Permit CITY TIGARD SITE WORK PERMIT
*1 DEVELOPMENT SERVICES PERMIT # : SIT2003 -00018
� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED : 8/6/03
SITE ADDRESS: / O3S0 5u/ 4/ 4/60/-A/ ST PARCEL : 1S135AB-00100
SUBDIVISION: TOWN OF METZGER ZONING : R -4.5
BLOCK: LOT: 005 JURISDICTION : TIG
CLASS OF WORK: NEW PAVING ?: RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 200,000.00
EXCV VOLUME: 11,946 cy LANDSCAPING ?:
FILL VOLUME: 11,200 cy SITE PREP ?:
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: sf
Remarks: Site work.
Owner: FEES
WASHINGTON CLACKAMAS CO
SCHOOL DIST 23J Description Date Amount
6960 SW SANDBURG STREET [BUPPLN] PIn Ck -Valu 6/13/03 $737.30
TIGARD, OR 97223 [FLS] FLS Pln Rv 6/13/03 $453.72
Phone: [BUILD] Prmt - Valu 8/6/03 $1,134.30
[TAX] 8% St Tax -Valu 8/6/03 $90.74
Contractor: [ERPRMT] Erosion Cntl 8/6/03 $120.00
ROBINSON CONSTRUCTION [ERPLN] Ersn Pick -USA 8/6/03 $39.00
21360 NW AMBERWOOD DR [EROSN] Ersn Pick -COT 8/6/03 $39.00 .
HILLSBORO, OR 97124 -9321 Total $2,614.06
Phone: 503 - 645 -8531
Reg #: LIC 63147
Required Inspections
Erosion Control Insp 846 -8444
Fill
Grading -
Paving Insp
Sprinkler supply lines
Fire system test
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. 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 rul- - • • •ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 throug OAR 952 -I6 -0100. You :y obtain copies of these rules or direct questions to OUNC by
calling (503) 246-66'9.
■ //
- • - - -. Issu By:
Permittee Signature: A " 7 -
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
• /OZSS sw gorsAv6 nE'Tz6e/A
j Site Work
`' Building Permit Application FOR OFFICE USE ONLY
Received � Building C/
Date/By: (p- B-0 �'D Permit No.S ti - COV i b
' �� r _ (rte \„ Plannin A Other
Cit of Ti and U �� C U t b 3 2 oor,
y g D ate/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 /. Date/By: :3D ^off D59 Permit No.: , CX�
Phone: 503- 639 -4171 Fax: 50 -1960 '� ti\ Post - Review Land Use
C? 5. 7 9� $ U � 110 ^_$ B . � II Date/By: Case No. - A
Internet: www.ci.tigard.or.us Contact J uris.: ® See P age 2 for
24 -hour Inspection Request: 50.364 DIVIS:061 Name /Method: Supplemental Information ' ,
TYPE OF WORK : REQUIRED DATA: :: : a,.,
Ig New construction ❑ Demolition , - 1 & 2 FAMILY DWELLING ' :,
❑ Addition/alteration/replacement
OF ❑ Other: ION
CATEGORY CONSTRUCT Permit fees* are based on the total value of the work performed. Indicate
❑ 1 & 2- Family dwelling CommerciaUIndustrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building 0 Multi - Family
❑ Master Builder ❑ Other: Valuation $
JOB. SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site addres Total number of floors
New dwelling area (sq. ft.) .
Suite #: Bld ' . /Apt. #: p Garage/carport area (sq. ft.) •
-
- Project Name: Pet e ✓ 06.0,6,16y Sct.ol r e t a c e .r Covered porch area (sq. ft.)
k
Cross street/Directio s to job site: / (/ Deck area (sq. ft.)
Other structure area (sq. ft.)
5G%/ 0
G�sf 0" CC Stet -
' REQUIRED DATA:. - .
COMMERCIAL - 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,
- ' r overhead and profit for the work indicated on this application.
1 5 >re l�' '46111.4 e�lioc. Ceti Av I a k 1
!IA /Gvre 01 S/ wo ✓� • Valuation $ZCO / 000.00
Existing building area (sq. ft.)
New building area (sq. ft.) ‘ 7 V.,* •
■
Number of stories 2
_PROPERTY OWNER 14,7 ENANT - Type of construction Type 2T
Name: skip A Occupancy group(s): Existing:
pp 4e., / New: E. /
Address: 6 6 0 .SG✓ - li .-f st 4 2 • /
City/State /Zip: T 4 l4 1 0 2 9'772 3
SD 3 - 93/ ' 0 0 3 / ax 7 NOTICE: All contractors and subcontractors are required to be
r
Phone: F �� : S° 3 3 / 0 licensed with'the Oregon Construction Contractors Board under
['APPLICANT t t;ONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: Cornlrltoae 6 hjtMlPion 111,1: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: ,j p ti h Ale / from licensing, the following reason applies:
Address: Stl o SW MAc4 14,s, Ave, £ /e 2.53
City /State /Zip: . Porl' /ai, •( 012 9 7 3 /
Phone: 03- 70r- y6 tic, I Fax: Sb? - 29S- f 9 6
E -mail: Joh n r
A, tQ C oner - sfbble . Gh' BUILDING FEES*
�* ' • Please refer to'fee o'fee s sc chedule:
. ' CONTRACTOR (j
Business Name: /Zob/w Soh 6 01 Sfiu c ha h Fees due upon application $ 137. ZO
Address: Z Rw,b
i 3 6 0 ^/J eragoI P'
City /State /Zip: }1 //l tot 62. !.'/ 7/L y Amount received PLS $ .1.53.1a
Phone: $ - Or- 3'S' 3 I Fax: S7)3 - 6 fFc - s 3 r 7- Date received: $ 07. 0 2-
CCB Lic. #: 6 3 Sl 7
Authorized Notice: This permit application expires if a permit is not obtained within
�,
Signature: Date: r 3/.1 180 days after it has been accepted as complete.
J Agri.— *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
6 -26 -203 9 : 53AM FROM MA I NT 359 5941 ✓ + 3 v 1 P- 2
' Jug. U3 ua Ua: b9 t:aP`P1Ert•atione OFFICE COPY' 1
�O3 5-f- Aiz
•
Fire Marshal's Division Offices -
`' c 1 A /7; ') North Division south D1 ten past Division
( \ r ' # I\ \ 14450 SW Jenkins Rd. 1401 5W Was= Court 674 7 Street
Tualatin Valley Beaverton, OR 97005
Tualatin, OR 97062 Oregon City, OR 87045
Ce & Rescue (503) 356.4700 (503) 61Z 7000 (503) 657 -1365
liY
Max (503) 644-2214 Fax (503) 612x7003 Fax (503) 657 -7913 •
FIRE FLOW and HYDRANT WORKSHEET
This worksheet is required to be submitted to and approved by the Authority Having Jurisdiction (AHJ)
before any permits for new building construction, building expansion, or fire hydrants will be issued by any
building department within the TVF &R District. Please complete, sign, and date the PREPARER
INFORMATION block. Then complete the GENERAL BUILDING INFORMATION block. Lastly, complete
either item A or B, and items C, C; E and F on page 2•titie d CALCULATING REQUIRED FIRE FLOW.
Please dearly print all requested information. See the instruction book for help filling out the form or call one
of the above numbers.
PREPARER INFORMATION
Preparer. Hk! A-a L—
Ph ?e 5a 3 — 70 r" ' c V e Fax: 5 — l q s — /Q q 6
Arct ltect / Engineer of Record: 742.e fin - Fc - p. - g‘,-X plc, Aa/ ,<L--1 0 T)
Phone: , 5 3 ZZ`•t — 0 1 ? 3 - Fax: P3 - rZ.t` —. LI8 36
4 Preparer Signature: Date: 4 /3
— -
GENERAL BUILDING INFORMATION
1 1
1. r roJect Name: _zee L`' 1- C7S/7 . ' ' iZ41 � L ,-
2.' reject Address:
city:, 7/440 Q'i county: 110,90A.44'01 Zip: 9 ,'223
3. construction Type(S) 0 Type I Fire Resistive or Typo It Fire Resistive
Type li One -hour 4 /, /N1,/62'4 /M.�
O N Heavy Timber or Type Y One -hour
• i O Type Type i1 Non -rated or Type Ill Non -rated
(3 1:313
Type V Non -rated c
4. Total Building Area: ...0 7 •O • Square Feet
s. Total Flee Aiea: 1p7'9 71- 493 - Square Feet eevroft4P PMY 3373 w . /(2j/ B
+
0. Building ire Flow: , � 0 .324'
9 . � . Gallons per Minute (Table Adll -Ad)
7 . ascribe the Fire Area: Of m o r e t h w a r t s nr a a r e a , Include an 8 112 X 11 on i x 1Z d - Weary the vatious Oro areas) •
.J -..2 Z. _I! / _i/ COY-- %- L: , C1_t�� . -I,—
e. Type of Occupancy. or Use of Building: y Je Je 4 • E 04 Z / -
1 w.. • -r I MO%I1MA �aMwa.ftwom..�..ir= wr u MM
6 - 26 -203 9 :54AM FROM MAINT 359 5941 P_3
.nine us Us ua : uua Lor-nerszone 5useub 1896 p. 4
A t
•
CALCULA REQUIRED FlRE FLOW
•
A. Single Occupancy Hazard tit using item A. OO t T use Item a) Y.,/ — yi p
Al Building Fire Flow GPM .
A2 Occupancy Factor b.
•
A3 (Multiply lino Al by line A2) Required Fire Flow • GPM • .
•
B. Multiple Occupancy Hazard (If using heir B. IMISU use item A)
61 ....Determine percent of each occupancy hazard In the fire area.
(Occupancy Hazard Class) (Fire Area) (Total Fire Area) (Percent of Fire Area) • Light Hazard SF T _ SF x 100 = y, •
Ordinary Hazard Grp 1 • SF . SF x 100 a tg
•
Ordinary Hazard Grip SF T SF x 100 = '% _
Extra Hazard GRP 1 SF T SF x 100 = % i
Extra Hazard GRP Z • SF SF x 100 = %
Add all of the percentages In the last column, they must equal 100% %
82 ....Calculate Fire Flow
(Occupany Hazard Class) (Factor) (Fire Area) (Fire Flow) (Bldg Fire Flow)
Light Hazard 1.00 x % x OPM = OPM
Ordinary Hazard Grp 1 1.20 x % x GPM = GPM
Ordinary Hazard Grp 2 1.30 x % x .GPM = GPM
Extra Hazard Grp 1 1.40 x % x GPM = GPM
Extra 'Hazard Grp 2 1.50 x i x GPM = GPM
• 83 Required Fire Flow GPM
•
C. Calculate the Minimum number of fire hydrants requited •
Required Fire Flow (A3) or (B3) 3750 GPM =1500 = 45 Ho. of Hydrants (Minimum 2 Req.)
qk
D.. Reduction of fire flow (check one box only and then complete the calculation in Section`E)
D1 13 Multiply either line A3 QB lino 63 by 75% for a full fire alarm
02 ....0 Multiply either line A3 QS line B3 by 50% for automatic sprinklers •
D3 CI Multiply either line A3 PR line B3 by 25% for central station supervised sprinkler protection •
W
Required fire flow
F e Flow 37,50 GPM x Reduction • 75. . /. ..
- 7otai Req. Fire Flow 251g GPM' •
(Line A3 2( e3) (Line 01, DT., gr 03)
- Minimum 1500 - Maximum 3000 GPM •
F . Available Fire Flow to the Bulldin>.g Test Results: , GPM
Please attach documentation of the- glow teat that wee made. ft ehall include date, time, location - of static/residual and
flow hydrants, and the fastei's name: phone number and address.
•
6 -26 -203 9 :55AM FROM MAINT 359 5941 P.4
•
•
•
JUN -24 -2003 TUE 08 :27 Ail FAX NO. P. 02
•
FLOW TEST
DATE: f / 1 3 TEST NUMBER:
TIME: / / ®7 ' LOCATION: 4l0r?4W is ,4 .
WEATHER; C6Ef� //iekT .
•
J.
ATTENDING PERSONNEL: •
1. i41I L L.✓rlO .P.,eis (LOCATION SKETCH ON BACK)
2 •
3.
4. _
•
•
HYDRANT NO. I HYDRANT NO. 2
NOZZLE SIZE . ' 2 in" 4" 21/2" 4^
STATIC PRESSURE
ANO GAGE NUMBER 96. �7
RESIDUAL PR ESSURE
AND GAGE NUMBER �,�,��� 5�
PITOT PRESSURE
AND GAGE NUMBER • f O / 7
FLOW
G.P.Ia. /S4�•8 / 79¢..
COMPUTED FLOW AT
20 P -5.1. RESIDUAL 2 7 . 44 t . 7 - a570•
WATER COLOR
DESCRIPTION • . • • .
•
•
•
REMARKS: -
D 0 V V V 0 0
DELTA FIRE, INC.
4-17 -1995 23
0
C%Ai 14 &i-L i3LV1D
(D
r
=�.?,_ "'kc;?�. wry` ._ �:.,.- :,. "a
FLOW AT SPECIFIED PRESSURE 0 t ;
PSI `Gs =A
STATIC'= 96 SI P -P
em
RESIDUAL = 60 PSI ?� ` Ps -Pr B
FLOW= 1846.8 GPM
PRESSURE = 20 PSI 413 C ^ • S4 =D
z 2 7b4 75 G
• �. fi -: �� OJT
A VAILABLE FLOW= _ =
0
CC
Q
M
m
N
FZ
(D z
•
CO .
r
d .
FLOW AT SPECIFIED PRESSURE ; y ; : Le e
STd TIC= 97 PSI :_ i
�•^ • — iI �1 q Z�'J
� .] 1 L L L l %..." �
RESIDUAL = 51 PSI �' =B
J.'4 Ps —P
ta i..
PLOW= 1794.8 GPM 4 P 't41B=C
��; _� „fit;
r 54
PRESSURE= 20 PSIs•,��• = C X . =D
s
E FLDT
2370 -
A VAILABLE .46 GP _ 41 §
L
0
LL
U-
r•-•••
CO
m L Q
I 0)
VI
m N
m
N
I
(D •