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Permit
CITY OF TIGARD . � �' „��;,, DEVELOPMENT SERVICES BUILDING PERMIT PERMIT # • BUP97 -0540 . 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/11/97 PARCEL: 2S102CB -00303 SITE ADDRESS...: 13165 SW PACIFIC HWY SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING:C —G BLOCK • LOT :033 JURISDICTION:TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION — CLASS OF WORK.:FPS FIRST • 0 sf N: S: E: W: TYPE OF USE...:COM SECOND...: 0 sf PROTECT OPENINGS? TYPE OF CONST.:5N ...: 0 sf N: S: E: W: OCCUPANCY GRP.:A3 TOTAL : 0 sf ROOF CONST: FIRE RET ?: OCCUPANCY LOAD: 0 BASEMENT.: 0 sf AREA SEP. RATED: STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD • 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL: SMOK DET..: DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC: BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0 VALUE. $ : 1470 Remarks : Burger King fire suppression for type -1 exhaust hood /remodel existing system to UL300 - Non C of 0 Required Owner: FEES JOHN POORMAN type amount by date recpt 14243 NW EVERGREEN PRMT $ 25.00 GEO 12/03/97 97- 301402 PORTLAND OR 5PCT $ 1.25 GEO 12/03/97 97- 301402 FIRE $ 10.00 GEO 12/03/97 97- 301402 Phone #: 645 -4616 Contractor: SANDERSON SAFETY SUPPLY CO. 1101 SE 3RD ST PORTLAND OR 97214 Phone #: 238 -5700 $ 36.25 TOTAL Reg #..: 000649 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001-10 through OAR 952- 00101987. You many obtain a copy of these rules or direct questions to OUNC by calling (503)246 -1987. Permittee Signature: .44, A , Issued By: ' ,VW +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Fire Protection Permit Application Plan Check e /0 -0 9C '1TY OF TIGARD Commercial or Residential Recd By tom d 512. SW'- ^.'.! , , ' D. Cate Rec. ,r?' 3 7 '1GAl2D, OR 97223 Print or Type Date to P.E. /0 503) 639 -4171 Ext 304 Incomplete or illegible applications will not be accepted Date to DST lam- e>( Permit 0( ` 0 WO • ?Aei ��llg�77Z fit. • Name of Development/Project Type of System (Complete A or B as applicable) Job ,?luPi e je/47G Address Address / _ it/by Sprinkler Wet ❑ Dry ❑ /1/6 5 S hti- / Z �' 17 Standpipes Name 1 D, ,o � Hazard Group Owner Marlin Additional /z/ 513 Address ,C A) I4x Information Density CJ/Stat D / `l Zip ` Pho� y 6/6 Des n Area I C1��7 g Na �j /� ,o � U K. f�' /Y� K. Factor Occupant. Mailing Address - - City/State Zip Phone . Sprinkler Project Valuation $ COT Business Tax or Metro 0 Exp. Date B. Fire - Alarm Submittal Shall Include Battery Calculations YES Contractor Name ,,y ` ©,f 1 tfLni/ . _ Individual Component YES (Sprinkler or Mailing Address Cut Sheets Alarm //V 5V = 0, Fire Alarm Project Valuation Company) rS t Zip Phone $ 17.9/40 � 97,?!/ ,3 l g --200a Project Valuation Subtotal Attach Copy State o st. Cont. Board Licit Exp. Date (A or B)„ $ / 4/ -7" of 141919 3---A9.- °Jtg r 1 Current COT Business Tax or Metro 0 Exp. Date Permit fee based on valuation $ Cie) Licenses (see chart on back) Z `-5 Name 5% Surcharge $ - S Architect Mailing Address FLS Plan Review 40% of Subtotal $ • . . d ,00 City/State Zip - Phone TOTAL $ -" Describe work A.) New 0 Addition 0 Alteration 0 Repair 0 PLANS MUST BE SUBMITTED. approved and a permit issued prior to installation. 'Three sets cf plans and site pin (and map) required whim shows location of 1 to be done: nearest B.) Basement er HoodNent 0 Spray Booth 0 I hereby akanowiedge that I have read this aoolicaoon. that the information given is Complete 0 Partial 0 Exitway 0 correct that 1 am the owner or authonzed agent of the owner, and that plans submitted are in compliance with Oregon State taws. Additional Description of Work: - /C 5Y45»(' / 75. ` l e# Sig f o, Date */2- /na ©6I t:<4'v6 5 I * 7o uL�oo i / `If 7 A.) In Existing Building Building 0 o Pers n Na a Phone Building 21- � g37Oo /70 Data B.) Commercial l"Residential 0 FOR OFFICE USE ONLY: Rat* at # - - - . Map/11#: - - - No. of stones: Sq. Ft Notes �j .�`� • Occupancy Class Type of Construction `C i / '-7 f ' .G _ 14 sts\firesupr.doc CITY CF TTGAR O c It! nINr. cc =4 c� _ .. . .. TOTAL PLAN STATE E BUILDING VALUATION PERMIT FLS REVIEW TAX PERMIT CF PROJECT FEES ( (65%) 5% ®o Im��s L 1 -1. .500 25.00 10.00 16.25 .1.25 52.50 1,5971 -1,500 25.50 10.50 17.23 1.33 55.66 1.501-1.700 28.00 11.20 18.20 1.40 58.80 1.701 -1,800 29.50 11.30 19.18 1.48 61.96 1.301 -1,900 31.00 12.40 20.15 1.55 55.10 1,S01 -2.000 32.50 13.00 21.13 1.63 68.25 2.001 -3.000 38.50 15.40 25.03 1.93 80.86 3,001 -4,000 4.4.50 17.30 28.93 2.23 93.46 4,001 -5,000 50.50 20.20 32.83 2.53 106.06 5,001 -6,000 56.:0 22.50 - 36.73 2.23 • .- 118.66 6,001 -7.000 62.50 25.00 40.53 - 3.13 131.25 7,001 -8,000 68.50 27.40 44.53 3.43 143.86 8,001 -9,000 74.50 - 29.30 48.43 - 3,73 156.46 9,001- 10,000 - 80.50 :. _ 32.20. 52.33 4.03 169,06 10,001 - 11,000 86.50 ' 34.50 56 4.33 181.66 11,C01- 12,000 92.50 - 37.00 60.13 4.63 194.25 12,C01- 13,CC0 98.50 39.40 64.03 4.93 206.86 13.001- 14,000 104.50 41.80 67.93 5.23 219.46 14,001- 15,000 110.50 44.20 - - 71.83 5.53 " - 232.06 15,001- 16,000 116.50 46.50 75.73 - 5.93 244 13.001- 17,000 122.50 49.00 79.53 6 257.25 17,001 - 18,000 129.50 5.1.40 83.53 6.43 269.36 13,001 - 19,000 134.50 53.30 87.43 . 6.73 282.46 19,00120,000 140.50 55.,20 91.33 7.03 295.06 20.00 ►21,CCO 146.50 53.50 95.23 . 7.33 307.666 21,001-Z2.000 152.50 6 1.00 99.13 7.53 320.25 2.2.001- 23,000 153.50 553.40 103.03 7.93 332.65 23.001-23,000 1 6 5310 106.93 8.23 345.46 24.001-25.0C 1 17 0.50 663.20 110.83 8.53 358.06 5 .00' 2-• - 113.75 8.75 ,- =c� t7�.:� 70.00 113.7 a.7„ r67.50 � 13.001-27.000 ►7 71.50 116.53 3.93 376. '7.7,001-23.001 184.00 73.50 119.30 9.20 386.40 -:5,001- 133.50 75. 12:L=1 9.43 395.85 9,001 - 20,000 193.00 77.21 125.45 9.55 405.30 30,001-31 ,C00 197.50 79.00 128.38 0.38 414.76 21,001 -3 2, 202.00 50.80 131. 10.10 424.20 2.2,001 33.000 205.50 • 82.50 13 13.23 432.63 33.001- 34,000 211.00 34.40 137.15 10.55 443.10 3 - 35,000 215.50 86.20 140.03 10.73 452.56 • 0 15ii3 0. CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 .4::1C:P.' Date Requested: / 7 y P.M. A.M. ` C/ T: , , Loc C56 i t , 1 /� BUP:_71 — 05-X0 Tenant: ' _..111! ,L / Sul— Bldg: MEC: Contractor: ,A /_ , , _ ! A/! / 7 S C J _II / 4 Phone: 3 - 70 PLM: Owner: �,' �/ � Phone: X / 70 ELC: ■ /1 �- ----^� dc.4.ti ELR: (� SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab - • Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Li " • / / / a Approved Approved Approved Approved ppiov Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL • O Call for reinspection �� D Reinspection fee of $ required before next inspection O Unable to inspect Inspector: ,�'1�iJ Date: / - '9k- Page of �t`A awAcirsca/7as 1101 S.E. 3RD AVENUE • PORTLAND, OREGON 97214 • (503) 238 -5700 tVM I 'P 1V 850 CONGER • EUGENE, OREGON 97402 • (503) 683 -9333 -I iSAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300 I ,Y. • CERTIFICATION - INSTALLATION /INSPECTION ks - 13 Customer Name V G6 j °� / r I if ' Address ��I b '5 . LL ,A (I i ,G_. 1 �LAJ I � . -f / C, A(_o (ri-' . SYSTEM j� _ (- _,...6, Model(s) and serial numbers 1'�- �" k' Z - / 2- 8_,,,,,,,,,L, L «r0yiiC_C 1 - ,. - _� Number of nozzles and Part No. �� _ .. 2 j V. CCU Number of detector(s) and degree rating r: Energy shut -off devices — type and size ' /' (- id (4S f/ A L i" Other accessory equipment prov (pu stat e sw etc.) / JC' rl C' .-'/ ft t e: COOKING /VENTILATING EQUIPMENT t' lir = Number of duct(s) and size L / .. " �/ .-- .Hood size and plenum size -C Lf 7g '' 'ky0 4 7 Q !� _ 7g.' !� Z( }��x Zb f Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those being � protected.) fJ �/ r 1. '7 / / / '/ f C/t /Cg'' 4. r . 2. 5. . 3. 6. TO BE COMPLETED BY INSTALLER `. ❑ YES ❑ NO P 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 l ocal codes. Exceptions to other provisions of NFPA 96 ❑ YES ❑ NO that were observed are noted below. r��q i I 1•1 J I understand that it is the recommendation of ANSUL Exceptio ) J1_ `l 7) 6 and of the National Fire Protection Association t:. /� M Standard 96 and 17 that the fire suppression system be • - NL /`` I � " 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 k- properly. CUSTOMER NAME AND TITLE ❑ YES ❑ NO All electrical work or work provided by others to SIGNATURE 4: complete this system installation has been completed. DATE INSTALLER N VU /1N U 1 1 / .4 4 - '.2 _ C ti t SIGNATURE 1.." r �•_ / ‘_ g D ISTRI BUTO / ?�' # / )- 4 S �.)1 , ► d� - .0,/- 6j /✓ ADDRESS _ )2 4 /1 ' :' C G� / • E DATE / /( -, ! C1 • I • �t�`At illIZ WVII AI 11 o S. S.E. AVENUE • P LAND, OREGON 97214 • (503) 238-5700 850 CONGER • EUGENE, OREGO MS )63 68 3 �` iSAFETYCOMPANY 2600 AIRPORT WAY, SOUTH • SEATTLE, WASHINGTON 98134 • (206) 340 -4300 . CERTIFICATION(INSTALLATI .IV1NSPECTION • Customer NameNif-Cr C_ k 1 ;\i(r . r Address .I 31 h , (. l/\/ . 1 /. % rc H LA 1 . -7 /c, Aan 2. • , SYSTEM . - Model(s) and serial numbers iL. I OZ.. - - Number of nozzles and Part No. - . ✓ . • i _ _ 1 ` , ��-- r Number of detector(s) and degree rating / R..-.- 3b 0 ti r Energy shut -off devices — type and size /4 1i'- (45 j/4 L 1/r - k . Other accessory equipment provided (pull station, electric switches, etc.) /14 / I G — C v`/ / ! C /;-i COOKING /VENTILATING EQUIPMENT Number of duct(s) and size /I IC � -.'/ (7 ` � F - Hood size and plenum size / Pi ?' 7 � �( c, / €- k -Z Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and indicate those being protected.) 1. / (ed S <A/4,:v 132f>> i..4 4. 2. 5. 3. • _ 6. TO BE COMPLETED BY INSTALLER s8' 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 r that were observed are noted below. I understand that it is the recommendation of ANSUL • Exceptions: (1' s . {a r 7i i., l• and of the National Fire Protection Association Standard 96 and 17 that the fire suppression system be ) ' .) 4. A419 L--° 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. i CUSTOMER NAME AND TITLE YES ❑ NO 1 All electrical work or work provided by others to SIGNATURE ,. complete this system installation has been completed. DATE it . 11 ti W til E 4 , t i 1 i �.y INSTA NAME V- • . , , . _ ,,_ - t- SIGNATURE _ - /�d. /L�, ,- - /*�•. r ' /- G - - rY DISTRIBUTOR 57.4.A.0 6.72-S �!✓ C i 6 - 4 : : : ! 1 , _,, `- 7 , - Lam 4 , ,,47 - 74 ADDRESS � /1,30 v c ✓' 1 t .7e4 DATE /,/ 1 / , r