Permit r
A CITY OF TIGARD BUILDING PERMIT ,
PERMIT #: BUP2006 -00046
n DEVELOPMENT SERVICES DATE ISSUED: 1/25/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S102AB - 03900
SITE ADDRESS: 12370 SW MAIN ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Upgrade of fire suppression system.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: UNK 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: $ 1,600.00
Owner: Contractor:
CAPISTRANO, NICHOLAS III METRO SAFETY AND FIRE INC
12370 SW MAIN ST 7055 NE GLISAN
TIGARD, OR 97223 PORTLAND, OR 97213
Phone: Contact #: PRI 503 231 - 2999
Reg #: LIC 63651
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/11/2006 $62.50
[TAX] 8% State Surcha 1/11/2006 $5.00
[FLS] FLS Pln Rv 1/11/2006 $25.00
Total $92.50
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.
o
Issued By: ry �./'�f.
L Permittee Signature: Spyo ca'Q 1
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 Sy
Buildine'Permit App ' Gc rule Ol l iCL: Hsi: ONLl'
1�
City of Tigard E� �" - - Permit No.:: _ 60 6 -A d V,
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 01 r �i4- , .� ;: (I �` D . 1 r ' Other Permit:
Inspection Line: 503.639.4175 1 N 1 2‘1 4 Date Ready ty: ® See Page 2 for
Internet: www.ci.tigard.or.us �� Notified/Method I1M Supplemental Information
pc TIGA5 D
TYPM REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
pa Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 2 3310 5. W , MAI 5{-. New dwelling area: square feet
City / State/ZIP: "'Ft g q.t2p Ott . q1 Z2 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: c1 Project name: )44-mt 1 14 Gc.paE5S Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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
DESCRIPTION OF WORK work indicated on this application.
o L 3 a0 u p 2 of P't ¢E Sii P p tzess,o N 6i6-re- /'+ • Valuation: $ / ( 0 Co
Existing building area: square feet
New building area: square feet
I� PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Al X Type of construction:
Address: 1 Z3 -1 O S , w • AAA A3 Occupancy groups:
P cYl� s: P
City / State/ZIP: - 1 - -, a Mth Da. ° n tZ3 Existing:
Phone: ( 5x3) le - $ 3'ZS Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: M o A• 4 rn 2E All contractors and subcontractors are requ to be
C FLAW n� licensed with the Oregon Construction Contractors Board
Contact name: E►2t under ORS 701 and may be required to be licensed in the
Address: 1 0 S N t 6 • (, L tSA-*J jurisdiction in which work is being performed. If
Z t 3 applicant is exempt from licensing, the following reasons
City / State/ZIP: POi✓- TLA•aw.D Pt2. 9'1 apply:
Phone: (5 z31 _ 2919 I Fax:: ( )
E -mail:
CONTRACTOR
Business name: e1 54-;All t .2e BUILDING PERMIT FEES*
Address: -/ C.•55 .c C,
. .5A -A.)
nn Please refer to fee schedule.
City /State/ZIP: Y�fLR ,D 02 s -r 2.13 Fees due upon application
Phone: (503 ) 2 3 1 - Zrl °1 Fax: ( ) l "1-d -alY Amount received
CCB lic.: ( 3 tp 5 I 1 o '
aNdf Date received:
Authorized signature: j This permit application expires if a permit is not obtained
I - I within 180 days after it has been accepted as complete.
Print name: C t at2o tn! /� Da te: 11 / Fee methodology set by Tri-County Building industry
Service Board.
i:\Building\Pennits \FPS- Pe+mitApp.doe 12/03 410- 4613T(11 /07/COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $ (‘DD
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
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.
l:\Building\Permits\FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT it: gll,Pap o6- (90046
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171 {�
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I - -
INSPECTION WORKSHEET FOR DATE: TI PAGE:
SITE ADDRESS: / .--370 W " • CLASS OF WORK:
SUBDIVISION: 11 LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE 03) 23/ ,..7_9 qQ
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: "C ^ 7- 4 Pour Time:
Code # Inspection Description Confirm # Contact # Message
,-91 Fri-x.0,-4.
6L-D
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Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAI ❑ CA L FOR INSPECTION ❑ ADDITIO AL F ES ASSESSED
Inspector: Aftl, Date: 4 C/V Phone #: (503) 718 -
U/ 1 _