Permit !w
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00232
1�; DEVELOPMENT SERVICES DATE ISSUED: 6/10/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (5031639 -4171
SITE ADDRESS: 11365 SW TIGARD ST PARCEL: 1S134DC -00700
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: A2.1 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1,132 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: $ 2,250.00
Remarks: Type 1 hood.
Owner: Contractor:
BAPS TEMPLE GUARDIAN FIRE PROTECTION
PO BOX 41160 1012 SW A ST
SAN JOSE, CA 95160 CORVALLIS, OR 97333
Phone: 408 - 453 -6464
Phone: 408 - 453 -6464
Reg #: 50-752-2T66355
FEES REQUIRED INSPECTIONS
Description Date Amount Final Inspection
[BUILD] Permit Fee 5/19/2004 $72.10
[TAX] 8% State Surcharq 5/19/2004 $5.77
[FLS] FLS Pin Rv 5/19/2004 $28.84
Total $106.71
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: b_,I_j , / ii` _e lit — . i /
Permittee l
Signature: AY yc„._
Call 639 -4175 by 7 p.m. for an inspection the next business day
1 50 Tim
Fire Protection System
p4PS 14 tr,
uirding Permit Application FOR OFFICE USE ONLY
Reced
City of Tigard Date VI ( �j/ / ,f Z( � PePermit ut No e �p � 13125 S W Hall Blvd., Tigard, OR 97223 Plan Revie //
Phone: 503.639.4171 Fax 503.598.1960 � ;l li Date/BY b- 7 '0 11 /13. Other Permit
Inspection Line. 503.639 4175 � ^• Date Ready/By /eris El See Page 2 for
Internet: www ci tigard.or us Notified/Method, / g / , L{ Supplemental Information
• TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
• Ei.1, ew 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 ap lication. c
❑ I - and 2- family dwelling commercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
• JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: // 3 66 s' �-c, 7Lc 9 . 4 _ 4 4 s4. New dwelling area. square feet
City/State/ZIP: 7 C 0171 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 3, 4 / 6: S, -�' / w4( 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, matenals, labor, overhead, and the profit for the
' DESCRIPTION OF WORK work indicated on this application.
U -.
Valuation: $ 2-' - p-- --
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stones:
Name: Type of construction: if / N /l.
Address: Occupancy groups: A 2 , 1
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
,a-APPLICANT . • ❑ CONTACT PERSON ' ' . NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
5 under ORS 7101 and may bei required to be licensed in the
Address: jurisdiction in which work
1s being performed If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone:( ) I Fax::( )
E -mail:
CONTRACTOR .
Business name: ' /j.J /% /
lc���
6; c C� st 1 </1 � s BUILDING PERMIT FEES*
Address: L(�/ / 1�- 4 Please refer to fee schedule
City/ State/ZIP: J � p
2(� ` ! `� ' ` J L 7 3 3 Fees due upon application
P h o n e : ( / / ) 7 S'Z — �Z l Fax• ( 7s 4 0- s
CCB lie.: Amount received
/0 o
Date received:
—
Authorized signature: This permit application expires if a permit is not obtained
___.CL.Gy within 180 days after it has been accepted as complete.
Print name: -- 17): 4. ) Ftv,p sd,4 Date: c / Vori * Fee methodology set by Tn -County Building Industry
Service Board.
I \Buiiding\Permns \FPS - PermitApp doe 12103 440-4613T( I 1 /02/COM/WEB)
Fire Protection Permit Check List
Describe mirk to be done: "
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition El 1 -1 0 heads: No plan review required.
❑ Alteration El 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, .0 or D as applicable): • • "
A.). Commercial Sprinkler .
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group •
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Fire Suppre System
Hood Project Valuation: $
CO Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: - $
. D:) Residential Sprinkler,,(Stand Alone System)'"
Square Footage: Permit Fee:
z "1
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: $ A26
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 OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
• BUP42746 Ca 3D--
Received -( ( Requested ABM M BUP
Location (- Suite MEC
Contact Person Kci.it P t__2 Ph ( $'ho) .�.� / �9� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner I3 ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ' r 1 SIT
Post & Beam !_� T rd
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing L�
Firewall • Writ
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
• • i 1
PASS •ART FAIL
• LU NG II
- • & Beam war
Under Slab -�� _
Rough -In nal& f
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL •
Service
Rough-In AN.innumwrimmv-
UG /Slab
51" 4.W'MVP
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL