Permit BUILDING PERMIT
a 'CITY OF TIGARD
PERMIT #: BUP2007 -00396
' COMMUNITY DEVELOPMENT DATE ISSUED: 7/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 1106C - 10000
SITE ADDRESS: 12494 SW WINTERVIEW DR ZONING: R -
SUBDIVISION: THORNWOOD PARTITION LOT: 001 JURISDICTION: TIG
PROJECT: BACKLUND
Project Description: Residential fire sprinkler addition, (3) heads. 470 square feet
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 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: P BAT�� IMP SURFACE: PRO CORR: PARKING:
VALUE: 6 —GYI
Owner: Contractor:
ISSAC BACKLUND CRAFTWORK PLUMBING INC
12494 SW WINTERVIEW 7742 SW NIMBUS AVE
TIGARD, OR 97224 BEAVERTON, OR 97008
Phone: 503 - 598 - 7177 Contact #: PRI 503 - 644 - 8698
Reg #: LIC 79666
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/30/2007 $187.50
[TAX] 8% State Surcha 7/30/2007 $15.00
Total $202.50
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
Ore. • - • ' ' • • •tification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may tain a copy
• ese rules or di t • - is •s o OUNC by calling 503.246.6699 or 1.800.332.2344.
i n ure: Issued By:� di 4 1d /
Permittee S g at x
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.
Il. ,,. _
Building germit Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received ��A f lit/ 7- 0c55.5
�flf�J Permit No
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re • ►�
C Phone: 503.639 4171 Fax. 503 598.1960 DateB : ,p C) Other Permit.
T i G n 1t D Inspection Line. 503.639.4175 Date • • y �� 0 See Page 2 for
Internet. www.tigard - gov Notified/Me od: Supplemental Information
TYPE OF WORK 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.
IN 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: /2 _1 j . S W (-../'jerk, t,I e Dr New dwelling area: square feet
City /State /ZIP: ; `J ar ! GO 911-24.1 911-24.1 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 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
A / (�
DESCRIPTION WORK 1 work indicated on this application.
jT ci L 3 .f v� I eIIn k ley ^Cc, 1,J -to €X; 57 )►7� - �^ I ✓ Valuation: $
5 r ; r r i 'el V'^ - Existing building area: square feet
New building area: square feet
Si°! PROPERTY OWNER ❑ TENANT Number of stories:
Name: r 534 � a t)v ■ 1 Type of construction:
Address: 12 L V jy ` S t,, Li jNi ,i ew (lf Occupancy groups:
City /State /ZIP: 4-, ge„) OIL 6111 VIA Existing:
Phone: (fc)) i Fax: ( ) New:
(ii 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 tojee schedule)
Business name: 0 S.Q-t. 0 4 PA t-.15 Permit fee:
Address: -7 3(,, CI'vvt, f Pi - State surcharge (8% of permit fee):
City/State /ZIP: /3f4 L.- 0 a `7 loo D
FLS plan review (40% of permit fee):
Phone: (go 3 ) Itt.(d- ASS' k f) I Fax: t1J J) 644- fl/P5 (Due upon application.)
CCB lie.: ) 6 6 6 Total permit fees:
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name: Date: within 180 days after it has been accepted as complete.
• Fee methodology set by Tri -County Building Industry
Service Board.
I \Building\Pennits\FPS•PermitApp doe 03/23/06 440-4613T(1 I /02/COMAVEB)
•
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: I $
C.) Fire Mann
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 (8% 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.
"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 \Permits \FPS - PermitApp.doc 2
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: BUP2007 -00396
13125 SW Hall Blvd., Tigard, OR 97223 DATE IS - D: 7/30/2007
Phone: (503) 639 -4171 I C I /
r ‘3 ' t
Inspection Requests (24 Hrs.): (503) 639 -4175 °-_.. � �
INSPECTION WORKSHEET FOR DATE: 10/1/2007 TIME: 7:00AM _ % PAGE: 6
SITE ADDRESS: 12494 SW WI NTERVIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: BACKLUND
DESCRIPTION: Re:dential fire sprinkler addition, (3) heads. 470 square feet
OWNER: BACKLUND, ISSAC PHONE #: 503-590 -7.t77
CONTRACTOR: CRAFTWORK PLUMBING INC PHONE #: 503644 -0698
Inspection Request Scheduled For: Date: 10/1!2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message si2 1/1/‘" 1
999 '
Sprinll�:r final 056673-01 503- 596 -'1177
Corrections /Comments /Instructions:
e /t/ c l/ ; / i j
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: " Date: 1 b Phone #: (503) 718 -
. ,
CITY OF TIGARD
BUILDING DIVISION P IT BUP2007 -00396
13125 SW Hall Blvd., Tigard, OR 97223 D ISSUED: 7/3012007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 12494 SW WNTERVIEW DR CLASS OF WORK:
SUBDIVISION: THORNWOOD PARTITION LOT #: 001 TYPE OF USE:
PROJECT NAME: BACKLUND
DESCRIPTION: Residential fire sprinkler addition, (3) heads. 470 square feet •
OWNER: BACKLUND, ISSAC PHONE #: 503-598-7177
CONTRACTOR: CRAFTWORK PLUMBING INC PHONE #: 503 644 - 8698
Inspection Request Scheduled For: Date: 8/9/2007 Pour Time: „ /u
Code # Inspection Description . ' Confirm # Contact # - sage
910 Sprinkler rough -in /test 053713-01 503-598-7177 Y
1./
Corrections/Comments/Instructions:
•
' r
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 ' CSC Date: g/6/6
Phone #: (503) 718 - !
q