Permit •
A i � CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00125
DEVELOPMENT SERVICES DATE ISSUED: 3/30/2005 I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134BC-00300
SITE ADDRESS: 12268 SW SCHOLLS FERRY RD ZONING: C -
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: Adding (6) sprinkler heads.
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: sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0 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: $ 1,700.00
Owner: Contractor:
BPP RETAIL LLC FIRE HEALTH & SAFETY EQUIPMENT INC
BY BURNHAM PACIFIC PROPERTIES 4611 NE MLK BLVD
ATTN: JOHN WATERS PORTLAND, OR 97211 -3347
SAN DIEGO, CA 92101
Phone: Phone: 503 - 249 - 0771
Reg #: LIC 65290
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/30/2005 $62.50
[TAX] 8% State Surcha 3/30/2005 $5.00
Total $67.50
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 in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: _ Permittee Signature: / /■
AettA 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.
I Fe Protec jon System
Building Permit Application FOR OFFICE USE ONLY
City of Tigard Received
DateB : l�l
_�� —0 !�2 permit No.:S �• 00 OA1.2
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
/ /a r a d 1,, Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 4 I I1 Date/B :
Inspection Line: 503.639.4175 e. „ Date Ready/By: Juris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: T IC.- Supplemental Information
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
®, Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling �Commercial/industrial
Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
• • JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: , 'R, 6 g S , 1.L) 5 .1 JLS F J f V lab New dwelling area: square feet
City/ State/ZIP: Pn r i-14 0 nk. Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: i!ue_kY �, Covered porch area: square feet
Cross street/directions to job site: ` Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST'
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: • Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
' II 'PROPERTY OWNER-: ' . ❑ TENANT Number of stories:
Name: 1 11` v ` . e { e _ , 13 -- \. i, \\ \\ Type of construction:
Address: Occupancy groups:
City/ State/ZIP: S Q_ ‘. P R 6 C QX Existing:
Phone: ( ) J Fax: ( ) New:
❑ APPLICANT ❑ CONTACT PERSON
_ _ , - NOTICE _,f'-.•,•j,!1: ,. ' , I ; ,
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
•• CONTRACTOR ,,
Business name:
l ✓ to t �� I-1 r� - • . d,. BUILDING PERMIT :FEES *.':;_ .:.,
Address: 1 ` /rp // .!J• L")/ .L. k: 1? C1U
1 Please refer to fee schedule.
City/State/ZIP: tPcs rr-I.i vide c)r 4 1 - A II —
Fees due upon application
Phone: (Sa3) a46' —Q 7- Fax: ( Sp3) p"7 ` - CS$-7,„k
065 a 4 Amount received
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: — T?irA. �„[Jn Li (C. r' � I Date: "5/14,41.5- * Fee methodology set by Tri -County Building Industry
Service Board.
is Building \Permits\FPS- Per,nitApp.doc 12/03 440- 4613TO1 /02/COM/WEB)
4
Fire Protection Permit Check List
Describe :workto: be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition 1. 1 -10 heads: No plan review required.
ki_Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work: A-1X) 6 1/1442- AS Ta cover p,1/44 n d
Qr�
Type of System (Complete A, B, C or D as. a licable : -
A.) Commercial Sprinkler
Pa Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor S .
Sprinkler Project Valuation: $
B.): ,Type I - Flood Fire Suppression System , ' ' 3 .
Hood Project Valuation: $
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): $ , 31)
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ K7-5
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.
i:\ Building\Forms\FPSchecklist.doc 12/24/03
CITY 05 TIGARD
BUILDING DIVISION PERMIT #: g(PZ — C012-5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1 TIME: PAGE:
SITE ADDRESS: (7-7-678 ({BLS ([ey2,12J CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
ww,1
211.rel /��, NM/ - rf
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 111 ADDITIO AL FEES ASSESSED
Inspector: tot vir Date: C 7 / �4Phone #: (503) 718-