Permit . V
CITY OF TIGARD BUILDING PERMIT
PERMIT # BUF95-0433
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 10/10/95
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (SDa:¢39L41 1
PARCEL: 1S126OC -01107
SITE ADDRESS...: 09627 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING: C -G
i, BLOCK LOT
REISSUE: FLOOR •AREAS - EXTERIOR WALL CONSTRUCTION -
CLASS OF WORK. :ALT FIRST sf N: 5: E: W
TYPE OF USE...: COM SECOND... : 730 s f PROTECT OPENINGS? - - - ---
TYPE OF CONST.:5N THIRD sf N: 5: E: W: '
OCCUPANCY GRP.:B2 TOTAL : 730 sf ROOF CONST: FIRE RET ?
OCCUPANCY LOAD:4 BASEMENT.: sf AREA SEP. RATED:
STOR.:2 HT.: ft GARAGE„ ..: sf OCCU SEP. RATED: 1HR
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD psf LEFT: ft RGHT: ft FIR SPKL:Y SMOK DET..:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM:Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: • PRO CORR:N PARKING:
VALUE. $ : 911
Remarks: sprinkler modification
Owner : FEES - --
WESTERN ROASTERS INC. type amount by date r:ecpt
PRMT $ 25.00 JHF 10/09/95 95- 266311
1680 WILLAMETTE FALLS DR FIRE $ 10.00 JHF 10/09/95 95- 266311
WEST LINN OR 97068 5PCT $ 1.25 JHF 10/09/95 95- 266311
Phone #:
Contractor:
FIRE SYSTEMS WEST, INC. .
219 FRONTAGE RD. N #8
•
PACIFIC WA 98047 •
Phone #: 360 -693 -9906 $ 36.25 TOTAL
Re g #. ° : 049732
REQUIRED INSPECTIONS -----
This permit is issued subject to the regulations contained in the Sprinkler Rough-
, Tigard Municipal Code, State of Ore. Specialty Codes and all other S p r i n k l e r F i n a l
applicable laws. 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. -
Permittee Signature: (11 -
Issued By : _--
Call for inspection - 639 -4175
' I
PLANCK# 6 - /3 C.
-
APPLICATION FOR PERMIT TO INSTALL FIRE SPRINKLER SYSTEM
BUILDING DIVISION, CITY OF TIGARD
639 -4171
Date: Co - I -9S A ( PERMIT # ekg 6c - OY 3 5
2 Valuation: Q=
Amt. Paid: '3 Le. — b Permit Fee: �L �=
5% State Tax: I 'Z=
Balance Due: 19. 40% FLS: I p
Plans must be submitted to the Building Division before installation. Three
sets of the plot plan, showing the layout and the location of the nearest
hydrant is required.
1 New Installation: Addition: Repair: Alteration: K
Complete: Partial: Exitway: Basement: Hood & Vent:
Spray Booth: IN EXISTING BUILDING: le IN NEW BUILDING:
. . 2-7,
NUMBER & STREET: l 1 9. ' vJ/sh LI - 4 a • ' 12• Q. T (tree 2 I 0 e .
NAME OF BUILDING or BUSINESS: s.a/ .. L Q J ✓Lip IA l
NO. OF STORIES: I SIZE OF BUILDING: OCCUPIED AS:
TYPE OF SYSTEMS: Wet: ) . Dry: Combination:
STANDPIPES: OCC.HAZARD: Light ORD.GRP.HAZARD 1 f_ 2_ 3_ 4 Extra
DENSITY GPM/Ft2 DESIGN AREA ft2 SPRINKLER AREA ft2
SPRINKLER ORIFICE SIZE: I /2. "K" FACTOR 4 • TEMP. RATING I c'i-
O
WN
R: J ADDRESS:
CONT CTOR: C,•NA %(it`.', Lo JyT.
PLANS DRAWN BY: ADDRESS:
REMARKS:
APPROVED permits includes only work described above and/or on plans and specification bearing the
same permit number and will comply with all applicable codes and ordinances of the City of Tigard.
SPRINKLER COMPANY: r I d1 . y yS • v4r�v.'T PHONE:3 too -Co 9 - `I' g 0 Lo
SIGNATURE OF APPLICANT: i v -^--'.. IA m..-K..--
BUILDING DIVISION:
PERMIT VALID FOR 180 DAYS
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