Permit ., CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00377
° COMMUNITY DEVELOPMENT DATE ISSUED: 11/21/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S135DA -03500
SITE ADDRESS: 11481 SW HALL BLVD 101 ZONING: C -P
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HEALTH TOUCH
Project Description: Adding and altering (5) spinkler heads.
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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 750.00
Owner: Contractor:
L N PROPERTIES, LLC A I P 5V 5r ,-t , hJe___
12725 SW 66TH AVE
PORTLAND, OR 97223
Phone: Contact #:
Reg #:
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/21/200E $62.50
[FLS] FLS Pln Rv 11/21/200E $7.50
Total $70
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.
f
Issued B . tee- / Permittee Signature: "i,,i
�i -,
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.
Fire Protection System
Building Permit Application
oorFicC.useONL % R
City of Tigard eceived
� u �Y 'e Date/13 . ; Permit NO.: 1 • '
14
° 13125 SW Hall Blvd., Tigard, OR 97223 y q n `' ' 1 6 D r
0`e ; Review
Plan Rev Other Permit Phone: 503.639.4171 Fax: 503.598.1960
T lGAR 17 Inspection Lin 503.639,4175 NOV I RaeReady/By: Jens: Et t See Page 2for
Internet: www.tigard- or.gov all a iGN.,' la6Afied/Method. t N r Supplemental Information
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0 New construction ❑ Demolition Permit fees* are based on the v of the work performed.
Indicate the value (rounded to the nearest dollar) of all
tyLAddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ,
iT .
work indicated I t application.
=a; o d ca on a ca
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OF = EONS'I-,[t CT30
Valuation: S
❑ 1- and 2 -family dwelling KCommercial /industrial
El Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms
>,;, _,, Total number of floors:
- „ ss: = `1nB <5 �'is "}INFOii11'I`� ;IO AP1D �t -: - �'_ �.�.�
_�;:� %n �sfr.= .�. t1�._ �cw- A �0.4 ? _e �twf���� =�ks
Job site address: 1./8 ( � AI . t A/ D New dwelling area: square feet •
• City/ State/ZIP: ,e j e • ` `� Garage /carport area: square feet
Suite/bldg. /apt. no.: ID ( , Project name: ' iV,"`°l 7711 of Covered porch area: square feet
Cross street /d to job site: Deck area: square feet
•
Other structure area: square feet
3: i �dR, i•..aeS -• • la' , ir4?* y z ;; .'z .,,
'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
u _ > rt'„ equipment, materials, labor, overhead, and the profit for the
w - -- -. ..4: ,ter - - ..,,, , 4 e'..'+.. ,i... ,te ";1,';.�,,,A K�F.,A, --:.ii t"za.,
a5.i;k 5 s 4,, = -.:zs St ,, v.: ,- -R ,,ESeR '.zi • s "` . `A.. 4 work indicated on this a lieatt
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/S D ` J L/,5• ZCt_O C=GC t, ,- 7 L �1, U l... �v
Valuation: S -7s-0 t
ttL��a K1.t1Z..S 'DZ. N ern) h I 1 C:L L -� Existing building area: v s q uare feet
cif
Otl l •
New building area: square feet
� . -',41 OP,,03I :.g '' x- %: ,;r itita .-e..rlitilag Number of stories:
Name: 'type of construction: .ri'
Address: Occupancy groups:
Lit:. 1AT
City /State /ZIP: Existing:
•
Phone: ( ) Fax: ( )
New:
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, LS �� _ _ �,,,._ ,. .. <'�s::° ._ , ,,. _. _ , r�s�S�;^� >'" �?z�X4 " ^�z:3::- .=;;�` � y! T1C�; >i';::.ic:�:rlfa:�- ,�.ra,� max;!;
\ v C.� r `E 1}40 ' � nt r act : contractors a : b subcontractors . a: required to be ,'u r::a:.:
Business name: � '1' C� All contractors and subwntractors are re aired to be
Contact name: ia.,.. �`
I licensed with the Oregon Construction Contractors Board
A'l � under ORS 701 and may be required to be licensed in the
Address: 1 q cW I'2$ ( � l - (('1J jurisdiction in which work is being performed. If the
City/State/ZIP: I ._ i a. D' . I t A applicant is exempt from licensing, the following reasons
n /y ( PPy:
Phone: ( ) �i-- "t 2 Fax: : ( 3 (fJ'�� f !J 1 16 Q
E -mail:
•
..,,..$..,.k.,, .... ......., «C04* :00. . i1, '- �.::
-.. . 4 ':� _ °:r: +.B I7II D IlY � TR7 FEE •
• B name: / �t�t/ t r C 1 l J ' utajr fee:
- "�'; -;�.?`;'`f
Address: I O � 5510 ( 1 . Ave
Permit fee: (� ��
City /State /ZIP: - -p t C/!z, r , � `v 7 V State surcharge (8% of permit fee): �
UP in� `r _ Fax: (
( F LSplanrevi(w e u %ofp upon appli
Phone: } � !/ K �j��j Z ( gj (Due upon
CCB lie.: tW✓ Total permit fees:
Authorized signature:
Amount received: 7o_
This permit application expires if a permit is not obtained
Print name: % ,"7 ,,_ A-13 (t1, Le, Date: 11 - 7, ..--(')'t within 180 days after it has been accepted as complete.
2 Al * Fee methodology set by Tri- County Building I ndustry
Service Board.
1:\ Building 'PennitsWPS- PormitApp doe 03/23/06 440- 4613T( I 1/02/C064/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
D. `c 'be o be:donec _
es n #
1.) ❑ New 2) Modification to sprinkler heads only:
dition 1 -10 heads: No plan review required.
• eration 11+ heads: Plan review required.
• ❑ Repair
Number of sprinkler heads:
•
Additional description of work:
T. e- :of�S.. #ems. bm le #e= '.B •C�or D =as: a ` '�licalle - - t� �_; -_,. -
fi r'
+i'
r'yl,
T ip t
't,'• fir;•:'
Z,. v
• rrim vial 5 "rilildeZ� =�� - -
s
Wet ❑ , Dry
Additional - - -Stand i es- •
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 5D, e
•
Hood Project Valuation: • I $
r)F`." ` ra.-.. d9:: rzp. <`r'"tY<tia�'?:..•o-'w,,:°- - ___ ;r= ^ia:r:�� .,r 1, w�F N'+:Y�,' %;� }, ' ^ � � ``.'.6.... "i;'. _yY
A � aye
-.x
1 .
`.F
Submittal shall Battery Calculations ❑. Yes
include: Individual Component ❑ Yes
Cut Sheets
•
Fire Alarm Project Valuation: $
.:�.- :W:.;,:•-:,... ,,.. - ' :,, -: _ :,::; >.;:. ;.��- vim.
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`'
Square Footage: Permit Fee:
0 to 2,000 $187.50t,:!r
2,001 to 3,600 $232.50 6 sT 4 R1 x z ;y . .:' .
3,601 to 7200 292.50 ;'•Fi:;n.:' -w:. n; ''; .y;.
` 4
and greater $381.50
•
7,201
Sprinkler Project Square Footage: • • - sq. ft.
F
t ctiori�Perms ees�� '
'''Fiie�Pio. e
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $ . . •
•
FLS Plan Review (40% of permit fee): $ •
TOTAL: $. .. ;
Plan review requires a completed application and 2 sets of plans at submittal. Plan r 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.
•
1:\ Buildin \Pem its \FPS- PemvtApp.doc 2
CITY OF TIGARD
BUILDING DIVISION , PERMIT Sk.11~320 €6 -00377
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1112112008
Phone: (503) 639 -4171 ! ■■ ���� uN ��0 , ill Requests (24 Hrs.): (503) 639 -4175 .�
/
INSPECTION WORKSHEET FOR DATE: 1/7/20 t' TIME: 7:01Am PAGE: 16
SITE ADDRESS: 11461 SW HALL BLVD 101 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HEALTH TOUCH
DESCRIPTION: Adding and altering (6) spinitier heads.
OWNER: L N PROPERTIES, LLC, PHONE #:
CONTRACTOR: AFP SYSTEMS INC PHONE #: 503-6919284
Inspection Request Scheduled For: Date: 1/7/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 079466-0/ 503-804-2447 N
Corrections /Comments /Instructions:
tlI P' I/, PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
r -
❑ FAIL i n CALL FOR INSPECTION _ ADDITIONAL FEES ASSESSED
Inspector: Date: I 7 447 Phone #: (503) 718-
C1 �* F TIGARD
2 BUILDING DIVISION PERMIT #: iiU ' ?; =U11..1'O, r /
1 13125 SW +Hall Blvd Tigard, OR 97223 DATE ISSUED: i,/ 11/7 €'s9;
Phone: (503) 639 -4171 47M,
• Inspection Requests (24 Hrs.): (503) 639 -4175 `__..
INSPECTION WORKSHEET FOR DATE: i ;i; &:t /;, f,ja TIME: (-0 :).AM PAGE: I',
SITE ADDRESS: 1 1.121 t.p HALL y ;( +lI_, 101 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: ! IE : all.T H 1 Otdt,#fl,
DESCRIPTION: mom anti` cli1 rinlrt ('.' cii ( I .
OWNER: (;-1 I '! - ii't; Li_ c: PHONE #:
CONTRACTOR: PHONE #:
Inspection R equest Scheduled For: Date: 1219/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
c:1i0 LSprplki <,Ir I,It. ;ih -i nit eat 078894•O1 al 1. 322-991 /' Cy i
Corrections /Comments /Instructions: G
l3
_
. . um
•
-_.)
.....„ i IA
. r9if fvf:J-1,— I )\_) ( s ,..kr —. ..)
---------t\\_./ L__A____, - , v --.I
1
. ` PASS I PARTIAL APPROVAL n CANCEL n NO ACCESS
/ FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
•
Inspector: /k 74 , --- L?) Date:fr (Pi Phone #: (503) 718 -Z`C —'lam