Permit C ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00446
r� DEVELOPMENT SERVICES DATE ISSUED: 12/17/01
4. " ��' �I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12220 SW SCHOLLS FERRY RD PARCEL: 1S134BC -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: 5N : sf N: S: E: W:
OCCUPANCY GRP: M 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: $ 825.00
Remarks: Install new grease hood and fire suppression system
Owner: Contractor:
BPP RETAIL LLC UNITED FIRE AND SAFETY
BY BURNHAM PACIFIC PROPERTIES 4611 NE MARTIN LUTHER KING JR
ATTN: JOHN WATERS PORTLAND, OR 97211
SAN CA 92101
rnone: Phone: 503 - 249 -0771
Reg #: SIC 00065290
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Mechanical Permit Require
5PCT CTR 12/5/01 $5.00 27200100000 Sprinkler inspection
PRMT CTR 12/5/01 $62.50 27200100000 Sprinkler Final
FIRE CTR 12/5/01 $25.00 27200100000
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 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 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature: 9?'7 2/2i( "O(S{lG//f4-
Issued By: - 4.► / .
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
. (2.-4,.., L - 2-isieri
y Building Permit Application
� f � , Date '6, p 1 Permit no.: 130 art/
, ,i� i � City of C Tigard
' - Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By:Q>) I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory WI Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: _ _ _ip IEW . 4 1MINEWMPMMIIII Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: _ , . v •
Description and location of work on premises/special conditions: ��-eg LI L4 L 30 e.7 S y .n
i !'h It)e -4J tv kau cr p t\'l OQl r i
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: I & 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.)
lial 411
Covered porch area (sq. ft.)
Mailing address: 1 is. r I Deck area (sq. ft.)
Other structure area (sq. ft.)
City: , , , �� State: p ZIP: _LA Other
Phone: 5b3 y { ��L E -mail: e2�
CONTRACIOR Valuation of work $ �J
MIMI NO
WA bldg. area (sq. ft.)
■ ��i� ='' M. New bldg. area (sq. ft.)
Address: k, I . L _ L :1,)
.� � ZIP: � L Number of stories
Type of construction
Phone: y./ .. 71, E -mail:
� Occupancy group(s): Existing:
CCB no.: , _ New:
City /metro lic. no.: 3 Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER 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 cants, please call jurisdiction for more informatio
rd
attached checklist. All provisions of laws and ordinances governing this o Visa 0 MasterCard
work will be complied t, whether �s ctfied herein or not. / Credit card number: Ex /
(/J u O / Date: / � S( P
Authorized signature: v t Name of cardholder as shown on credit card
Print name: E1) 1.4.) i (( 044 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.) ❑ New ❑ Addition ❑ Alteration ❑ 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, B or C as applicable):
A.) Sprinkler Wet ❑ Dry ❑ _
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $ g �S
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $ S`
Permit fee based on valuation (see chart): $ (7a
8% State Surcharge: $ S , o(J
FLS Plan Review 40% of Permit: $ as 00
TOTAL: $ S7)
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.
is \dsts \forms \FPSchecklist.doc 11/21/01
CITY OFJIGARD 24 -Hour I
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST -____
Received Date Requested r 2_2 AM PM BUP
Location / Z -- L - 2, 0 ,tjti F' Re/ Suite EC — 0 0
Contact Person r-d / / d h ( ) 4 / c / - D 7 7/ PLM
Contractor Ph ( ) S7 5-7$ 1 SWR
BUILDING Tenant/Owner Cc_vw L--' ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes c9,_ j rzet4._ SIT
Post & Beam L(.-4, -�1�
Shear Anchors - /�_
Ext Sheath/Shear c i�1/ � Y4 . _
Int Sheath/Shear
Framing
Insulation _7 GtJy( f '
Drywall Nailing
Firewa I
ire Spri kl � re
ire arm ... � 6
R Ceiling of (
Roof s
S
o ` 2. 01.1%
Other: 1, 12 / 71/t v( — W,nki-c,erx--e'
Fin
AS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In y t
Water Service
Sanitary Sewer
Rain Drains r
Catch Basin I Manhole / / n"
Storm Drain
Shower Pan 1
Other:
Final
PASS PA FAIL
- o : eam
Gas Line
Smoke Dampers
Fina
mo w PART FAIL
RICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA I
Approach/Sidewalk Date ` — Inspector \ Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL