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Permit
CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00183 � DEVELOPMENT SERVICES 503-639-4171 DATE ISSUED: 5/12/2005 SW Hall Blvd., PARCEL: 1S126CA-01000 SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C -G SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG Project Description: Fire sprinkler system REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: FIRST: sf N: S: E: W: TYPE OF USE: O SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N : sf N: S: E: W: OCCUPANCY GRP: A2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 118 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: $ 3,000.00 Owner: Contractor: WASHINGTON SQUARE PLAZA SOUND FIRE PROTECTION INC BY THE CAFARO COMPANY° 10756 SE HWY 212 P 0 BOX 422 CLACKAMAS, OR 97015 FLone AM P 4 NJ 7932 Phone: F- 774 -5109 655 -3775 FEES Reg #: LIC 70003 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 4/27/2005 $72.10 [FLS] FLS Pln Rv 4/27/2005 $28.84 [TAX] 8% State Surcharl 4/27/2005 $5.77 Total $106.71 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: :1(.:4, i, �.. Permittee Signature: ale-104 c 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. • `i Fire Protection System . -, r- y. i a c • Building Permit Ap FOR-OFFICE USE ONLY `y City of Tigard APR 1� DateBy: ', ,3� 0 , u PernutNo.: '7, oz —(/' U/_ , 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review / , �dj / -i //NN,vilii �b h !j� Other Permit: p Phone: W Hall vd. Fax: 503.598 97223 _. �'�M�yp i � / Plan Re Date/By: ` Inspection Line: 503.639.4175 y iii o f • a :, o Lr... Date Ready/By: Ju ® See Page 2 for U Internet: www.ci.tigard.or.us BUILDING DIVISION f TG Supplemental Information t� ��. �5�5;��a*:S?�.. ,' ;,�£a: a��4" *:r:�2. �•. t 4k,,.... �•. x3t^.; �ru=`, - „.i: -' ' - fS' .'"F{+°zat t, .,,,�, �1 ”. t ',;`P °' ^ s e 0 zi• �i•rAi•., a'Ik m. i:.F`�, : { �r ,:�..». X z E, ,, � " � ,, ; , + ",=RE t UIRED DATA. 1- .AND'2 "FAIVIIIJY`DWEL., . ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the P t I_, , tom t 1 & k "` it ''' " " C ' work indicated on this application. t -' � &k ,. C GON9'PRUCTION t mi pp , � r� „ m.� , ,'4i t ..�a >a;a ..,�`�- r..,�,,.,a kf . � .,. � -.,�- �, x, x,•u: �,a`S�Y;?��.` k a �.!�,A;i2:� #el v.., � J U�3�K >,<. }" �' F .,. El 1- and 2-family dwelling Valuation: $ y g Commercial /industrial 1=I Accessory building El Multi-family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: :u"s =,. �4�6 " <.:s �1vv '�M':.�W "�,*Svl,.�;3:: ;.MS'.� :�.eF % °n "L•:' ��'6: ?.`.•.k.',�«' �E,.L „S , ",iii:` _ �`3r�£e, ,: i,.a •.`�. ' ' 5, {,,i,RC';, er x :' :,;,`::.. r a ,< .<•t S Total number of floors: f j dOB 3TTE "£INF,ORMATIQN ;AND..LQCATIQIV « 4 1 • g < Job site address: 1 p p I S GJ • N l_r: g LY D New dwelling area: square feet City/State /ZIP: 7'7 C'�A R2- 0 / ? 7 � Z 7 Garage /carport area: square feet Suite/bldg. /apt. no.: f 4X22 Project name: 430 /21A Covered porch area: square feet Cross street/directions to job site: . 51 ,, aE 'N 6d R 6_ go pp Deck area: square feet t. Other structure area: square feet r REQUIREDJDATA : COMM . U ERCIALSE CIIECKLIST. _ ?.' ° . ��x•,.,.,,� .. • Subdivision: .A 5 N td G a ... 1- 2 Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the i 1 `t. , >�V _ DESCR iril60 F WORK��` y gfrf v work indicated on this application. y T rivAre7.- ref f Kb V gm F N A 00,... A g�4- 0 Cf4 Yto N Valuation: $ 0 � / f or Srp-1 rf k.l f�,2 Re A RS , Fe p C ,v! n,.DATE- /R l M "C,0 , Existing building area: square feet /� 6� New building area: square feet ^ rte " [ PRORERTY OWNER • f ; �, , , ®T ENANT M {" ^A " Number of stories: I Name: MO' CA PAU> frb STI4 w a S, P/IP.rt+P4 011 P Type of construction: Address: 3 5. e .S O J ry h R. I fl IAN S. 7 5 i Occupancy groups: City/State /ZIP: P %./ ALL y p V A q Cg 7 Q t 3 ' Existing: Phone:(7, g�0_ q' Fax: (25 ?) g4-g_ 12 New: s s t , IC APPLANT , £3 ` ” „ p , P ERS ON _ 1 ` , m ^, q�,t �r . t �„ A_"_ � , _ o- - - 5 -r, $` NOTI s CE Business name: So 0 AID F'IRf p RA f r-r , N � c_ All contractors and subcontractors are required " to be Contact name: �p /� 1 t` licensed with the Oregon Construction Contractors Board I✓ r r D W rb under ORS 701 and may be required to be licensed in the Address: f C �7 ,- 4 S,_ r , f w`' 2_ 2_ y. jurisdiction in which work is being performed. If the .5' t �� q7 applicant is exempt from licensing, the following reasons City/State /ZIP: l 5..2:3 al4 mR 7 o f 5 apply: Phone: () g 5-5- , ; 77 5 Fax:: ( 3 ) b 5S.- Z ?9.0 E -mail: mat y�z:, ,��,, wsy;v:,�;�3.5:.`3�,= ':�y„„ .._ i. iF�:•: a a°;+.. 5�"¢ ".r:�`r��:�,T.'.;s �.;a:;:,,, :,,,�c-s;. ;,,` ";. �:,+;��e- .•;z;.:X'..'„'.:�;'s.E°a , ;� i a;y �� . A; i «Ar�`:=.iT''`•�: r ae c ,4 € Business name: NiNJ i1- d k o C ir�m Lam- r , ,, :•, ` . ti � � � � � BUILDING =PERMIT °£FEES Address: • o q C s' , F ,t .,. �.. �� ( wy 2.( Please refer to fee schedule. City /State /ZIP: CO A At aS • O v S 2 45--c p Fees due upon application Phone: ( 5 3 ) b 5 r ., 3-7 7 5- Fax: ( 7 ) - Z 7 ! ° CCB lic.: 7 m po 3 g.„ p ( (1 _ 07 . © Amount received - , I Date received: _,,, Authorized signature: ( 7 )tl' This permit application expires if a permit is not obtained /// J within 180 days after it has been accepted as complete. Print name: ��/ i /Id t 0, (V p 'a 4 Date: fl P R `2 s(. 5 * Fee methodology set by Tri- County Building Industry 1'� l Service Board. i:\Building \Permits \FPS- PermitApp.doc 12/03 440- 4613T( 1 1 /02 /COM /WEB) Fire Protection Permit Check List 1.) 0 Nelk • 2.) Modification to sprinkler heads only: LI Addition El 1-10 heads: No plan review required. [Er Alteration V11+ heads: Plan review required. [] Repair Number of sprinkler heads: Additional description of work: 7.x Ra., 4D U,(1, cgAriE • , As--12w,f(-19 PD Pt/'7L facir‘n y Wet ID Dry Additional Standpipes Information: Hazard Group (.3 6 ) Density Design Area K. Factor Sprinkler Project Valuation: $ ? ----patwzrwm, AtiiintattroTdaLligiplitgarol,g351461 Hood Project Valuation: $ Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets Fire Alarm Project Valuation: $ itLLWijkid irweaivf Square Footage: Permit Fee: 0 to 2,000 $187.50 ';••6 2,001 to 3,600 $232.50 3,601 to 7,200 $292.50 7,201 and greater $381.50 .1 i6,266666486:66T . Sprinkler Project Square Footage: sq. ft. Project Valuation Subtotal (A, B & C): $ Permit fee based on valuation (see attached chart): $ 1 2. Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ 5 FLS Plan Review 40% of Permit Fee: $ 7 0 TOTAL: $ ito 6 Plan review 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. i:\Building\Forms\FPSchecklist.doc 12/24/03 • . CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2005r00183 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2005 Phone: (505) 639 -4171 vrd Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/14 /2005 TIME: 7:10AM PAGE: 80 SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK: SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE: PROJECT NAME: BAJIO DESCRIPTION: Fire sprinkler system OWNER: WASHINGTON SQUARE PLAZA, PHONE #: 253. 040.4349 CONTRACTOR: SOUND FIRE PROTECTION INC PHONE #: F- 774 -5109 Inspection Request Scheduled For: Date: 6/14/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 910 Sprinkler rough -in /test 009136 -01 503- 655 -3774 Y F(P1Pd — e. o Corrections /Comments /Instructions: IA OE- • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FT INSPECTION ❑ ADDITI NAL ES ASSESSED Inspector: , �� 1� , ,1� \ Date: 13 one. #: (503) 718 -