Permit rr
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00649
DEVELOPMENT SERVICES DATE ISSUED: 12/19/2005
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--- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S134AA -01900
SITE ADDRESS: 10115 SW NIMBUS AVE 150 ZONING: C -G
SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT: 001 JURISDICTION: TIG
Project Description: Fire sprinkler TI, relocating (1) head.
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: 5: E: W:
OCCUPANCY GRP: B 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: $ 150.00
Owner: Contractor:
ROBINSON, WILLIAM R /CONSTANCE A UNITED FIRE HEALTH & SAFETY EQUIP
ROBINSON, LYNN + BELL, KAY ET 4611 NE MARTIN LUTHER KING JR
BY ELLIOTT ASSOC PORTLAND, OR 97211 -0771
PORTLAND, OR 97204
Phone: Contact #: PRI 503- 249 -0771
FEES Reg #: LIC 65290
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surchari 12/19/200: $5.00
[BUILD] Permit Fee 12/19/200E $62.50
Total $67.50
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 -0. -1010 gh OAR 952 - 001 -0100. You may obtain a copy of these rules r direc uestions to OUNC by
calli g 503-246-669' o : Id' 332 -2344.
Issu:d By: 1 . /,' // Permittee Signature:
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 System
Building Permit Application FOR OF►•ICIE: 1 0\I.1
City of Tigard Re B� , �o‘ OM= : .v
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 'A'' .. r: I ` Date/ . Other Permit: • Inspection Line: 503.639.4175 _ , . , _1_1 Date Ready/By. ®See Page for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Info
TYPE OF WORK 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
® Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2 -family dwelling ❑ Commercial /industrial
Valuation: $
❑ Accessory building CI Multi - family
Number of bedrooms:
❑ Master builder 0 Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: \ \`: S td ,..1 b.:\ s12, S �T New dwelling area: square feet
City /State/ZIP: — o R C‘`I �'-� Garage /carport area: square feet
Suite/bldg. /apt. no.: \ 5 j Project name: .4 0 , p A 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.
Valuation: $
Existing building area: square feet •
New building area: square feet
❑ PROPERTY OWNER I X] TENANT Number of stories:
Name: K®O1W0 V s 4 SAri. RA ty Type of construction:
Address: 1K 4 S' . LAN) 6 , ` I 4 A - Occupancy groups:
City /State/ZIP: \ k 4A )\ QC' z,1,14, Existing:
Phone: ( S135) /S v loco Fax: ( )
New:
Ig APPLICANT R1 CONTACT PERSON NOTICE
Business name: }.O aka VS K � di AAA/ All contractors and subcontractors are required to be
Contact name: ' licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: apply:
Phone: ( 5 0 ) 5 ( I C t ( I Fax :: ( )
E -mail:
CONTRACTOR
Business namc: U l� 1 r t FI Q � A f e. & " 4F£/ 1P• BUILDING PERMIT FEES*
Address: cl ,QE. M 7 N ri ' 1 ( 4 u , 1 Please refer to fee schedule.
`
City / State/ZIP: b na c%94/ - 3 7 Fees due upon application
Phone: (Er;, acJ 9 - C77/ Fax: ( )
CCB lic.: r VII Amount received
" � S�qa Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name . Date: 4' `�_ ® • Fee methodology set by Tri-County Building Industry
----._.._____ �V ` Service Board.
i:Mluilding\Pennils \FPS- PamitApp.doc 12/03 4104613T(II /02/COM/W®)
City of Tigard: Fire Protection Permit Checklist '
ti ` 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 w
Type 'of System (Comple A, B, C or D as applicable):
A.) Commercial Sprinkle
Wet [❑ D
Additional Standpipes
Information: Hazard Group
ensity
►r esign Area
K. actor
Sp .l' nkler Project Valua • ; n: $ j50 '
B.) Type I - Hood Fire Suppression stem
Hood Project Valuation: I $
C.) Fire Alarm
Submittal shall Battery Cale . 'ons ❑ Yes
include: Individual romp. ent ❑ Yes
Cut She-
Fire A rm Project nation: $
D.) Residential Sprinkler (Sta 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 grea - $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $ 4 CO a . 5O
Permit fee based on square footage (D) (see fees above): $ _
State Surcharge 8% of Permit Fee: $ 5.0
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ • 4 7. 5
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.
I:\ Building \Permits\FPS- PermitApp.doc 2
"4t
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00649
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/19/2005
Phone: (503) 639- 4171+ °! I h
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2i7/7006 TIME: 7:02AM PAGE: 69
SITE ADDRESS: 10115 SW NIMBUS AVE 150 CLASS OF WORK:
SUBDIVISION: 1 KOLL BUSINESS CENT[ :R 1 IGARD LOT #: 001 TYPE OF USE:
PROJECT NAME: CAFE PERSIA
DESCRIPTION: Fire sprinkler T1, relocating (1) head.
OWNER: ROBINSON, WILLIAM R /CONSTANCE A, PHONE #:
CONTRACTOR: UNITED FIRE HEAL(H & SAFETY EQUIP PHONE #: 503-249-07/1
Inspection Request Scheduled For: Date: 2/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 SpiinkIer rough -in /test 026362 -05 503 -516 -7000 N
Corrections/Comments/Instructions:
A,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL f L i FOR IN ' ECTION ❑ ADDITI AL F ES ASSESSED
411; Inspector: Date: v Phone #: (503) 718- 62-4.2"—/
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2006.0O&19
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12715'120
Phone: (503) 639 -4171 P1 n al'"
Inspection ,Requests (24 Hrs.): (503) 639 -4175 F '. —
INSPECTION WORKSHEET FOR DATE: 2/7/2006 TIME: /:07Atri PAGE: 60
SITE ADDRESS: 10116 SW NIMBUS AVE 160 CLASS OF WORK:
SUBDIVISION: 1 KOLL BUSINESS CENTER TIGARD LOT #: 001 TYPE OF USE:
PROJECT NAME: CAFE PERSIA
DESCRIPTION: Fire sprinkler TI, relocating (1) head.
OWNER: ROBINSON, WILLIAM F7 /CON STANCE A, PHONE #:
CONTRACTOR: UNITED FIRE HEAL I H & SAFETY EQUIP PHONE #: 603. 249-0771
Inspection Request Scheduled For: Date: 2/7/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
9.99 Sprinkler final 026362 -06 603- 516 -7000 N
t :r 30
Corrections /Comments /Instructions:
..______
1 0J - A - c
r- A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
�1
Inspector: Mt 'yak
_ Date: 1 0,6 Phone #: (503) 718 - \