Permit (185) 31 v CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2007 -00562
COMMUNITY DEVELOPMENT DATE ISSUED: 11/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 15 BA -00100
SITE ADDRESS: 16200 SW PACIFIC HWY Z - ALBERTSONS ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG
PROJECT: ALBERTSONS
Project Description: Fire sprinkler alteration for TI
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: 3N sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1,338 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:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 11,550.00
Owner: Contractor:
IBJ SCHRODER BANK + TRUST CO COSCO FIRE PROTECTION INC.
•
BY ALBERTSONS INC #565 11800 NE 95TH ST #240C
ATTN: CORPORATE ACCTG DEPT VANCOUVER, WA 98682
BOISE, ID 83726
Phone: 208 - 395 -4711 Contact #: PRI 360- 883 -6383
FAX 360 - 883 -6390
Reg #: LIC 67508
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/25/2007 $134.00
[TAX] 8% State Surcha 10/25/2007 $10.72
[FLS] FLS Pln Rv 10/25/2007 $53.60
Total $198.32
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 - •ted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Y. • ay obtain a copy
of thcr
s or dir- . q - • n to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issu : ( ( j(
Permittee Signature y 4
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.
Fire Protection System
Building Permit Application FOR OFFICE USE ONLY
I Cl of Tigard � , Received _i -
Permit No.: i
DateDate/13 ° `J g 13125 SW Hall Blvd., Tigard, OR Plan Revie
Phone: 503.639.4171 Fax: 503.598. �J l T 2 5 •/ l / Date/ : % ��ra Other Permit:
Inspection Line: 503.639.4175
TIGARD U Date Rea. �® ®SeePage2for
Internet: www.tigard or.gov
MTV ®� CIGAR® ) Notifie # �� �� Supplemental Information
TYPE 0 ! ORK R • QUl ' D DATA: 1- AND 2- FAMILY I • ELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the , ork performed.
Indicate the value (rounded to the near dollar) of all
X Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhea•, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application
� Valuation: $
❑ 1- and 2- family dwelling 1°ti Commercial/industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathroo s:
JOB SITE INFORMATION AND LOCATION Total number o oors:
Job site address: t t 2400 SO p q G; 01417 , New dwelli' : area: square feet
City /State /ZIP: '7 G 44 4 7 7 p.. 17Z L if Garage /.. .ort area: square feet
Suite/bldg. /apt. no.: I Project name: //6 e p' f �,,„ r c �j , p ' Coy ed porch area square feet
Cross street/directions to job site: 5 14/ �(KS „T { s 12!4c .e_ D ck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
1 DESCRIPTION OF WORK / work indicated on this application.
kid i k ��' 1 U ¢' /1 w `jf�45 41 t e / /] �{p4e vl ir Valuation: $ 14 cce , O O
er /�[/ � �' /� DA-, y ,-441 S Existing building area square feet
FIw ' u+
C w _, v A G /� ✓ New building area: square feet
PROP ERR V OW I ',NT Number of stories:
Name: Al f sod PS wk L • Type of construction:
Address: ;.3--0 / 41424 ( .0,4- e 2_ 0 1 W. Occupancy groups:
City /State /ZIP: / .O )S'e i J. 8-3 7 Z C. �+ �q Existing:
Phone: ( f) 795 ^ r 2_ `f 3 Fax: ( ) 3 7.5 - ti�j J 0 New:
/ V APPLICANT ❑ CONTACT PERSON NOTICE
Business name: c 5 C.. C) i t iz,. -f P ipo ¢.G(i -, 0 ,,-, All contractors and subcontractors are required to be
Contact name: R e t Q j * 4t d licensed with the Oregon Construction Contractors Board
/ _ G Al � under ORS 701 and may be required to be Icensed in the
Address: l 0 eD M/' 1 S S ! • p jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State /ZIP: /�G, i/ e I�.. ..� 4- •. �� G P Y
apply:
Phone: (3 6 ?^ 6? p 3 I Fax:: ( )
-
E -mail: Rs.„_,q/Z.(v i& c 0 F it..., . co ►'+--0
CONTRACTOR t 1 BUILDING PERMIT FEES*
�1 _ � - r p I — P /r �/ y 1,3
(Please refer to fee schedule) )
Business name: W /` p t �n0 t Permit fee:
O ti
Address: ( BD J 9,s d7 0 -.0'44 _
City /State /ZIP: Vtnkou Vet 1 104- ggay_.
- State surcharge (8% of permit fee):
FLS plan review (40 /o of permit fee):
l (p
Phone: pl) $ $ ' 3 - (,3 g3 Fax: ( ) 4 (Due upon application.)
CCB lic.: 6, 7 - g a l Total permit fees: !��
Authorized signature: C ount received: i f f. 3 !®
This permit applicatio expires if a permit is not obtained
I Print name: gee ;g. fi fe) Date: L O • 2.5- -- 64,2_1 within 180 days after i has been accepted as complete.
* Fee methodology set by 'l;ri- County Building Industry
Service Board.
I:\ Building \Permits\FPS- PermitApp.doc 03/23/06 440- 4613T(11 /02/COM/WEB)
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CITY OF TIGARD ". , R� 4 2-' ) .° z
BUILDING DIVISION PERMIT #: fjt,Jp' 0 70
ilk 13125 SW Hall Blvd., Tigard, OR 97223 j DATE ISSUED: I2/70 ;f7
Phone: (503) 639 - 4171 ° '.��� 1 � ° �N�l114,i lit('
Inspection Requests (24 Hrs.): (503) 639 -4175 '!+�
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7 :07AM PAGE: r,
SITE ADDRESS: 16200 SW PACIFIC HWY Z - ALBERTSONS CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: . ALBERTSONS
DESCRIPTION: TI
OWNER: IF3J SCHRODER BANK + TRUST CO, PHONE #: 208
CONTRACTOR: CURT FAUS CORP. t PHONE #: 03- 699.1103
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Inspection Request Scheduled For: Date: 1/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Me a
795 Mi; c. inspection " / 063821 -01 503. 710.2713 Y
Corrections Comments /In uctions: i ,
(qlq. GI-NC - �: 6 7 , 0 0 C-6. ?- . � '� -
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
O r-AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ /J ( ; t ' SZ--_____ ' Date: / 2-(/ b " Phone #: (503) 718- �"