Permit r ~' BUILDING PERMIT
.A CITY OF TIGARD PERMIT #: BUP2005 -00177
� DEVELOPMENT SERVICES DATE ISSUED: 4/22/2005
1 1I I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S 134BC -00300
SITE ADDRESS: 12272 SW SCHOLLS FERRY RD ZONING: C - G
SUBDIVISION: GREENWAY TOWN CENTER LOT: JURISDICTION: TIG
Project Description: Fire supression (6) 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: 3N sf N: S: E: W:
OCCUPANCY GRP: A2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 174 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: $ 1,350.00
Owner: Contractor:
BPP RETAIL LLC GUARDIAN FIRE PROTECTION
BY BURNHAM PACIFIC PROPERTIES 1012 SW A ST
ATTN: JOHN WATERS CORVALLIS, OR 97333
SAN DIEGO, CA 92101
Phone: Phone: 541 - 752 - 2258
Reg #: LIC 100355
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/22/2005 $62.50
[TAX] 8% State Surcha 4/22/2005 $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: 4 "..
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.
FirProtection System
, r , Buildine Permit Annli EIVED 1.-cm Orrlcl: rsl: ONI.1
City of Tigard Received D — _0' Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 AQR 2. 2 2 I A Plan Review - / � OO 6�1 Phone: 503.639.4171 Fax: 503.598.1960 i . DateIB . Other Permit:
Inspection Line: 503.639.4175 Y Q Ti :_ ► I ' 'I I Date Ready/By: . ®See Page 2 for
Internet: www.ci.tigard.or.us C G Notified/Method Supplemental Information
SUIL004 1
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
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 , pt
Camercial /industrial Valuation: $
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Oth Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 12, L7 . s 641; s . 4 �`/ ,,, ok New dwelling area: square feet
City / State/ZIP: �- 9 1 t , Garage /carport area: square feet
Suite/bldg. /apt. no.: / C Y I Project name: a,- `ff � .4 7; .el s 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: 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.
...C—
< < /0 aluation: $ /3
; C/� /Of E 4s.6►D Al_ a y�,�t, —
.[ d� �/ Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( )
New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: G L4,A 42 jC !2 c e ,, !, All contractors and subcontractors are required to be
Contact name: E„¢,� �,, y cv ✓J licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 10 / l i,!/. 4r C jurisdiction in which work is being performed. If the
City/ State/ZIP: 6 t ' 4 //i s � 77 t 3 >
applicant is exempt from licensing, the following reasons
Phone: (��)() 7 ` ..,> •Sis I Fax:: (S4 () 7 cs ii_ -y
E -mail:
CONTRACTOR
Business name: V c.„4ZfC,1 /. �,...c / BUILDING PERMIT FEES*
Address: S � Pi
in �� G s Please refer to fee schedule.
City / State/ZIP: 6. / a:3e 9.7,',, Fees due upon application
Phone: (gri I) / Z..*m_ 5 I Fax: ( 5 4 (1) `75 2.5"9'
Amount received
CCB lic.: /OD S
Date received:
Authorized This permit application expires if a permit is not obtained
�c, within 180 days after it has been accepted as complete.
I Print name: 7 f aeze �Q v ,� xl9�/ Date: is-/ — ` ca - 4" — f • Fee methodology set by Tri -County Building Industry
Service Board.
i:\ Building \Permiu\FPS- PnmitApp.doc 12/03 440- 4613T(11 /02/COM/WEB)
4
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition El 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair b
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 $
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.
I:\Building\Permits \FPS- PertnitApp.doc 2
CITY OF TIGARD ^7
BUILDING DIVISION PERMIT #:r '� ( 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 U- 1L.
INSPECTION WORKSHEET FOR DATE: G> ( G / 0 TIME: PAGE:
SITE ADDRESS: (Z527/7.- Zg Qy CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: Mc $qjAM, VS
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
920 - T&2 TU
Corrections/Comments/Instructions:
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(P EST-- HIV
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIO AL F ES ASSESSED
1
Inspector: Date: JIIIP Phone #: (503) 718-