Permit CITY OF TIGARD - BUILDING PERMIT
PERMIT #: BUP1999 -00471
aw*� DEVELOPMENT SERV 4. DATE ISSUED: 11/22/99
' ' j " '�' II 13125 SW Hall Blvd., Tigard, OR 972 i ) -r ',l L
SITE ADDRESS: 11945 SW PACIFIC HWY 242 PARCEL: 1S135DD -03301
SUBDIVISION: HOFFARBER TRACTS NO.1 - ZONING: C -G
BLOCK: LOT: 002 JURISDICTION: TIG
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: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,740.00
Remarks: Fire suppresssion for Type I exhaust hood.
Owner: Contractor:
TIGARD PROPERTIES INC SANDERSON SAFETY SUPPLY CO.
2106 SE OCHOCO ST 1101 SE 3RD ST
MILWAUKIE, OR 97222 PORTLAND, OR 97214
•
Phone: Phone: 238 -5700
Reg #: LIC 00064969
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PRMT GEO 11/8/99 $50.00 99- 319546 Sprinkler Rough -In
Sprinkler Final
5PCT GEO 11/8/99 $4.00 99- 319546
FIRE GEO 11/8/99 $20.00 99- 319546
Total $74.00
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Pe rm itee \ j
S nature: �'.',, , r4 i ' % . c , - te
-
Call 639-4 5 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application Plan Check # — 5
CITY OF.TIGARD Commercial or Residential Rec'd By -
13125 SW HALL BLVD. Date Rec'd - -
TIGARD, OR 97223 Print or Type Date to P.E. —'
(503) 639 -4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST 1 4 Permit #846 9 IV
Called I I - 9 - 1 'i
Job Name -- - velopm env roj / 69� Type of System (Complete A or B as applicable)
Address Address A.) Sprinkler Wet ❑ Dry ❑
N X/1 S%Ge�e ANTI Standpipes
Owner Mailing Address � Hazard Group
Additional
City/State Zip Phong Information Density
Name Design Area
(
Occupant Mailing Address K. Factor
City/State Zip Phone A.1) Sprinkler Project Valuation $
Contractor Name r/ ���,Op C � B.) Fire Alarm
(Sprinkler or ('i9i r .. 5 a »4/ 5
Alarm Company) Mailing Address Submittal Shall Include Battery Calculations YES ❑
Prior to permit //eQ/ ,S',g fed
issuance, a City/State Zip Phone Individual Component YES ❑
copy Cut Sheets
of all licenses � , 0 - fly 3V - 570o B.1) Fire Alarm Project Valuation $
are required if State Const. Cont. Board Lic.# Exp. Date
expired in COT
database !y"' t `1, .761 Project Valuation Subtotal (A & or B) $ / !,I/ op
Name Permit fee based on valuation
(see chart on back) $ s-19 ��
Architect Mailing Address 7% ° �/
Surcharge $ T 00
City /State Zip Phone FLS Plan Review 40% of Permit
Describe work A.) New a Addition 0 Alteration 0 Repair O TOTAL $
to be done: /24 . op
B.) Modification to sprinkler heads only:
1. 1 -10 heads= No plans required Plans required: Submit three sets of plans, including a vicinity map and
2. 11 += Plan review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application, that the information given is
Number of sprinkler heads: correct, that I am the owner or authorized agent of the owner, and that plans submitted
Additional Description of Work: ,C`, ,f -?ILA/ ,� are in compliance with Oregon State laws.
7 l ,� / C �irf la Slgnat o O wner/Ag tt Date ,/ �j
A.) In Existing Building ew Building ❑ /7- r/_ ! 69
Building Contac Pe on me Phone
Data B.) Commercial gesidential ❑ B ® � f / 76
FOR OFFICE USE ONLY:
No. of stories: Plat # Map/TL #:
Sq. Ft: / , /35 -633'/
Notes C - i f- Z. e070 / ?--
Occupancy Class Type of Construction duvvt
A P _ 7' -k. a L 0 , e
i :\dsts \forms \firesupr.doc 7/2/99 //-62--P,
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BPS
(-11-0 3
1/24/2001 Information Summary fo' Case #: BUP1999 -00471
1:26:35 PM
Activity
Hold Updated
Activity Description Date 1 Date 2 Date 3 Dish. Level By Updated
BUPC784 Sprinkler Final 12/8/1999 12/8/1999 12/8/1999 PART' No Hold RB 12/8/1999
tOCObtain ELC permit.
Restaurant in operation!- Washington County Health Dept.- OK
,MEC1999 -00445 (Hood)- OK
Fire Extinguisher req'd. Purchased this date through Sanderson. Identification of fire extinguisher shall be placed at location.
!Trip Test- OK (Certification received.)
BUPC799 Final Inspection No Hold RB 12/8/1999
BUPC005 Application received 11/4/1999 RECD No Hold GEO 11/8/1999
•
BUPC008 Permit created 11/8/1999 DONE No Hold GEO 11/8/1999
BUPC012 Plans routed to Plans Examiner 11/8/1999 SENT No Hold GEO 11/8/1999
BUPCO29 DST Post Review Completed No Hold GEO 11/8/1999
Need Washington County Health Dept letter.
BUPCO24 Plans Approved by CPE 11/8/1999 DONE No Hold RDP 11/8/1999
BUPCO22 Plans Approved /Routed to DSTs 11/8/1999 DONE No Hold RDP 11/8/1999
BUPC530 Electrical Permit Required 11/8/1999 11/8/1999 No Hold RDP 11/8/1999
BUPC784 Sprinkler Final 11/8/1999 11/8/1999 11/30/1 FAIL ' No Hold TLP 12/1/1999
BUPCO29 DST Post Review Completed 11/9/1999 DONE No Hold BON 11/9/1999
•
BUPC090 (F) Ready to issue 11/9/1999 DONE No Hold BON 11/9/1999 •
BUPC100 (F) Issue permit 11/22/1999 DONE No Hold DEB 11/22/1999
Per Jim Funk, the Wa County Health Dept approval letter is NOT required for the FPS permit. Spoke with Sanderson Safety, they
requested that I issue and mail the permit on this date.
BUPC945 Request inspection research 1/24/2001 DONE No Hold JMT 1/24/2001
•
•
Fees
•
Fee Trans. Create Created
Type Description Code Revenue Account No. Date By Amt. Due
PRMT [BUILD] Permit Fee 245 - 0000 - 432000 11/8/1999 GEO $50.00
5PCT [TAX] 8% State Tax 100 - 0000 - 207020 11/8/1999 GEO $4.00
FIRE [FLS] FLS Pln Rv 245 - 0000 - 433020 11/8/1999 GEO $20.00
•
Case People Listing
Role
Type Name / Address Company Name Hold Primary
CON SANDERSON SAFETY SUPPLY CO. • N
1101 SE 3RD ST PORTLAND OR 97214
OWN TIGARD PROPERTIES INC Y
2106 SE OCHOCO ST MILWAUKIE OR 97222
.. _ u •
-- PERMIT "PLAN
■
L = H ■ l T
Building Permit IBM ElIP1:3i'3-U04±1 3t jtus I Er F
Name: TIGARD PROPERTIES INC Updated: 12 -15 -99 JMT General
Address: 11945 SW PACIFIC HWY 242 Jur: TIG
Description: Master # (BUP1999 -00471 1 Project: (FIRST WOK 1 .Pecifics &
Areas
(F ire suppresssion for Type I exhaust hood.
Setbacks
Reissue: I Const.
Class of Work: FPS 1 Dates
Type of Use: COM l Received: 111/8/1999 1 Required
Items
Type of Construction: Target:
Occupancy Group: I Issued: 11/22/1999 1
Occupancy Load: I Expired: 15/20/2000 1
Valuation: $1,740.001 Finaled: 1 I
! l.: a , 11 4 6PERIIIIIIf'PLAN I 1 0 4 .l u - 1 _ . : "
Copyright ®1997 -1999 Tidemark Computer Systems Inc. 1/24/2001
All Rights Reserved.
i
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour In$eection Line: 639 -4175 Business Line: 639 -4171 „��
Date Requested AM PM BLD (
Location / / % 4S 5" Cc Gr f-� G� thakSuite MEC
Contact Person CPh PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
T
Post & Beam
Ext Sheath /Shear �'�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall ^�
Fire Sprinkler / 6 � �' Cl 1 ---
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer N o
Rain Drains
Final
PASS PART FAIL
M.L
71 : 111 7 - Team
Rough In �
Gas Line Y
S �� mm�. Dampers 1.4-
1Ir��!r'
S PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk � Date 2? / Inspector Ext
9 ns eco ( '�' / x
Other P
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
GAR BUILDING INSPECTION DIVISION
MST
24 -Hour 1 ection Line: 639 - 4175 Business Line: 639 -4171 BUP iqq? 6
( Date Requested t 1 1( 1 AM PM BLD
Location 11 � - go P;t C 4 Pt �- 4 Suite e)-(f MEC 4
Contact Person e)0 COI) /L Ph a 3 (ag PLM
Contractor Ph SWR
BUILDING Tenant/Owner Rig- (. 1 �D ELC
Retaining Wall ELR
Footing Access:
Foundation
0:36 FPS
Ftg Drain / (� Crawl Drain Oirc1 i0 00y:y.$ ��+e -K �c or SGT
Slab SIT
Post & Beam
Ext Sheath /Shear � 5 * j_
.}�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler r
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING i77 7'
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Ball /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
4111 -
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT ' EMOVE this inspection record from the job site.
-CITY OF TOGA tD BUILDING INSPECTION ' - SION MST
'' 24 Flour Inspection Line: 639 -4175 Business � 39-4
l a i: at /BUP rg9'9 -az y7i
Date Requested �/ St ” AM • BLD c�
�fS /a.cc e., 4W Suite `f_L / CF 7� �o y �
,,pp n �, rJ sJ
Location (19 S
Contact Person 1�E� ('./rpk-1 �Y sue- Ph ---7 S' S70 Z) K (G� PLM � -�f
Contractor (o- S 2 3 e ) Ph ,.., — ' 7 �� SWR
BUILDIN Tenant/Owner , �1 \- mo rs (]
r aQ_,/" tC, 1 ELC
R etaiining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Slab
Crawl Drain Inspection Notes: A? j� .reSS (AC, U 4 e -
Post & Beam 4r-TCpt_ _ Al c u !T j , ., p SIT
Ext Sheath /Shear L .,L /l, D ek - /Luis
Int Sheath /Shear
Framing SD)/(.A.
14 -C ft) W Y LCSS -4K .4=~ 6 L(,JG,.,S
Insulation - /12)1- - j am J
Drywall Nailing ../g _ t ft
Firewall
ire Sprin 'CO
Fire arm /--)'-) / pi �-
Susp'd Ceiling .}-- L,..6, �U"'' �1
R
V
oof �i 5 A, f 6-'v.-/- L "� L /---.
Misc:
� C PTO Final 1iG l gg6;1 6 0 4-4 ` n
PASS�ART� „ FAIL /
PLUMB e -T--- I T'R y "r a Le---_
Post & Beam
Under Slab dia F ■ . ■ ‘.„� c -,N.,S`r `- �-- GI •
Top Out
Water Service
Sanitary Sewer 1 ` C- �'+--�
Rain Drains � S. fd� •
Final
PASS PAR FAIL
n 16 L host & Beam (.....w.----- 6- C.,,;(1/4_ �
Rough x t-,, ..sky- 5 _
Gas Line
S t o e Dampers e1,6■- Ce_ L C---0.--A'' L 1
tiolp PART FAIL
RICAL
Service
Rough In
UG /Slab
•
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call f r reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Q
Other Date ® ” ` Inspector Ext / I' 7
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/A«i"'111/1/ 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700
. 4. E 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333
i[HE SAFETY COMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300
k
CERTIFICATION - 41(STALLATION /INSPECTION
. ,(;
Customer Name U /r
Address ��47' ®,,� .5 /I� +� ,�.
7 a - .
SYSTEM
Model(s) and serial numbers /ka Ae ° 6 6'"`` 6 e/
Number of nozzles and Part No.g. Al fet .i, s.I1 3 • diVaretiffr
Number of detector(s) and degree rating
0
Energy shut -off devices — type and size Almir 64/ am/6 it
Other accessory equipment provided (pull station, electric switches, etc.) 4 3 4y6/' ' pe" .4.4re*
a
COOKING /VENTILATING EQUIPMENT
Number of duct(s) and size
Hood size and plenum size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those
being protected.)
1. / - :). i .k
4.
I
2. 1 — 5.
3. 6.
TO BE COMPLETED BY INSTALLER
. ❑ YES ❑ NO
The fire suppression system is installed in accordance TO BE COMPLETED BY CUSTOMER
with the manufacturer's instructions, NFPA Standard
96 and 17 (current issue), and all applicable state and
local codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO
that were observed are noted below. I understand that it is the recommendation of ANSUL
Exceptions: and of the National Fire Protection Association
Standard 96 and 17 that the fire suppression system be
inspected and maintained every 6 months to ensure
continued efficiency and reliability and that failure to
do so may result in failure of the system to operate
properly.
CUSTOMER NAME AND TITLE
❑ YES ❑ NO
All electrical work or work provided by others to SIGNATURE
complete this system installation has been completed. DATE
INSTALLER NAME
SIGNATURE y i
DISTRIBUTOR .j 001 /
ADDRESS / /(Jf 1 - P
... — ...... ,
w.
DATE ..