Permit .,
- CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00010
.�,�I��, DEVELOPMENT SERVICES DATE ISSUED: 11/25/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11505 SW HALL BLVD PARCEL: 1S135DA -01400
SUBDIVISION: ZONING: C -P
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: 5 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: A2.1 TOTAL AREA: 0.00 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: $ 18,000.00
Remarks: TEMPLE: Fire protection system for new temple.
Owner: Contractor:
BRAHMAPREMANANDA ASHRAM/TEMPLE FIRESTOP CO
11515 SW HALL BLVD 9384 SW TIGARD ST
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 620 -6140
Phone: 620 -6140
Reg #: LIC 63846
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 11/7/02 $216.10 Sprinkler Rough -In
[TAX] 8% State Tax 11 /7/02 $17.29 Sprinkler Final
[FLS] FLS Pln Rv 11 /7/02 $86.44
Total $319.83
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: .t !/6
Pe rm ittee ii,
Ugh
Signature: i\
Call 639 -4175 by 7 p.m. for an inspection the next business day
r
Building Permit Application
1 Date received: /f of G" : ) Permit no � ‘,4 A 2�
,yak City of Tigard �,``
_.. Project/appl. no.: Expire te:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
•
Phone: (503) 639 - 4171 Date issued: By eceipt no.:
Fax: (503) 598 - 1960 Case file no.: "-- Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
I 0 1 & 2 family dwelling or accessory RCommercial /industrial 0 Multi- family Af'-New construction O Demolition
0 Addition/alteration /replacement 0 Tenant improvement ® -Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION .
Job address: ;lam a 1 . e_, r Li/ • , Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: 'BIZ 41. - t a I a !i rl 4: - A 'C... .
Description and location of work on premises /special conditions:
n t
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: t P414 A 13, ► ' - , ' (Floodplain,septic capacity, solar, etc:)
Mailing address: 1 ) 5 * biZ 1.4.4-1-4.- rot . 1 & 2 family dwelling:
City: (},hizz State:OLL, ZIP:Q Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: . Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
•
Name: ► p co , Covered porch area (sq. ft.)
Mailing address: q35, - _ -. lC,, • p i I . Deck area (sq. ft.)'
EMENEEMMIIIIIIII State :+f2_ ZIP:gi 2..../:: Other structure area (sq. ft.)
Phone: ,�2..0- G, i 4 Fax:563 LG_/ol ¢'
Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ I 5 Cam '
! Existing bldg. area (sq. ft.)
Business name: �( 1€_�STb New bldg. area (sq. ft.)
Address: ' '394 .S10 TIE, L' I S'
Number of stories
HE ;111,M State: tj` ZIP:97Z
Phone: ,+ ..--, Type of construction
Fax :9300 -0t(i E- mail:. ---
Occupancy group(s): Existing:
CCB no.: ( g New: ,
Cit - • lic. no.: (,( 7'7 Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: - i/ 1 ' ' 4 1-1-4- provisions of ORS 701 and may be required to be licensed in the
i Address: rf Z( -, • 0 56 5 LUTE (S. jurisdiction where work is being performed. If the applicant is
State: 6/2., ZIP: G1720 S- exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone:59 2Z2- 2.1 0 , ,Fax: E -mail: -_
.ENGINEER
' Name :e i1Q(, +I L s- k_ 5. Contact person: C,4 41 1_ Fees due upon application $ 3 ' , :•' '
Address: f;.• 23 50 _ la- C' PO) Date received:
City:'- - v r„ P bb I State: b2. ZIP: en t' Z? Amount received $
Phone:r9, 6Z.y )t( -%32 Fax: E- mail:.._.- Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this o Visa 0 MasterCard
work will be complied • ith wh• -r specified herein or not Credit card number: Expires /
Authorized signature: 4 £ d' , t1 ..Ii h! i' `: (C ` - 1 02 Name of cardholder as shown on credit-card
Print name: ( ris ifill �� 'egg Cardholder signature $
cLY Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00 /COM)
k.
; -i
Fire Protection Permit Check List
A.) fig New ❑ Addition ❑ Alteration Li Repair
B. Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.,
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:
Additional description of work:
Type of Sy et ®®r C_asapplicable) 5 _£ _. 44
A.) Sprinkler Wet Dry ❑
Standpipes
Additional Hazard Group Li Lbw
Information Density , It)
Design Area loc.
K. Factor S.fte c1.2-
Sprinkler Project Valuation: $ '(Q, O(7D°b
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: $
Pro ject Valuation Subtotal (A, B & C): $ LS ono d'±'
Permit fee based on, valuation .(see chart): $ 2i 1 , 't
8 %,:S.tate Surcharge :$
FLS Plan Review 40% of 'Permit: $ _ Qd
TOTAL: $ :(C 63
is \dsts \forms \FPSchecklist.doc 06/07/01
4
CITY OF TIGARD 24 -Hour I.
BUILDING Inspection-Line: (5 1 )) ` 9 -4175
INSPECTION DIVISION Business Line: (5 3) 9 -4 1 ST
2* �� :UP - 600 /
Received Date Requested /j _3 AM PM i BUP
Location _ A fl__-/°/ Suite MEC
Contact Person 60'J.l.t.K.2- Ph ( ) SD i t -- ?a PLM
Contractor Ph ) SWR
BUILDING • Tenant/Owner i)* ELC
Footing •
Foundation ELC
A ccess:
Ftg Drain ELR •
Crawl Drain • •
Slab Inspection Notes: SIT
Post & Beam .
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear l?'
Framing
Drywall Dryll Nailin.-'
Firewall
Fire Alarm
Susp'd Ceiling I
Roof
Other
n-
r S PART FAIL_ •
7 B ING
• ost & Beam
b p - - - - /. 7 , -, 7 , „.",‘
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
Low Voltage .
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call or reinspection RE: 0 Unable to inspect — no access
Fire ADASupply Line r� \ /.0 i
D I Inspector �, _ Ext
Approach /Sidewalk P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24;Hour , •
BUILDING (-) Inspection Line: ,(50/639-4175 r --- "1 1 1 . : ....,
•-•-•
' INSPECTION DIV4S104; '----"/ Business Line: - :Cr • . 4171 -
' . „....04 - ,_, up ek s , .,, ...:. f ' r ' •it
H . - - • 57 1i ! ' - 1 , V VI ' '''' 0 4 ' " " 4 i ' . . ' . . . . '', i - ) - ' Z, . .- ' 0 c) 0 / CI
Received Date Re uested L ,,,- - - • 4131---.-
Location 1 1 5 /.. . •
. r . Suite MEC ..
LI
Contact Person Q ., .Ph (_24_) .5 - 30 7.,.__ PLM
, ---
Contractor . , _ Ph ( ) SWR
2 1 . BUIEDINGPINIFIr.7 Tenant/Owner r - ELC
Footing
Foundation ELC
110 :;.0
Ftg Drain .%A';2 e4-;-. .!.': -- ,-,. - . r - , :, ,7 ',It-, , t1 ELR
Crawl Drain VA=1-,4,t'tWt-Z,,-AVS-k-gA4V:4-?4t?PAV.% ;
: iVik' - ;t., i
Slab Inspection Notes: . SIT -
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
---- '
ISMI' 7 " ,
, /O: d
Framing
Insulation / d: b /
Drywall Nailing ,
Firewall .
A ' ...... A
Fire S. rinkler _
crow li 1111 • , 1 --- ___ . .
usp • Ceiling
7 .../ id: 6v .
Other:
0
PART FAIL L 1
s. Lgt 94Notwat* - 6 79. ---rj . 6-14--- -7/c i).-e—L- c---
Post & Beam / 0 : .
Under Slab
Rough-In
Water Service
Sanitary Sewer
• Rain Drains
Catch Basin / Manhole Cg
;
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
V ) / :4
f
itilEdHANICALEMW
Post & Beam
ROugh-In
Gas Line
Smoke Dampers
Final
• PASS PART FAIL
ELECTRICALit';':,
Service
• Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final
. 0
PASS PART FAIL Reinspection fee.of $ . required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
,
SITE - 24 , Atd-.74kiti Li Please call for reinspection RE 0 Unable to inspect - no access
,.._
Fire Supply Line
ADA 1 1A-70
4 <_ j ,,?
Approach/Sidewalk Date Inspector Ext
Other:
Final . DO NOT REMOVE this inspection record from the job site.
I PASS PART. FAIL