Permit (84) v CITY OF TIGARD BUILDING PERMIT
0 PE RMIT #: BUP2008 -00115
COMMUNITY DEVELOPMENT DATE ISSUED: 4/14/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 115BA -02500
SITE ADDRESS: 16200 SW PACIFIC HWY U ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: 001 JURISDICTION: TIG
PROJECT: 123 FIT
Project Description: Modification of fire sprinkler system, add (1) head and relocate (1).
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: 2N sf N: S: E: W:
OCCUPANCY GRP: B 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: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 250.00
Owner: Contractor:
SN PROPERTIES PARTNERSHIP CREEKSIDE CONSTRUCTION
1121 SW SALMON ST- 1795 SW 216TH AVE
PORTLAND, OR 97205 BEAVERTON, OR 97006
Phone: Contact #: PRI 503 - 789 -7781
FAX 503 - 591 -7522
Reg #: LIC 111475
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/14/2008 $62.50
[TAX] 12% State Surch 4/14/2008 $7.50
Total $70.00
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
Orego Ility Noti 1 - '.n Cente Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
oft se rules or direct q 6 es ' = • by calling 503.246.6699 or 1.800.332.2344.
Iss d By: , �� /� .I ' Permittee Signature: X 00,),,_, (
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.
•
` Bu,Vdittcz Permit Application ' '
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received Date/13 : Sy /Y Og Permit No.: � ,, X., --Col
l ig • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
12 . Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
T G A K D Inspection Line: 503.639.4175 Date Ready/By: RI See Page 2 for
Internet: www.tigard- or.gov Notified/Method: 7ica
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.
❑ 1- and 2- family dwelling ❑ Commercial/industrial Valuation: $
El 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: I G 70o s t„► Pat. c.,, Hwy U New dwelling area: square feet
City /State /ZIP: , �t>� DP, Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 1 Z 3 r,'._ 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.
M -y ee) p
S._,t,. $ys L n 7. r 6 f5 Valuation: $ Zs0 00
I i Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: 5 fJ Pr11- p Lnr,- slt' Type of construction:
Address: 1 I 'L I 61,o S 6.1. r. s A- Occupancy groups:
City/State /ZIP: po r i I „k 0A. 9 7 7 0 5' Existing:
Phone: ( ) Fax: ( ) New:
❑ 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*
Business name: 6,....,h—A- (Please refer to fee schedule)
G t"t kS� t�l-. Permit fee: eCa , S
Address: 1 155 SW 2 1 b} k A.-k.
6 State surcharge (12% of permit fee): 7 . 5 0
City/State/ZIP:
�fw� Or 97uD F LS plan review (40% of permit fee): O
Phone: (Sh ) ) 781- 7 78 / Fax: ( ) (Due upon application.)
CCB lic.: i i / L/ 7 S Total permit fees:
C)6 /J , Amount received: ( 76
Authorized signature:
f 4w✓ This permit application expires if a permit is not obtained
Print name: Da -1 .13,--,117 I Date: Li pe 6 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
1:I Building \Permits\FPS- PermitApp.doc 03 /23/06 440- 4613T(11 /02ICOMIWEB)
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 130 heads: No plan review required.
teration ❑ 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
El 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.
"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- PecmitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2008 -00 1 1 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/14/2008
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 i
INSPECTION WORKSHEET FOR DATE: 4/15/2008 IME: 7:02AM PAGE: 12
SITE ADDRESS: 16200 SW PACIFIC HWY U CLASS OF WORK:
SUBDIVISION: TIGARD TOW NE SQUARE LOT #: 001 TYPE OF USE:
PROJECT NAME: 123 FIT
DESCRIPTION: Modification of fire sprinlder sVstern add (1) head and relocate (1).
OWNER: SN PROPERTIES PARTNERSHIP, PHONE #:
CONTRACTOR: CREEKSIDE CONSTRUCTION PHONE #: 503 - 769 -7761
Inspection Request Scheduled For: Date: 4/15/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G9 SprinHer final 068401 -01 503-789-7781 N
Corrections /Comments /Instructions: _ _
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`, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: r , )' 4" D ate: q/14AL Phone #: (503) 718 -��
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