Permit 111111 C ITY OF TIGARD BUILDING PERMIT
B :
COMMUNITY DEVELOPMENT DATE PERMIT ISSUED#: / U 6 / P 2 2 0 0 0 0 9 9 00004
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104AD - 04 500
SITE ADDRESS: 12617 SW WALNUT ST ZONING: R - 4.5
SUBDIVISION: TVF &R FIRE STATION LOT: JURISDICTION: TIG
PROJECT: TUALATIN VALLEY FIRE AND RESCU
Project Description: Fire Alarm
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: S2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 91 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:Y
DWELLING UNITS: 4 FRNT: ft REAR: ft FIR ALRM : U HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: N PARKING:
VALUE: $ 6,000.00
Owner: Contractor:
TUALATIN VALLEY FIRE & RESCUE METRO SAFETY & FIRE INC
20665 SW BLANTON ST PO BOX 33650
ALOHA, OR 97007 PORTLAND, OR 97068
Contact #: PRI 503 - 231 -2999
Phone: 503-649-8577 FAX 503 - 256 -4691
Reg #: LIC 63651
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 1/6/2009 $159.50
[BUILD] Investigation Ft 1/6/2009 $159.50
[TAX] 12% State Surcha 1/6/2009 $19.14
[TAX] 12% State Surcha 1/6/2009 $19.14
(additional fees not listed here)
Total $397.16
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center.
Those rules - • th in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling .246.6699 o 1.:!•.332.2344.
Iss ed By: / 'I/
�� Permittee Signature: /0 ,. 1 i ( C-�/7 �c'�—
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System � FOR OFFICE USE ONLY
City of Tigard Vkiv DateB Received
a fire % Permit No.: 1 ! .- 6000
II • 13125 SW Hall Blvd., Tigard, OR 97 C 750 Plan Revie i ' �
i Phone: 503.639.4171 Fax: 503.598.1960 `P 0 v DateB : 4 �J 1k LC• I Other Permit:
T I G A K D Inspection Line: 503.639 J � Date Re. ° - :y: Ju 0 See Page 2 for
• Internet: www.tigard - or.gov 001 X Notified/Method: I 0 , Supplemental Information
Or
G �� J
TYPE OF V' P REQUIRED DATA: 1- AND 2- FAMILY DWELLING
New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling �$ 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: t Z(a1 / Z (.L.)111fvu4.. 3'77 New dwelling area: square feet
City/State /ZIP: 'J lets sb 0 . Cf 7 2.Z3 Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: 'r') F .1- (Z 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: 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, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
' Valuation: $ (D I000�° --
Existing building area: square feet
New building area: square feet
K PROPERTY OWNER ❑ TENANT Number of stories:
Name: /l/ F a- 2 Type of construction: 5-F
Address: AD/pips"' 6w ' ,f07.01 ' 1 Occupancy groups: 52
City/State /ZIP: A Lo -t D (2 97e ie, 7 Existing:
Phone: ( ) Fax: ( ) 7 New: 0C-C- [o7 cif
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
' (Please refer to fee schedule)
Business name: /4/3 T i t o . F6 Ql-- F- it e � e _ . Permit fee:
Address: i 43 2c( -S E.. Srei-R-k- S !
City /State /ZIP: { d, .,a R , q 7 Z3 State surcharge (12 % of permit fee):
FLS plan review (40% of permit fee):
Phone: (563 ) 2 3 1 • Zit 49 ' Fax: ( 553) ZS � ( s . c ! / (Due upon application.)
CCB lie.: tiO3(,5 Total permit fees:
Authorized signature: /6/04,ej / Amount received:
This permit application expires if a permit is not obtained
Print name: li t�t� ceks Date: f - 5 _ 09 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\Building\Permits\FPS- PermitApp.doc 03 /23/06 440- 4613T(II /02/COM/WEB)
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 ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
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: $
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.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
I:\ Building\ Permits \FPS- PemritApp.doc 06 /25/08 2
tItY OF TIGARD
BUILDING DIVISION PERMIT #: nt ,p2(10aila
13125 SW Hall Blvd., Tigard, OR 97223 I . 1 DATE ISSUED: 4)442006
,.., :a! pi l i .iN
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 l
INSPECTION WORKSHEET FOR DATE: 12/31/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: •26'17 SW WAI,NUT ST CLASS OF WORK:
SUBDIVISION: TVIr&R FIRE. STA11014 LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: 11,700 sf. fir° Elation
OWNER: PHONE #: 603-049-05/7
TiJALATIN VALLEY FIRE: & RESCUE, •
CONTRACTOR: FIRST CASCADE CORPORATION PHONE #: 50'3
Inspection Request Scheduled For: Date: 12/31/2003 Pour Time:
Code # Inspection Description Confirm # Contact # Me- -ge k
9913 Alarm fir2:!17 079299-01 503-341-7634 Y 4T1(Al
Corre tions/Comments/Instructons: r" I
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Inspector: Vtiut4./
Date: a -$k /0 ' Phone #: (503) 718-__
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