Permit CITY OF TIGARD
BUILDING PERMIT
PERMIT #: BUP2004 -00169
X41 DEVELOPMENT SERVICES DATE ISSUED: 4/16/04
'- --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12256 SW GARDEN PL BLD.1 PARCEL: 2S101 BB 01500
SUBDIVISION: CROW PARK 217 ZONING: C -
BLOCK: LOT: 003 JURISDICTION: TIG
REISSUE: pL FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: . "6 FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 101 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: Relocate (10) sprinkler heads.
Owner: Contractor:
SPIEKER PROPERTIES LP WYATT FIRE PROTECTION INC.
4380 SW MACADAM AVE STE 100 9095 SW BURNHAM
PORTLAND, OR 97201 TIGARD, OR 97223
Phone:
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -
[BUILD] Pernut Fee 4/16/04 $62.50 Sprinkler Final
[TAX] 8% State Surchart 4/16/04 $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: /
Permittee s
----4---
Signature: /•
Call 639 -4175 by 7 p.m. for an inspection the next business day
won System
D FOR OFFICSE ONI (ec
Pei • � 1j `ation Received�� Bu USE
9
APR Date /By:7/� i� " Nq��C/Ao2o6 -Z ie
f Planning �ppr6al Other
City of Tigard 1 6 2004 D ateBy: Permit No u�a00 Doody
CITY Plan R eview Other
13125 SW Hall Blvd. OF TIGARD
• Tigard, Oregon 9722- UILDING DIVI I Date/By: Permit No
Phone: 503-639-4171 Fax: 503-59 6
S n Akk - Post - Review Land Use
( � �� I' � I Date/By: Case No.
Internet: www.ci.tigard.or.us Contact Juris ® See Page 2 for
24 - hour Inspection Request: 503 639 - 4175 Name /Method: 77 r Supplemental Information
F _��; �TYPE�OF'W,ORK , ' w . _� , . � ,_., ..z; ' � . �REQUIRED; ;�.,b— �` - =:
- � i i l - , �, X y�,, s _ -
construction De molition b `1` &'' FNMA Y = DWELLIN . G' °;
Addition/alteration/replacement ❑ Other: .
❑ New constr ❑ .. . _;;P >_,.R, :x`, i; - :k._� a Nit ,
`; ��� ���
%CATEGORY ;OFD. CONSTRUCT "IONV_ .._ -:` 6,.. = Note: Permit fees* are based on the total value of the work performed. Indicate
1 & 2-Family dwelling �Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
y we g overhead and profit for the work indicated on this application.
n Accessory Building ❑ Multi - Family
n Master Builder ❑ Other: Valuation $
No. of bedrooms: No. of baths:
`� ; �J,OB: SITE:INFORMATION and,LOCATION ^ - 4 �£'�`:: '' �'��� Total number of floors
Job site address: Z�S�o 3, v , GP 'J l Q. New dwelling area (sq. ft.)
Suite #: Bldg./Apt.#: Garage /carport area (sq. ft.)
Project Name: A. 6 , 6. , (3L.t.t LIB) 6411. Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
` -< f# 'w`" ",is._ xx : - d . t REDyD (, N a :;, >r:
= "'+ .'' :' 'i
- - ' ✓ ��,`^y � irFU'S'i. : «..� t t.x:. ` :x-.; ....^.� 4_ : iK.`F.r A.e°
-.1: At� ?COM ':USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
- - "•DESCRIPTION OF WORK . , the value (rounded to the nearest dollar) of all equipment, materials, labor,
_ overhead and profit for the work indicated on this application.
Valuation S /000
Existing building area (sq. ft.) i
New building area (sq. ft.)
Number of stories
❑ ; PROPERTY • ,- .1 D . TENANT :.'„ : ; ; ;,- ?` i fii Type of construction
Occupancy group(s): Existing:
Name: New:
Address:
City /State /Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
D. APPLICANT ❑CONTACT »PERSON - w `: r 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: _
ii - ' fy : , ik,.: ` -'r. es,,6. slv. . ,.�,.,, -- :.:a:A ✓2.' ; ;
Phone: Fax: - -, - A .,. ' >r. = GTP * :,'„t, y " ..
` �� d > '�'' � ": ..Nth -v �ii�� �; " :�_ �, ;x. r'�-.i p. } :: ; F:. , ;i.' -� :: r. '
E -mail: �, ` ?`:�` ` "' fr {: `a` +" � r. ' Ieastecr.efe r , o.fee'schedule."• ::+; �;, .. - _, i
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... •s, .• >" _ Y ' ± �' L� A±�i3 ±'lt^oFCa5��:,,t's.Xn,. s,� ".hti�:�;.'r�sa4r
CONTRACTOR
Business Name: A 0 tA) Fees due upon application $
Address: /0/ S A,j, & h 1,164,,v Amount received $
City /State /Zip: 'T6It f) o — ' - 71-2--...3
Phone:(5r33) 4 -2- � Fax: (z3) ! -96S 7 Date received:
CCB Lie. #: 64677 ' =
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: � Date: �E+ �� 180 days after it has been accepted as complete.
( c -t-71 go tie_ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i \Dsts \Permit Forms \B1dgPermitApp doc 01/03
Fire Protection Permit Check List
Describe work to be done:
A. ❑ New B. Modification to sprinkler heads only:
❑ Addition a- 1 -10 heads: No plan review required.
Alteration Li 11+ heads: Plan review required.
Li Repair
Number of sprinkler heads: IC,
Additional description of work:
1 &Jl T S Paci \i'MJT Y2 tJ toe J5
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet E-. Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1
B.) Type I - Hood Fire Suppression - -
Hood Project Valuation: $
C.) Fire Alarm �` _��:'. ; ,
Submittal shall Battery Calculations Yes Li
include: Individual Component Yes Cl
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System •
Square Footage: Permit Fee: :.
0 to 2,000 $187.50
2,001 to 3,600 $232.50x'. .. ,
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): $ I 00O
Permit fee based on valuation (see attached chart): $ h2 . SO
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ 5.00
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ (p
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: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP ', --00 ( (v
Received - • Date Requested 7/Z AM PM BUP
Location ( ' ` J ( b uite _ MEC
Contact Person Ph ( ) C &R — l PLM
CgDtr.� � � Ph ( ) SWR
� BUILDIN Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire I �--
ire Sprinkler
'iTe
Susp'd Ceiling
Roof '
Ot.. _.:4t1111
PART FAIL
AL
I • = ING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
:MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service ■
Rough -In /��� ; ;► _ ' �
UG /Slab I&V4•MI-Irff�IIIIb' r _,
Low Voltage _
Fire Alarm
LW
Final
FAIL El Reinsp tion fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS SITE ` ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL