Permit .W
., CITY OF TIGARD BUILDING PERMIT
1114 PERMIT #: BUP2004 -00399
. COMMUNITY DEVELOPMENT DATE ISSUED: 1
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 BD - 00103
SITE ADDRESS: 07805 SW HUNZIKER RD ZONING: I -L
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Sprinkler system conversion.
REISSUE: r r ig FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: Al T' FIR sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 3N sf N: S: E: W:
OCCUPANCY GRP: H3 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: $ 6,000.00
Owner: Contractor:
FIG M CO FIRE SYSTEMS WEST INC
BY NORRIS BEGGS + SIMPSON 600 SE MARITIME AVE #300
ATTN: BLAKE HERING VANCOUVER, WA 98661
PORTLAND, OR 97204
Phone: 503 - 273 -0384 Contact #: PRI 360- 693 -9906
FAX 503 - 289 -2208
Reg #: LIC 49732
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/18/2004 $100.90
[FLS] FLS Pin Rv 8/18/2004 $40.36
[TAX] 8% State Surchari 8/18/2004 $8.07
Total $149.33
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.�,.T.hose..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,OIJNC by calling 503 ..246.6699 or 1.800.332.2344.
Issued By: L___-- � ;�( �'I° 2 Permittee Signature: - T h �,� ( �1�, ! 'iL —
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
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B ding Permit Application
Date received., , / im s, Permit no.: : ►_sr .,Ga31M'f
A ,, :,�,�, City of 'Tigard
• - [ , (P �t roject1app1. no.: Expire date:
Ciryo}Tigard Address: 13125 SW Hall Blvd, Tigard, pig/223
IQ1 Y L� �
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 AUG 1 8 2 004 Case file no.: Payment type:
Land use approval: _ i 1 &2 family: Simple Complex:
t• yr
Li i6ARL `
- � , TYPE,OF PERMIT -- _ O
❑ l & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi-family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement XFire sprinkler /alarm ❑ Other:
- • ':.:s JOB SITE. INFORMATION
Job address: 77,0rj SSA/ 14 um z, k Bldg. no.: Suite no.:
Lot: I Block: 'Subdivision: I Tax map /tax lot/account no.:
Project name: jr IL 1 T 1,71,4o s ✓•t A t_ ‘
Description and location of work on premises/special conditions: �r.uve. ; : D( - Sp•r INA t. 2_ 51 sm - M (c) cue t
s — - .T i ,At P 2- • . set. 4Ai:2 k • Vie - ► u4. AA ", . - P .
. OVI'NER ' - , . ' FOR SPECIAL INFORMATION, USE CHECKLIST r
Name: Alarv�r - S , /3 -�;C: ? 5 /r,7pson/ ( Floodplain ,septiccapacity,solar,et .)
Mailing address: iz.t sto ,Vlatr - n,.i 5,, : sr e- 2000 1 & 2 family dwelling:
City: po T L4 State: 0 ZIP: 9 7 g Valuation of work $
Phone:503- 273 '-1 I Fax:03 -2 a3_ 4'E -mail: No. of bedrooms/baths
Owner's representative: c N ee f_ c?at 1 G, Total number of floors
Phone:503 2 - 03 $ . Fax: _, E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name:' ,(I,� g t -7� Covered porch area (sq. ft.) Ok
Mailing address: (pp s - M,or, ..n
fe „we- 5Z . - 300 Deck area (sq. ft.)
City: Am ,t State: ZIP: • .:4 . Other structure area (sq. ft.)
Phone: _ Fax: , • E-mail:
Commerciallindustrial/multi family:
? 3 no4 Sv3 — 4
- " CONTRACTOR Valuation of work $ 6.606'' c � c
Existing bldg. area (sq. ft.)
Business name: p sys, ,_, wc � --, —
New bldg. area (sq. ft.) C
Address:40 s� 1 7 2 , 4e0 - 4, 0 ,"
/1Ae0 rr v Rv .5v, ;i.e... ;i.e... 30
. v, 0 i"
Number of stories /
City: U kfr l Au , v �e . I State: W q [ ZIP: ?Rs e , /
Type of construction
Phone:�lod -e9? S90G I Fax:2326?-zzas E -mail:
Occupancy group(s): N" -, Existing: <Deoi a/AlIZI
CCB no.: ` ?732. New: 4-xriA Nf1 4.er) 1.
City/metro he. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City; I State: 'ZIP: exempt from licensing, the following reason applies:
Contact person: 1 Plan no.:
Phone: Fax: E -mail:
ENGINEER .
Name: Contact person: Fees due upon application . $
Address: Date received:
City: 'State: 'ZIP: Amount received $
Phone: I Fax: I 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 mote information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa ❑ Mastercard
work will be complied with, whether s cified herein or not. Credit card number: . /
Aut signature: .�.' Date: Z -c) Name of cardholder as shown on credit card
Ai $
Print name: � , 4, $' /A/ Cardholder signature Amount J
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6roQ/COM)
•
•
•
Fire Protection Permit Check List
A.) ❑ New ❑ Addition ID Alteration ❑ 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: Coc/re &% v1y 5 /5r % 7-0 c ' 7 -$5/ 1 `
13 ( ..T,Lisrar!/,1? ee,+Dy 124 Stag_ c //eck p= /uc� Sw/kH /f�a Loop r' y if
M a /4/5" may! T-/ /c/L.
Type of System (Complete A, B or-C as applicable):
A.) Sprinkler Wet E Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area _ ' Z•53 S' op
K. Factor B. o
• Sprinkler Project Valuation: $ 600n a°
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: $
Project Valuation Subtotal (A, B & C): $ 6.000 -°
Permit fee based on valuation (see chart): $ /oo 9'
8% State Surcharge: $ 8 • 0 7
FLS Plan Review 40% of Permit: $ tiC ` 36
TOTAL: $ / 4 19 — ' 37
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 11/21/01
CITY TIGARD DA-A/
Bul
BUILDING DIVISION O PERMIT #: -2O)— 003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: r 7- / J
Phone: (503) 639 -4171 uy ii�@Ifili��- [ `
Inspection Requests (24 Hrs.): (503) 639 -4175 =��
INSPECTION WORKSHEET FOR DATE: /242 TIME: q ,
PAGE:
SITE ADDRESS: 7 OO / tO/ ?744( `,LV CLASS OF WORK:
SUBDIVISION: � ;l LOT #: TYPE OF USE:
PROJECT NAME:
40-
PROJECT
DESCRIPTIONG & .Tv w 54 56e 3k D �- / F... ie-telt
i 9 V ' " Y PHONE #:
"� C - ONTRACTOR: L -3(O 0 •7 -7/ 2-to -/ 3 /1 v i PHONE #:
Inspection Request Scheduled For: Date: " / t Pour Time:
Code # Inspection Description Confirm # Contact # Message
qq PP ` on r �' Wes'
Corrections /Comments /Instructions:
'54 p/ ,'fl Gal A, 6z. e - RIAW A - Aid
Ci.041/417149-v dA/n . l 7`-6
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I PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
Ti FAIL e _ ! CALL FOR INSPECTION ❑ ADDITI• AL EES ASSESSED
Inspector: ® lit Date: Phone #: (503) 718 - %�Z