Permit �, �' OF BUILDING PERMIT
CITY TIGARD
PERMIT #: BUP2004 -00452
,(4 DEVELOPMENT SERVICES DATE ISSUED: 9/23/2004
+ -_ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09430 SW CORAL ST 230 PARCEL: 1S126DC -04400
SUBDIVISION: LEHMANN ACRE TRACT ZONING: C -P
BLOCK: LOT: 007 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: NONE : 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: $ 1,000.00
Remarks: Install (8) heads befow clg.
Owner: Contractor:
MARTIN OFFICE BUILDING FIRESTOP CO
1672 SW WILLAMETTE FALLS DR 9384 SW TIGARD ST
WEST LINN, OR 97028 TIGARD, OR 97223
•
Phone: 503 - 557 -8000
Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
•
[BUILD] Permit Fee 9/23/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchari 9/23/2004 $5.00
Total $67.50
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By:
Perm ittee 0111\
Signature: 4
Call 639 -4175 by 7 p.m. for an inspection the next business day
, Fire Protection System ,3 a - a o9 -o (Pi/
Building Permit Application
FOR OFFICE USE ONLY: : - ;.
Received Building t
C � I ��� Date/By: Permit No�,��,� p ly() 9/7;72.... Cit of Ti and RE Planning Approval Other
y g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 SEP 2 3 2004 Date /By: Permit No,:
i ii Post- Review Land Use
Phone: 503-639-4171 5 3 5 -It -' A 0 i l " Date/By: Case No.
Internet: www.ci.tigard.t�'t'" r OF TIGARD '1'I` 6 '
� Contact Juris.:
dUt«ING � p � Su See Pane for
24 -hour Inspection Rec
i9lU� ®1� Name /Method: Supplemental Information
- i.,�.:% ` „k4`, - "C�'��4 ,:m:. >.�t.�^r,:m�, . �` i, T` "v�,�5 '-�«�$i��- s7, �#-".€,, . ; r �..[e"
,-sue ”, �.x '' N- :l TYPEsOF WORK ; t -4 a
� ,� � �} � ��
v '� } i
111 New construction ❑ Demolition .,1- t 2 %- 1 & 2 F DWEL t � r
:' -• r.' 8 ^.. _ u 5 � ti., �-"'v A1F,a � Leh . v,.h.a�.' ,. X
p ❑ a:
X Addltlon/alteratton/re lacemen Other:
':: CATEG,ORYfOkaCONSTRUCTIONI. z "x,0 ,. A'`As` Note: Permit fees* are based on the total value of the work performed. Indicate
n 1 & 2- Family dwelling ICommercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
El Accessory Building Multi- Family
❑ Master Builder ❑ Other: Valuation $
F;` h' `'M='' ;' ;;:' JUB`SITE NFORMATION iiiitEOCATION. ;; -, ,-''": __;`,'; No. of bedrooms: No. of baths:
Job site address: ei4 50- eor 3-r; Total number of floors
New dwelling area (sq. ft.)
Suite #: ,,i.,j d I •Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: f / /2f /1/me-re //T, / e Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
m r� a 3 re t REQUIRED DATA c ` r �'- g it,{
° + V 44' USE CrIECKLIST' ±' L ;
Subdivision: I Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
"�;4� �
s,.t.,,,,.. t;�� �"'��DES RIP.TION�.,' ,3 < ,., .ba'�::�.: OF
WURK�' "6�:""� � >`:�y
�; • �`�:�° the value (rounded to the nearest dollar) of all equipment, materials, labor,
jot� „�� overhead and profit for the work indicated on this application.
Valuation S f OO
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
- PROPER# OW NERS: == ,. ®- xTENANT ` ' e t 'j,F °v.- . ., ''l Type of construction
Name: A ,u14i o 1i1e v . j rerip�f I eov Occupanc group(s): Existing:
Address: /6.7� 5 a) -- LL4 i P u U (42 , 14 New:
City /State /Zip: agiff L, ,. ),J, 072 9'70
Phone: S7f F1X. NOTICE: All contractors and subcontractors are required to be
® %APPI ICANTz - - ' °` ' "" , • `' : -, licensed with the Oregon Construction Contractors Board under
• 'CONTAGT� PE n
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: I Fax: ,y.F.
;� r ;, xi, .. ^� �.... : . <vv.�',v.r..���. "�:5� ts.., - -���� :; "���`a�` x �s^";A g
44. " �BUILDING:PERMTTtEEES* 5
E- mail: 4 �� >'w=�.#
, 4y „ Please,refer to fee schedule igt ; e
se a Ay• 'e a.. -4 Ex R., }•�a` "L. - k w fi ' ._,vsx.',s' *;;,: ^ ," S -r`.1 i, ,`,,,, . = r,".,4 -..;. s• `L.f. < k ., .ur
-.�.�� :::���- :�:.., x� - -°:�` . >, �;.._ . � „ CONTRAC,'T,�R r ,�, , {�.. � "�:�;a��- `�^ .�, . �._ .�,.;' °o-,�b���� `�`r,`` � �h .
Business Name: �f (�(0 Fees due upon application S
Address: A , /3t'x 73O3¢.•
Cit /State /Zi.: 4 4 ,Q OR ' Ze / Amount received S
Phone: (,70.6/ I 0 Fax: &ZOsrpr d Date received:
CCB Lic. #: 638
Authorized
Signature: Date: 7/23/01— Notice: This permit application expires if a permit is not obtained within
/ ISO days after it has been accepted as complete.
6/41 t e b ' FI *Fee methodology set by Tri- County Building Industry Service Board.
,` (Please print name)
is \ Dsts \Permit Forms \BldgPermitApp.doc 01/03
Fire Protection Permit Check List
Des cribe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ 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 X Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1000
B.) Type 1 - Hood Fire Suppression System:
Hood Project Valuation: $
FireT.Alarcn ; .
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential£ Sprinkler° .(Stand AloneSystem)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50 7 ,
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: $ 67750
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.
is \dsts \forms \FPSchecklist.doc 02/28/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 639 -4175 4,01216-
INSPECTION DIVISION Business Line: (503) 639 -4171 , /
/ _ p� Q � 6.5 BUP ape V- 00 `-tS,R,
Received c� Date Re nested l Z O AM PM BUP
Location 1 4136 _a-0 Suite 2 30 INIIIIPIA f
Contact Person Ph ( ) S7 a --l3 /4 PLM
Contractor 1 Ph ( ) SWR
LDINC Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: , ELR
Crawl Drain
Slab Inspection Notes: /' \ k or_s- SIT
Post & Beam
Shear Anchors [ 6e. /Opt)
Ext Sheath/Shear G.e
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: ,
AS PART FAIL # / , •
PLUMBING y
Post & Beam
•
Under Slab
Rough -In '
Water Service 3.
Sanitary Sewer W
Rain Drains `
Catch Basin / Manhole W .
• Storm Drain
Shower Pan , :
Other:
Final
P SS PA; FAIL
M HAN e , L, .. ,
Po &B=_
Ro :h
Gas ;:• -
Sm• , Dampers
ASS PART FAIL
LECTRIC AL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ' . 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA / Y ) 1� U / ) 2, / D � Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL