Permit • CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00096
A . 4 4010 (k DEVELOPMENT SERVICES DATE ISSUED: 3/15/01
'�� Ja 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD PARCEL: 1S1346C -00300
SUBDIVISION: ZONING: C -G
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: : sf N: S: E: W:
OCCUPANCY GRP: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 225.00
Remarks: Adding two sprinkler heads
Owner: Contractor:
BPP RETAIL LLC LARSEN FIRE PROTECTION CO
BY BURNHAM PACIFIC PROPERTIES LYLE LOUIS LARSEN
ATTN: JOHN WATERS 16410 S HIRAM AVE
SAN D I GO, CA 92101 ORAON E. 4 J O R 97045
Reg #: LIC 118596
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 3/15/01 $62.50 27200100000 Sprinkler Final
5PCT CTR 3/15/01 $5.00 27200100000
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Perm itee
Signature: /2)511Pin /
Issued By: 1 f/414 Q.e...
Call 639 -4175 by 7 p.m. for an inspection the next business day
, .. Building Permit Application
City of Tigard Date received: 3 I t�d t Pe n : gooi -
Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF puma
❑ I & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement IX Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: 1 __ ; 0 .S v! - ,,1\ . , .p • R. Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: . o • • L
Description and location of work on ises/special conditions: (! a) S ∎ nc.le 1-1@o00C.
00
- S Si-N. • - I; M iT e , co 1 -QC) 0' a o of - Gry / ?.
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: State: 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.)
- Deck area (sq. ft.)
Mailing ad 1 y 1 ■ �; OAS Other structure area (sq. ft.)
ZIP:
Phone: 6,-AM,, Fax: . - 691- E -mail: Commercial/industrial/multi- family: ^^
CONTRACTOR Valuation of work $ oC oc*, a o
Existing bldg. area (sq. ft.)
Business name: CASSC■\ Wu L • n ' VNC, New bldg. area (sq. ft.)
Address: 1. • C' vv. A■Je_
City: pc- Cyr ECM ZIP: . , 04 Number of stories
Type of construction
Phone: Fax: E -mail: Occupancy group(s): Existing:
CCB no.: 1 l $.c
New:
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCI IITEC 17DESIGN 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 $
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 laws . • ordinances governing this ❑ Visa ❑ Mastercard
work will be complied with, whe er s • - d herei t , of j l Credit card number: / /
�/ i Expires
Authorized signature: Date: / -SA 1 Name of cardholder as shown on credit card
Print name: ON3."1k2v•.) tAct_ P. y $
( Cardholder signature Amount
Notice: This permit application expires if a permit i i not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COM)
0.1
Fire Protection Permit Check List
A.) ❑ New Addition ❑ Alteration a 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: o�
Additional description of work:
•
Type of System (Complete A or B as applicable):
A.) Sprinkler Wet Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1`46 00
B.) Fire Alarm
Submittal shall Battery Calculations Yes Li
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $ aoa
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $ 67, 5
is \dsts\forms \FPSchecklist.doc 10/04/00
BUP - •Building Permit ELC - Electrical Permit
J Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical fmal
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing J Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical fmal
Masonry/Reinforcement
Framing
MFG- Structure set -up MEC - Mechanical Permit
Insulation Inspection Description Date Passed By
Drywall nailing Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofmg Lab Final
Structural observation Mechanical final
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab _
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in 316 la Plumbing top -out
Sprinkler final 3t k411 0 t RP/backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls _ Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS
CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2001 -00096
42- DEVELOPMENT SERVICES DATE ISSUED: 3/15/01
=' ;.� II 13125 SW Hall Blvd.. Ti lard. OR 97223 (503) 639 -4171
SITE ADDRESS: 12280 SW SCHOLLS FERRY RD PARCEL: 1S1346C -00300
SUBDIVISION: ZONING: C -G
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: : sf N: S: E: W:
OCCUPANCY GRP: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 225.00
Remarks: Adding two sprinkler heads
Owner: Contractor:
BPP RETAIL LLC LARSEN FIRE PROTECTION CO
' BY BURNHAM PACIFIC PROPERTIES LYLE LOUIS LARSEN
ATTN: JOHN WATERS 16410 S HIRAM AVE
SAID CA 92101 °EigoGnCell C.1 , 97045
Reg #: LIC 118596
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 3/15/01 $62.50 27200100000 Sprinkler Final
5PCT CTR 3/15/01 $5.00 27200100000
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 mor
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.
Permitee
Signature: /
Issued By: 7T 4'vl
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD BUILDING INSPECTION DIVISION 70 7 4- �'
24 -Hour inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP 2(.4, / - 9 �.
Date Requested .3 - I AM PM BLD
Location / L Z Sa S r✓ saw') Suite MEC
Contact Person Ph �,�,� y14 ' PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
ire Alarm
Susp'd Ceiling
Roof
M'
na
PASS PART FAIL
LU ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
• Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �, 1
Approach /Sidewalk Date i 1 l \ �� \ I nspec t or E x t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.