Permit A .. r BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2005 -00401
�A DEVELOPMENT SERVICES DATE ISSUED: 8/19/2005
,.� I-' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG
Project Description: Add, remove & relocate 267 sprinkler heads.
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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 938 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: $ 22,001.00
Owner: Contractor:
TIGARD PROPERTIES INC FIRE SYSTEMS WEST INC
8320 NE HWY 99 600 SE MARITIME AVE #300
VANCOUVER, WA 98668 VANCOUVER, WA 98661
Phone: 360- 574 -6255 Phone: 360 - 693 -9906
FEES • Reg #: LIC 49732
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/16/2005 $264.10
[TAX] 8% State Surchari 8/16/2005 $21.13
[FLS] FLS Pin Rv 8/16/2005 $105.64 •
Total $390.87
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- -0010 throb , h OAR 952 - 001 -0100. You may obtain a copy of these -rates or direct questions to OUNC by
c i ng 503 - 246 -6699 • r 1 -8 3 •4. •
I ued By: , _ , : / I! !t_! Permittee Sig; 4 F
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 Pr ect System �,,,c.
n „� �'`
Building Permit Application -� 1 FOR OFFICE USE ONLY
v � �� y�+ ' -
City of Tigard \C �_” , d n d , 6 � � PermitNo.. ;dam - Ods 00 6
13125 SW Hall Blvd., Tigard, OR 97223 , - ° ``�
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i / / ''�a d 4hri� r11 \ Date/I3 : • • Other Permit:
Inspection Line: 503.639.4175 Date Ready/13y ® See Page 2 for
"
Internet: www.ci.tigard.or.us t y " 6t • ao Notified/Method: Supplemental Information
� 0, i a o � �
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' • . ; 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
fi 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 AZ 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: I S 9[I c s (, pA ('C. 4v New dwelling area: square feet
City/State/ZIP: ¶7 / OIL Garage/carport area: square feet
Suite/bldg. /apt. no.: z Project name: J a.N N5 �1-1 L 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: Lot no.: Permit fees" are based on the value of the work performed.
Tax map /parcel no.: • Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
- DESCRIPTION OF WORK ' work indicated on this application.
Valuation: $ 7-2 00 j
ho 01 IX E►7+ovG / REL c.C.Artr OP s (9/ mc.S
Existing building area: 3 1 000 square feet
I
New building area: O square feet
PROPERTY OWNER - ❑ TENANT Number of stories:
Name: MG Go¢ n-n b.J Type of construction: V 3
Address: 3 96) 2 N L 1 r p RDA p Occupancy groups: 09-9 t noivuse li
City/State/ZIP:Ug C1�. / AZ '533) Existing: II
Phone: (4-130 36') 9Oo Fax: ( ) New: Il
APPLICANT ❑ CONTACT PERSON ,NOTICE . , -•••' ---''..,' '
Business name: r1Re 5(es 's " r All contractors and subcontractors are required to be
Contact name: JRt�Ory l `J Jq�'1�C� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: C.a SE t r.-R0,_ 1 - r, 11y L• jurisdiction in which work is being performed. If the
/ State/ZIP: q applicant is exempt from licensing, the following reasons
Ci
n V�[pt,l VbyL I M'f l t6A/ apply:
Phone: (3(:p) Gq3 7106 Fax:: ( )
E -mail:
' CONTRACTOR • • -
Business name: -
% ° BUILDING PERMIT.. FEES; *., , - _ , ,
Address:
Please refer to fee schedule.
City/ State/Z1P: Fees due upon application 390. $-7
Phone: ( ) Fax: ( )
Amount received
CCB lic.: 4 9 Z
Date received:
Authorized signature:. This permit application expires if a permit is not obtained
c• - within 180 days after it has been accepted as complete.
Print name: , s 4 s AIti•Q; t w Date: Si?- I4 '—o • Fee methodology set by Tri-County Building Industry
Service Board.
i:\ Building \Perrnits\FPS- PermitApp.doc 12!03 440-4613T(11 /07JCOM/WEB)
•
Fire Protection Permit Check List
Describ a work to be done:
t A7s -_
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: 7
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: $
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.
i:' Building\Forms\FPSchecklist.doc 12/24/03
CITY. Or .TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00401
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/19/2005
Phone: (503) 639 -4171 :,, �11 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .. '! !+� " f
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7:07AM PAGE: 66
SITE ADDRESS: 11945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO - ANN FABRICS
DESCRIPTION: Add, remove & relocate 267 sprinkler heads.
OWNER: TIGARD PROPERTIES INC, PHONE #: 360-574-6255
CONTRACTOR: FIRE SYSTEMS WEST INC PHONE #: 360- 693.9906
Inspection Request Scheduled For: Date: 9/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 016099 -01 503 - 310 -2624 Y
Corrections /Comments /Instructions: ( t `- /�
x�
' Al :.-- . P I I ft . AB Uir al,
_.....,... Ira I - figior . I vr 0 „„„„--- .......-
❑ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL OR INSPECTION ❑ ADDITI NAL F ES ASSESSED
Inspector: o f I►! Date: q (✓ Phone #: (503) 718 -