Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00452
*As DEVELOPMENT SERVICES DA ISSUED: 12/18/01
'' ,. � II 13125 SW Hall Blvd., Tigard, OR 97223 (5031639 -4171
SITE ADDRESS: 08060 SW PFAFFLE ST . PARCEL: 1S136CD -00600
SUBDIVISION: SPRINT PCS WIRELESS MONOPOLE ZONING: C -P
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: AI/ 0 FIRST: sf N: S: E: W:
TYPE OF USE: '60M SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0.00 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: $ 30,731.00
Remarks: Fire Protection.
Owner: Contractor:
EEI SOLUTIONS FIRE SYSTEMS WEST INC -
5665 SW MEADOWS RD, SUITE 300 600 SE MARITIME AVE #300
LAKE OSWEGO, OR 97035 VANCOUVER, WA 98661 .
Phone: Phone: 360- 693 -9906
Reg #: LAC 49732
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT DLH 12/10/01 $325.53 2001 -4805 Sprinkler Rough -In
Sprinkler Final
PRM2 CTR 12/18/01 $2.77 27200100000
5PCT CTR 12/18/01 $26.26 27200100000
FIRE CTR 12/18/01 $131.32 27200100000
Total $485.88
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 -6699 or 1- 800 -332 -2344.
Perm ittee C
Sign re: �� 1. 41 ,
Is ued By: ,,
� Call 63 • -4175 by 7 p.m. for an inspection the next business day -
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Building Permit Application
Date received: 12 - 1 -0 1 Permit no.:, /J p„, _ 'I5 �--
‘-' . l'k City of Tigard
- Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By: 4 7 Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex: `yam
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory Commercial /industrial ❑ Multi- family ❑ New construction ❑ Demolition N;
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: ', () . • s, tAl, Pf /e. 37 i &el_ Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: _ tr, , c 4
Description and location of work on premises/special conditions: c'/e Pro f c'fr'0/7 /0/ .She- ii And O!/ ct 5 X
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: Phi SOYA .o S ( Floodplain ,,septiccapacity,solar,etc.) -'.f
Mailing address: 566 S h/. /J7G& • el./5 Rd. 300 1 & 2 family dwelling: I
City: G 0 we 0 State: OR ZIP: ' 7035 Valuation of work $
Phone:50 - • - 1 Sc Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
.'- • APPLICANT Garage/carport area (sq. ft.) 4
Covered porch area (sq. ft.)
Name: P,' Sys tem.5 kle 51' Deck area (sq. ft.)
Mailing address: , 0 _, F. f 7 t; ;' ' VG• 300
City: (Jcr/Gvut/er El=73 ZIP: - 1 `, Other structure area (sq. ft.)
Phone:360 - G9 - • • 06 Fax:513-�q 0 $ � C�m L m o e iaUindustriaUmulti- family: cc
CONTRACTOR
ialuation of work $ ,0� 7.3/
r C s f p S �' Existing bldg. area (sq. ft.) '
c
Business name: New bldg. area (sq. ft.) a �00
Address: 00 . . i71 -' 7 i /)1 t. • c. • do z
Number of stories
City: CO dv MIMI ZIP: • •, 6 6 J
Type of construction S ttt. 1 5 •
Phone: ,,D - G9 - 5. od Fax: 5 ..,q. c T.Ct/'1
Soccupancy group(s): Existing: /01..
CCBno.: c L iP 457301 New: 1••.' +w Aug
City /metro lie, no.: f S 40 EX. /O- 0 / 0 Z Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER • licensed with the Oregon Construction Contractors Board under
IMENIMIMERIIIMIIIMIll provisions of ORS 701 and may be required to be licensed in the
Address: /2 , . W, , I - '1 d J 1 jurisdiction where work is being performed. If the applicant is
City: o r.f kel 1.
State:O ' ZIP: ' 211 exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: 50 - t21 -sill Fax: E -mail:
ENGINEER
Name: I1-f l K 6sN5i1N Contact person: Fees due upon application $ 4 8 8
Address: 3 3 0../. ._ II : L. Date received:
EirilliEZM ZIP: U so Amount received $ 325".c3
Phone: co- 222- q Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this U Visa ❑ MasterCard
work will be complied with, whethe spec' d herein or not. Credit card number: Expires /
�/� �
Authorized signature: a'{-• - / Date: / - 7` Of Name of cardholder as shown on credit card
Print name: L ee 1AMt f Zt% / Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 4w -46t3 (6ro3/COM)
f LS
4 4icil I yes ,e, -
Fire Protection Permit Check List
A.) XNew ❑ Addition ❑ Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads: /al
Additional description of work:
Type of System (Complete A, B or C as applicable):
A.) Sprinkler Wet ) Dry ❑
Standpipes
Additional Hazard Group L 9 ht
Information Density JO 9pinl5t. F-.
Design Area 900 S Ft.
K. Factor �d.0
Sprinkler Project Valuation: $ 30, 731
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: $
Project Valuation Subtotal (A, B & C): $ 3 0, 73/ =°—
Permit fee based on valuation (see chart): $ 3 aZ, 3O 1i •
8% State Surcharge: $ PG , a 6 —
FLS Plan Review 40% of Permit: $ / 3 / . 3 a -
TOTAL: $ 4%.c. 88
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.
is \dsts \forms \FPSchecklist.doc 11/21/01