Permit ,
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00274
zmillik DEVELOPMENT SERVICES DATE ISSUED: 7/18/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 DC -03700
SITE ADDRESS: 07095 SW SANDBURG ST ZONING: C -P
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Installation of fire suppression system in hood.
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: 0 sf N: S: E: W:
TYPE OF USE: COM SECOND: 0 sf PROJECT OPENINGS?
TYPE OF CONST: UNK : sf N: S: E: W:
OCCUPANCY GRP: UNK TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 0 HT: ft GARAGE: 0 sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: 0 FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,975.00
Owner: Contractor:
UNITED FOOD + COMMERICAL WORKERS UNIVERSAL FIRE EQUIPMENT
UNION LOCAL #555 8049 SW CIRRUS DR
PO BOX 23555 BEAVERTON, OR 97008
DGAne: RD, OR 97281
o Phone: 503 - 641 -8702
FEES Reg #: LIC 86723
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/28/2005 $62.50
[TAX] 8% State Surchari 6/28/2005 $5.00
[FLS] FLS Pln Rv 6/28/2005 $25.00
Total $92.50
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 • OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules direct questions/ f NC by
calling 503 - 246 -6.99 or 1-800-33 /
Issued By: 4 / ` I _ Permittee Signature
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
7025 sw 5 6 81F
t Fire Protection System 1.4•04o1 OS
Building Permit Ap Iica'tion FOIR OFFICE USE ONLY
R ECEIVED
City of Tigard Received
B . -, e _ _ Permit No.: 1D - - .
pate/B . • ,�� � ) A
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
�
Phone: 503.639.4171 Fax: 503.598.1960 A' ;..r'I L `• p��g r J'/, Other Permit:
Inspection Line: 503.639.4175 JUN 2005 ���!l L �_ 2 8 4. 1 Date Ready :y: ® See Page 2for
_�
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method - f la-. Supplemental Information
BUILDING DIV-1SiCN 3r0 k"z., t")41)°"` ^p
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
dition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
12 1- and 2- family dwelling Xommercial /industrial Valuation:
• ❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
lob site address: 7 �.9• 6 S
, 9 s New dwelling area: square feet
— TT City /State/ZIP: � . O r cl -7Z� � Garage /carport area: square feet
Suite/bldg. /apt. no.: 1 Project name: / 4_194 6:575 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
,S: L-0.... ?2 1 13--J-e- -4— S "9 , Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
• Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ / 97 6'
A y T14 � A � ! _ ,... 1 �C Existing building area: square feet
New building area: square feet
, PROPERTY OWNER I e a TENANT Number of stories:
Name: 60-C i „..9 z__,:, C ,9.( 65'5 Type of construction:
Address: 79-9 5 50- 161.- f, S4: Occupancy groups:
City / State/ZIP: -. A t S '7 7 3 Existing:
Phone: (603) 6FSy 2F22 Fax: ( )
New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: u h , r , S . A. f - • , iim, / (f All contractors and subcontractors are required to be
Contact name: 6 r .p� 1 � • 4 licensed with the Oregon Construction Contractors Board
/ under ORS 701 and may be required to be licensed in the
Address: g �(, f ") C4 iteY s D p, jurisdiction in which work is being performed. If the
City / State/ZIP: 2 6 C.- applicant is exempt from licensing, the following reasons
<533) 6 i- Z 2 �/ I ( - 3l -/ 'y7 apply:
Phone: Fax: :
E-mail ' —
CONTRACTOR
Business name: —5 . �tr-rr.
'_,� P7 - 6v11-(..,_ BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City /State/ZIP:
Fees due upon application
Phone: ( ) I Fax: ( ) ,
CCB Iic.: g6 72.3 t f '; Amount received
Sd q / /
j Date received:
Authorized si re: /'�/ This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
I Print n ::;(- . r P Q • P14-51-4 I Date: 6 -2g -QS • Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Pennits\FPS- PermitApp.doc 12/03 4404613T(11/02/COMAVEB)
r 4, t • • � •
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe ork to be done:
1.) ) New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: I $ j t7 j•.d b
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
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.
l:\Building\Permits\FPS- PermitApp.doc 2
TIGARD ..
BUILDING DIVISION PERMIT #: BUP2005 -00274
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/18/2005
Phone: (503) 639 -4171 *yl
Inspection Requests (24 Hrs.): (503) 639 -4175 ..- ..
INSPECTION WORKSHEET FOR DATE: 8/30/2005 TIME: 7 :11AM PAGE: 94
SITE ADDRESS: 07095 SW SANDBURG ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LOCAL 555
DESCRIPTION: Installation of fire suppression system in hood.
OWNER: UNITED FOOD + COMMERICAL WORKERS, PHONE #:
CONTRACTOR: UNIVERSAL FIRE EQUIPMENT PHONE #: 503641 -8702
Inspection Request Scheduled For: Date: 8/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
920 Suppression trip test 014573.01 503 - 641 -8702 Y
998 N_Pct N 1 3 ._ 0 14GI 1-o1
Corrections /Comments /Instructions: z� l 4 576'1E--—.
IlgitU
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 111 ADDITInNAL F ES ASSESSED
ork IG,
Inspector: Date. Phone #: (503) 718-