Permit A, - ` O F TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00111
II, DEVELOPMENT SERVICES DATE ISSUED: 4/5/04
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134DC-00700
SITE ADDRESS: 11365 SW TIGARD ST
SUBDIVISION: ZONING: R - 4.5
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: 5 - 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: $ 15,000.00
Remarks: Fire alarm system for new temple
Owner: Contractor:
BAPS TEMPLE A & E SAFE & ALARM CO
PO BOX 41 160 PO BOX 179
SAN JOSE, CA 95160 MCMINNVILLE, OR 97128
Phone: 408 - 453 -6464
Phone: 408 - 453 -6464
Reg #: 603- 472 - 665998
FEES REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 3/15/04 $187.30 Smoke detector insp
Final Inspection
[TAX] 8% State Surchar4 3/15/04 $14.98
[FLS] FLS Pln Rv 3/15/04 $74.92
Total $277.20
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling • 2 -.: •9 or 1- 800 - 332 -2344.
Issu • d By: _ )` -
Pe rm itte - • /
Signature: X I-f-re `,r - ,—
Call 639 -4175 by 7 p.m. for an inspection the next business day
//36$ sw 7/c4a.o 5/
Fire Protection System
Build1Frg Permit t. !,t ,tea• I` t E FOR OFFICE USE ONLY '
City of Tigard O� DateB ,� � Permit No . t J/ -� /` /
13125 SW Hall Blvd., Tigard, OR 9722 �� Plan Revte Other Pemu
Phone 503.639.4171 Fax 503.598. 4 I RO ' � I Date : •3I 0Y / if„.., ' / i �
inspection Line. 503.639.4175 IIG ,. Date Ready /By. ® See Page 2 for _,„,,,
Internet: www.ci.tigard.or.us 01\4 OF oN1S10 - � �'f I Notifed/Method f - Supplemental Information
gvIL
TYPE OF WORK RE Q U IRED DATA :' ,I - AND 2- FAMILY DWELLING
121 e; 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. OI?, ` CONSTRUCTION, 1', work indicated on this application.
El 1- and 2-family dwelling J-e6mmercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
1:1 Master builder ❑ Other: Number of bathrooms:
- , ., •'-' . JOB' SITE' INFORMATION; AND LOCATION , ' J ' ' Total number of floors.
Job site address: //365.w 7 / G 4 A17 sr New dwelling area: square feet
City/State/ZIP: 7- G 4P-0 V K - Garage/carport area. square feet
Suite/bldg. /apt. no.: Project name: i3 - A . p ' 77/.4P /£ Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED D 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, matenals, labor, overhead, and the profit for the
• - - DESCRIPTION, WORK work indicated on this application
Valuation: $ / S/ 600
Existing building area: square feet
New building area: square feet
::: 10 PROPERTY. OWNER. ; '_r. ,;❑',TENAN•T" ''', ' t ` Number of stones.
Name: 3 b p, s Type of construction:
Address: / / `//3 S 4 l 7....t C 9 R p 57-'' Occupancy groups:
City/State /ZIP: D' G A 2._7 612 Existing:
Phone: ( ) Fax: ( ) New:
• •APPLICANT ' - '''' ` ''• _ ° -❑ CONTACT PERSON' • = NOTICE
Business name: A ek 5 A /r N </ n N //i n c All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
�( i) L� t- e R under ORS 701 and may be required to be licensed in the
Address: 5.--3 e 4 g NIv y r, 4 k J l7 O , 8 GEC / 7 C junsdiction in which work is being performed If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
�h /N /,t/0 a 'E v 2 3 7 i Z8' apply:
Phone: KO; )44 7Z -6 n Fax: :(<iC3) y7 L-3s - 7c,
E -mail: da • (�cW c4 e,- l� q S e C u .-/ • r y , r7 /Qy�'1
• -, CONTRACTOR:' t t/ •
Business name: A f s Ai F 0 4 0 , 3 9 4 /4111. . BUILDING—'PERMIT FEES` • -
Address:
t7 0, / y Please refer to fee schedule
City/State/ZIP: 1 '11 C /,,- r A-+ 4/ 1„),-' //a U rL 9 7/ L Q'
Fees due upon application
Phone: (co-; ) y 7 t- .6 ■3 . Fax: (co:3 ) y 7 2 - 3 S 7 0
r Amount received
CCB lie.:
6Si9.Y 0 6,7/
Date received:
Authorized signature: .� _ 0� �_ _ /J This permit application expires if a permit is not obtained
!/ a.e�/1 � - c within 180 days after it has been accepted as complete.
Print name: T2 p 1) le / S L , E iidf de Date: ? _ e y * Fee methodology set by Tn -County Building Industry
I, Service Board.
I \Buiiding\Pennits \FPS- PermttApp.doc 12/03 440.4613T(I 1 /02/COM/WEB)
1 • . 1
• Fire Protection Permit Check Li , ,
.d' .� ..- ` I se .w��'f � , ' " 7 ?f :, F �o�� F !���� : 03rr n;'��4'i'.:vl�nifl:':t� {lN�%1 , .
Cr.
Descrilie:work'to be_d 'one: • , , - .� _ a_ . _ , ' �.� • �*:� �.., ::_ . �, -.,•:�
. 1.) ' New - 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
•
Additional description of work:
•
. :Type0Sy stem - (Complete A ,•B :•C.ior as `ap,plicable): , :, ir° ° : ?, j' e.e
' . A.) ` .;Commercial''Spiriinkler• : - ,.Y: „ ., '``: : ::
❑ Wet ❑ Dry .
Additional 'Standpipes ..
Information: Hazard Group' -.. '
Density .
Design Area '
K. Factor
Sprinkler Project Valuation: $
B) ='Typel -_ •I ood,Fire Suppression'System'• '' ' ' '" „' V'' "Y :, d "" .
' - Hood Project Valuation: I $
:-' .C:) Fire_Alarim'.. '`, - 1 ... '
` ' Submittal shall Battery Calculations El-Yes .
. include:- . Individual Component J — Yes
Cut Sheets
Fire Alarm Project Valuation: $ ./ s, 6co
€ D ) Residentiafgkinkleir (S,tand' Alone System)','": . " ": 0:. c •;:1 • •.,' „�-, r, . ;
Permit Fee: :r. , �, .•r 'F 6:4 F f
Square Footage: . • �'., ■ s ,� + ' - 4
; 1 -
0 to 2,000 $187.50 ' 4 • �' - ‘', ,, ,1:.,;.";'.:•77' . - -- -7'4 `' -.Y
2,001 to 3,600. $
232.50 i,_:. �•�., "��'�, �,
3,601 to 7,200 $292:50 `� . ;r ,:. ,, a,- .;�. -,!, r ;<:i, ;,,,•ti;,,r ;
> ,: r ,,u-r ;e rr. -_ F ,4; ,gip,.; . ,,., ',', -�,,
7,201 and greater $381.50 .. , ., , �� ' ” `,W-, t
k
Sprinkler Project Square Footage: - . . : ; - '•sq: ft. ' •
•
-Project Valuation Subtotal (A B & C): • $ /S- M��
Permit fee based on valuation (see attache' d chart): . $
Permit fee based on square footage (D) (see fees above): $ ,
- - State Surcharge 8 %0 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. , - - - -
is\ Building \Forms\FPSchecklist.doc' 12/24/03 - '
1 .
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP '7054 — ®0 ( l (
Received / _ Request fc /� AM PM BUP 2� —(23f)(:)(33 Location ) S Suite MEC
Contact Person Ph (5) Sl-S C V/' PLM
Contractor Ph ( ) SWR
(
BUILDING.--- Tenant/Owner 2 7 — -'_ �.2. ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fi : • •. er
Susp eiling
Roof
Other:
PASS PART FAIL
ING
Post & Beam 1 111 PM MEM Ng. WM
Under Slab
Rough -In I II 6111M111/
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan � = 7 '
Other: r W
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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: 111 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