Permit A. CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2001 -00078
li DEVELOPMENT SERVICES DATE ISSUED: 3/14/01
13125 SW Hall Blvd., Ticrard, OR 97223 (503) 639 -4171
PARCEL: 2S101 DD -00400
SITE ADDRESS: 06825 SW SANDBURG ST
SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: C -P
BLOCK: LOT: 001 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: 3N : 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: $ 6;000.00
Remarks: Installation of fire alarm system in new building.
Owner: Contractor:
TOC MANAGEMENT SERVICES BACHOFNER DATACOM INC
6825 SW SANDBURG STREET 55 SE MAIN ST
TIGARD, OR 97223 PORTLAND, OR 97214 -3346
Phone: Phone:. 503 - 233 -2006
Reg #: LIC 111978
•
FEES • REQUIRED INSPECTIONS
Type By Date Amount Receipt Fire Alarm Insp
PRMT CTR 2/23/01 $100.90 27200100000 Final Inspection
5PCT CTR 2/23/01 $8.07 27200100000
FIRE CTR 2/23/01 $40.36 27200100000 •
Total $149.33
•
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.
Perm itee ,40
Signat e: _
•
Issue. y: 1 • Off �
Call 639 -4175 by 7 p.m. for an inspection the•next business day
P . . 4111110, --P47-7/72-gro2S ,..5 2)3 1 ) \ tIA°\
Building PE
ed: r 5 4 Permit no.: b u 69,291 -�`
111 �y City of Tigarc
. r..,a.r,a I. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ❑ Commercial/industrial Cl Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement Cl Tenant improvement Fire sprinkler /alarm ❑ Other:
JOB STI E I NFORMATION
Job address: - -,?` 1 5C1s--+ t. Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: - (7) 7 NI •
Description and location of work on premises/special conditions: �i4S 4 L .9 6(4
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 1 0 C. (Floodplain, septic capacity, solar, etc.)
Mailing address: , z„ L� flN'O Ltlar' 1 & 2 family dwelling:
Start ) . ZIP: Valuation of work $
Phone: 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.)
Covered porch area (sq. ft.)
Mailin: address:z j INcA r ..z, ; ;i Deck area (sq. ft.)
Mr UERIEMIII Other structure area (sq. ft.)
Phone: Z_,'3S ) 3 Fax e.S E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ h, C°
Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.) ....
FIMMEIEMEMIIIIIIMIE Number of stories
City: }- 74'n State:0 & ZIP: • 7o// V
Phone: 1,70. a, -. : 7 5 Fax: E -mail: Type of construction r
Occupancy group(s): Existing:
-- CCB no.: /1 / '7 8 4' �� - !f New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI l I IECT /DISlGNI;R licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $ / 4". '
Address: Date received:
City: State: ZIP: Amount received $
Phone: 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 ws and ordinances governing this 0 visa ❑ MasterCard
work will be co - • •. wi dip epecified herein or not. Credit card number: Expires
Authorized signature. Date:- Name of cardholder as shown on credit card
$
Print name: � . -} r V • a .) 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.) za New ❑ Addition ❑ Alteration Li 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:
• Additional description of work:
Type of System (Complete A or B as applicable):
A.) Sprinkler Wet ❑ Dry Li
Standpipes
Additional Hazard Group
Information Density
Design Area
•
K. Factor
Sprinkler Project Valuation: $
• B.) Fire Alarm
Submittal shall Battery Calculations Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $ (90e)®
Project Valuation Subtotal (A & B): $
Permit fee based on valuation (see chart): $ /od • C'O
8% State Surcharge: $ o7
FLS Plan Review 40% of Permit: $ i - 3�
TOTAL: $ /V9.53
i:\dsts\forms \FPSchecklist.doc 10/04/00
s ELECTRICAL PERMIT -
CITY TIGARD RESTRICTED ENERGY
�y DEVELOPMENT H BMEN f 639 -4171 DATEESSUIED: E 2702 0 00280
SITE ADDRESS: 06825 SW SANDBURG ST 0 1 / PARCEL: 2S101DD -00400
SUBDIVISION: SALEM FREEWAY SUBDIVISION O ZONING: C-P
BLOCK: LOT: 001 & JURISDICTION: TIG
Project Description: Installation of fire alarm. 1
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: X OUTDOOR LANDSC LITE:
OTHER: : HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: .
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
TOC MANAGEMENT SERVICES BACHOFNER ELECTRIC INC
6825 SW SANDBURG STREET 55 SE MAIN
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 620 -1710 Phone: 233 -2006
Reg #: LAC 00044569
SUP 2808S
ELE 26 -451C
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
•
• PRMT CTR 11/27/2000 $75.00 2720000000 Elect'I Final
5PCT CTR 11/27/200C $6.00 2720000000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Permittee Signature 0-Ax /9,, 4/e Ai / i 9-,L &y
OWNER INSTALLATION ONLY —
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day