Permit (192) BUILDING PERMIT
CITY I D PERMIT #: BUP1999-00434
1A DEVELOPMENT SERVICES DATE ISSUED: 10/11/1999
��' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16200 SW PACIFIC HY Z PARCEL: 2S115BA -00100
W
SUBDIVISION: ZONING: C -G
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: 3N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 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 : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 5,200.00
Remarks: Fire alarm permit
Owner: Contractor:
IBJ SCHRODER BANK & TRUST SECURITYLINK OF AMERITECH
BY ALBERTSON'S INC #565 12119 NE 99TH STREET
ATTN CORP ACCTG DEPT #2094
B9 l 83726 VA Jo OUV f _ 98682 -2461
Reg #: ELE 26514CLE
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Fire Alarm Insp
PRMT BON 10/04/199c $87.00 99- 318721 Final Inspection
5PCT BON 10/04/199 $6.09 99- 318721
FIRE BON 10/04/199£ $34.80 99- 318721
Total $127.89 ORIGINAL
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Pe Signature: f V� — Po'
Signature: �,
Issued By: 8-
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application Plan Check #9 $C
CITY OF TIGARD Commercial or Residential Rec'd By
13125 SW HALL BLVD. Date Rec'd 9 - off 9 - 1
TIGARD, OR 97223 Print or Type Date to P.E. 10- `1 ° ? •
(503) 639 - 4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST / - 4
Permit # gJPI'r - 0 _ ' Jf
Called
Job Name of Development/Project Type of System (Complete A or B as applicable)
A I G�ri-sr, S
Address Address `/ A.) Sprinkler Wet ❑ Dry ❑
Name 1 be,-k,:,-,s Standpipes
Owner Mailing Address Hazard Group
Additional
City/State Zip Phone Information Density
Name /1 Design Area
_ /1--P,--1-3 ain.
Occupant Mailing Address K. Factor
S c v.--+
City /State Zip Phone A.1) Sprinkler Project Valuation $
Contractor Name B.) Fire Alarm
(Sprinkler or Sec ,.— •- r\,C.:,.� {'ru,.... Ar„.IP -teC.k
Alarm Company) Mailing Address Submittal Shall Include Battery Calculations YES U2'
Prior to permit 1 Z_i l ✓t/F `cif L. S+. S.-, . 7_ogal
issuance, a City/State E /State Zip Phone Individual Component YES �
copy Cut Sheets
of all licenses [A ,,, „ 1 ,/Ac 5 37_ .fin- LS 3 -.5 /13 B.1) Fire Alarm Project Valuation $
are required if State Const. Cont. Board Lic.# Exp. Date S 2 , 00
expired in COT Project Valuation Subtotal (A & or B) $
database GO S Sc G/ /c S 7 , OLS
Name Permit fee based on valuation $
Architect Mailing Address (see chart on back)
7% Surcharge $ 6-
• City/State Zip Phone FLS Plan Review 40% of Permit $ -. 8u
Describe work A.) New 0 Addition • Alteration 0 Repair 0 TOTAL
to be done: $ a g
B.) Modification to sprinkler heads only:
1. 1 -10 heads= No plans required Plans required: Submit three sets of plans, including a vicinity map and
2. 11 += Plan review required the location of the nearest hydrant.
I hereby acknowledge that I have read this application, that the information given is
Number of sprinkler heads: correct, that I am the owner or authorized agent of the owner, and that plans submitted
Additional Description of Work: are in compliance with Oregon State laws.
Tom' 34-q 1 /"` re- ct k �� Signature of Owner /Agent Date
A.) In Existing Building ❑ New Building ❑ (....1-- /2- S
Building Contact Person Name Phone
Data B.) Commercial ❑ Residential ❑ -- N , --P, h 1 Cr • C. .36e) - ZS .? • 3 i )1
FOR OFFICE USE ONLY:
No. of stories: Plat # Map/TL #:
Sq. Ft: .
Notes
Occupancy Class Type of Construction
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is \dsts \forms \ftresupr.doc 7/2/99
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Location
Albertson's Food Center 0565
52407 Durham
Tigard, OR
II. Codes
A. 1996 NFPA 72 Chapters 1,3 -7 as Applicable (Remote Station)
B. 1996 NEC Articles 250, 725, 760
C. Local, City, State
III. Control
A. 1 RA -D7412BB Control Communicator Fire Sec. 8 Acces2
B. 1 RA -D8132 Battery Charger
IV. Fire Alarm Initiating Devices
A. 1 RS -1T-LP Manual Pull Dual Action
B. 1 Waterflow Switch Connection Only, Provided by Others
C. 2 Tamper Switch Connection Only, Provided by Others
V. Fire Alarm Indicating Devices
A. 1 RA -D1256 Fire Command Center
B. 2 WH- MT- 12 -LSM -VFR Horn Strobe 15/75 Candela
VI. Zones
1. Class B Bell Circuit Supervision
2. Class B Tamper Switch
3. Class B Not Used
4. Class B Not Used
5. Class B Not Used
6. Class B Not Used
7. Class B Manual Pull Stations
8. Class B Water Flow
VII. Wiring
A. All Circuits and Wiring Shall be "Power Limited"
B. Initiating Zones Shall be 18/2 or 18/4 U.L FPL Cable
C. Indicating Circuits Shall be 14/2 U.L FPL Cable
D. System Ground Shall be 14 THHN Green Conductor
E. Under Ground and Outside Wire shall be 14 THWN, TWWN, or TWN in Approved Raceway
VIII. Listings
A. All Equipment Shall Be U.L Listed and Compatible
IX. Power Supply
A. Primary -110 VAC Dedicated 20 Amp Circuit
B. Secondary -17 Amp Hour Battery
X. Alarm Supervision
A. Human
B. Remote Station Installing Branch/Contractor
SecurityLink from Ameritech SecurityLink from Ameritech
2461 McGaw Road 5110 N.E. Sandy Blvd.
Columbus, OH 43207 Portland, OR 97213
800 -477 - 1112 503-288-3430
UUFX S3605-1
04/17/2000 • Activities for Case #: BUP1999 -00434 •
9:15:00 AM •
Assigned Hold Updated
Activity Description • Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
BUPC005 Application received 09/30/1999 GEO RECD No Hold BON 10/04/1999
BUPC008 Permit created 10/04/1999 . BON DONE No Hold BON 10/04/1999
BUPC012 Plans routed to Plans Examiner 10/04/1999 BON DONE No Hold BON 10/04/1999
BUPCO24 Plans Approved by CPE 10/05/1999 RDP DONE No Hold RDP 10/05/1999
BUPCO22 Plans Approved /Routed to DSTs 10/05/1999 RDP DONE No Hold RDP 10/05/1999
BUPC785 Fire Alarm Insp 10/05/1999 10/05/1999 • NOTE No Hold RDP 10/05/1999 Sprinkler monitor alarm -
Central Location
BUPC799 Final Inspection 02/23/2000 TLP PASS No Hold AKJ 03/02/2000 •
BUPCO29 DST Post Review Completed 10/11/1999 BON DONE No Hold BON 10/11/1999
BUPC090 (F) Ready to issue . 10/11/1999 BON DONE No Hold BON 10/11/1999
BUPC100 (F) Issue permit 10/11/1999 BON DONE No Hold BON 10/11/1999
BUPC960 Case Finaled 03/02/2000 AKJ DONE No Hold AKJ 03/02/2000
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