Permit f' BUILDING PERMIT
CITY OF TIGARD `y� '4' r
P ERMIT #: BUP2002 -00078
x i DEVELOPMENT SERVICES DATE ISSUED: 3/21/02
• ��� �� 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -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: 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: B TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 204 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: $ 2,800.00 , ,
Remarks: Fire sprinklers.
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:- 503 - 620 -2086 Phone: 360- 693 -9906
Reg #: LIC 49732
' FEES REQUIRED INSPECTIONS
Type By Date . Amount Receipt Sprinkler inspection
PRMT CTR _ 3/6/02 $72.10 27200200000 Sprinkler Final
5PCT CTR 3/6/02 $5.77 27200200000 '.
FIRE CTR 3/6/02 $28.84 27200200000 '
' Total $106.71 .. .
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180' days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law .
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 _through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 • ::: - -2344.
c
. _
Sig :turd: - - ) t ,
Iss -4:1 By: ! _'! 1 iilCid_> .
Call 639 -4175 by 7 p.m. for an inspection the next business day ,
41t - = it 3 /3 oz_
Building Permit Application T ..:. -F- ,./-..,,'). D atereceived: Permit no.:
� •�t�. - �y City of Tigard
EIVED /07/1 — ( . — (27o - 7�
' __ Projecdappl. no.: Expire date:
Address: 13125 SW Hall Blvd, F E aR 223
Ciry of Tigard Phone: (503) 639 -4171
Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 MAR 0 6 70t2 Case file no.: Payment type:
OF Flli�►1�D `�
Land use approval: �� - 0 N 1 &2 f amily: S imple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ CommerciaUindustrial ❑ Multi- family ❑ New construction 0 Demolition
0 Addition/alteration /replacement ❑ Tenant improvement ,'Fire sprinkler /alarm 0 Other: `
JOB SITE INFORMATION
Job address: g 0 GO 5. In/ , 'fAff /e, Bldg. no.: Suite no.: %.
Lot: I Block: 'Subdivision: I Tax map /tax lot/account no.: V--
`
Project name: Cam e.r on " Z A
Description and location of work on premises/special conditions: 7U7r7 Pn t i/Y1iro ver'n./ 1 .EE/ nf/ cL cf.--,--
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: e I✓ , sc i,,,,,.0,-/$ (Floodplain, septic capacity, solar, etc.)
Mailing address: SG6 S 5. t.✓. (i?e'.do ids ZI dl. 0 300 1 & 2 family dwelling:
City: L4 ke 03'461 1 b 'State: OR ZIP: 9 7.93.5 Valuation of work $
Phone:co - . 5' - -2 0 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.)
Name: Ft re Sys ft,-.13 tie_ S , Covered porch area (sq. ft.)
Mailing address: 600 S. r. /17,,!',>✓.',re_ Ai 4,_. 1 6('f0 Deck area (sq. ft.)
City: (JCJICO (.vex' I State:y I ZIP: 9' g 6 6/ Other structure area (sq. ft.)
Fax:543 E -mail: o
Phone:36O -69J- f4 dV . zZo4 Lttt•/�Jt�rt, tam oCi mmercial/industrial/multi- family:
a•+�
•• CONTRACTOR s Vafuatlon of work $ / 1
Existing bldg. area (sq. ft.) O. 400
Business name: Frt. SYf itt'MS W r y New bldg. area (sq. ft.) . , rtA.. — •ohs
Address: 6 d 0 5, F M I -,' ,l,! M L A vt . 01 00 Number of stories Z
City: , /&4C0 w I State: i.d 9 I ZIP: 9 4 6 / Type of construction 5re e../ fi.v'►e_
Phone: J60 -693 . 77061 Fax:f -22 E -mail: Occupancy group(s): Existing: L l /t t z
CCB no.: _ New: 'eh./ Ii
City /metro lic. no.: 45-- • E , 7 -0/-02— Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: Z..-K3 - me h I. le c--/-5 provisions of ORS 701 and may be required to be licensed in the
Address: / /L! f, hi. SaJrtiot, $�, jurisdiction where work is being performed. If the applicant is
City: rbr f / mil I Statel0� I ZIP: 9 zp exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: 503- Z L Fax: E -mail:
ENGINEER
Name: ' inK Coast4 //r Contact person: Fees due upon application $ /0 6. 71
Address: 31'3 �j f t,/, K t� il /f pe. Date received:
City: par/ 4,/I r IState4R IZIP: 5720/ Amount received $
Phone:5o3- 2z1_9, j 3 I Fax: I 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 ❑ Visa O MasterCard
work will be complied with, whether spe ifre h in or not. Credit card number: / /
Expires
Authorized signature: � Date: 3 - 9- 2 .— Name of cardholder as shown on credit card
Print name: 4 et_ LA) hL f2e. Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
Fire Protection Permit Check List
A.) ❑ New ❑ Addition i4 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: a
Additional description of work:
Type of System (Complete A, B or C as applicable):
A.) Sprinkler Wet Dry ❑ _.
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 42, $00
B.) Type I - Hood Fire Suppression System
Hood Project Valuation I $
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $ a, 100
Permit fee based on valuation (see chart): $ 7a. Io •
8% State Surcharge: $ S, 77
FLS Plan Review 40% of Permit: $ as. 8 4
TOTAL: $ /06.7 I
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