet
City /State /ZIP: i l CI C4 (n� � c Garage /carport area: square feet
Suite/bldg. /apt. no.: 2,....° D Project name: ,Oti Q1--' 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
DESCRIPTION OF ;WORK, . , work indicated on this application.
-
��o c tTo_ _ S r �f tt.� �,
Valuation: $
4�de OPLQ Sp •'''t (/ _ i I _ y _ , V Existing building area: square feet
�l� New building area: square feet
. ,
0 PROPERTY OWNER ° ' ,, ❑ TENANT, ' : "" Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
0 APPLICANT' . • ; ❑ CONTACT- PERSON ,N NOTICE.
Business name: L t° S. All contractors and subcontractors are required to be
Contact name: S 113--e..51-,q l ^� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: e tJ 6 ) 3 $'7 jurisdiction in which work is being performed. If the
City /State /ZIP: (/,/' iC e.J lAl ol r i applicant is exempt from licensing, the following reasons
apply:
Phone: (3 ) 7 37 7.2 C Fax: : L6o) "2 77 2 -5
E -mail:
CONTRACTOR
Business name: & 1/1 Cf/4 c C u t P r__� - - BUILDING PERMIT 'FEES*'.
Address: /9 () 6 0, r - 73 1-.7 Please refer to fee schedule.
City /State /ZIP: ( C 644 9 i----7 Fees due upon application
Phone: ( 72 Fax: (3G6) `2 37 c/63 Y •
CCB lie.: 6-7? r� 7 i.e,-2.-4-)..o C 7, / 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: S C Ge.P c,—) Date: _ 3 ,( * Fee methodology set by Tri- County Building Industry
Service Board.
i : \Building\Permits\FPS- PermitApp doc 12/03 440- 4613T(11/02/COM /WEB)
- ,t
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work'to- be'done
1.) ❑ New Modification to sprinkler heads only:
[`Addition 1 -10 heads: No plan review required.
/❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: a.
Additional description of work:
Type Of System (Complete A, B - C or D as applicable): .
A) Commercial:Sprinkler
in 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
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.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
Plan review requires a completed application and 3 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:\B uilding PermitslFPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005.OIk193
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
9/26/2006
Phone: (503) 639 -4171 v �
Inspection Requests (24 Hrs.): (503) 639 -4175 ,, - I I..
INSPECTION WORKSHEET FOR DATE: 9!27/2005 TIME: 7:05AM PAGE: 80
SITE ADDRESS: 09430 SW CORAL ST 200 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 007 TYPE OF USE:
PROJECT NAME: DR. CLARK
DESCRIPTION: Relocate 1 and add 1 sprinkler head. '1
OWNER: MARTIN, ROBERT CLARE, PHONE #:
CONTRACTOR: T & L COMMUNICATIONS INC PHONE # : 360 -737 -9725
Inspection Request Scheduled For: Date: 9/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 016601 -01 360-737-9725 N
Corrections /Comments /Instructions:
J R-( kiV (-:trCili ri &)--Al 4
SS ❑ PARTIAL APPROVAL III CANCEL ❑ NO ACCESS
❑ FAIL , n CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
i iir , I
Inspector: lir Date: ? v /05 Phone #: (503) 718 -