Permit I, '.. , '
CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2006 -00085
, y I� Y DEVELOPMENT SERVICES DATE ISSUED: 2/23/2006
`` "' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S113AD -01700
SITE ADDRESS: 16920 SW 72ND AVE ZONING: C -G
SUBDIVISION: ROSEWOOD ACRE TRACTS LOT: 030 JURISDICTION: TIG
Project Description: Add, remove & relocate (106) sprinkler heads.
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 553 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: $ 11,000.00
Owner: Contractor:
BRIDGEPORT LAND LLC FIRE SYSTEMS WEST INC
3939 NW ST HELENS RD 600 SE MARITIME AVE #300
PORTLAND, OR 97210 VANCOUVER, WA 98661
Phone: 503 - 224 -2676 Contact #: PRI 360- 693 -9906
FAX 503 - 289 -2208
FEES Reg #: LIC 49732
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 2/9/2006 $148.90
[TAX] 8% State Surcharl 2/9/2006 $11.91
[FLS] FLS Pln Rv 2/9/2006 $59.56
Total $220.37
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 -00 0 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions • OUNC by
callin 03 -24 -.6• • or 800 - 332 -2344.
Issu d By: ID ., , j i_i1 , Permittee Signature:._
c
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.
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City of Tigard 9 Receilved � - 9 ,� )� Permit No UC g uv Oy‹ - -
Plan
13125 SW Hall Blvd., Tigard. OR 97223 Plan R eview
Phone: 503.639.4171 Fax: 503.598. I9 0 J Y RyZ- 21-06 50 Other Permit:
Inspection Line: 503.639.4175 Ch V OF TIGARD i 1 1 . ), : Date Read tB Jaris' o See Ps
.,r-- :.•:,;, Y Y ge 2 for
Inter www.ci.tigard.or.us BUILDING DIVISION - - Notified/Method2 237 i 6 T /Cr Supplemental Information
SAO \L trj / \ --eQPN t 0 \Sa
. 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.
Valuation: S
❑ I- and 2 -family dwelling commercial /industrial
❑ 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 d q) O .- 72 > /10»Q- New dwelling area: square feet
City /State /Z1P: T; e C.DTL Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name - mss t., G I,,„,, a_. 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 applicatioii
/ rte- d�� 1 0 � 'i k �� Valuation: ' -O n J G�QS ' Ov
( - Existing building area: Il 1-400 square feet
New building area: square feet
❑ PROPERTY OWNER • - ❑ TENANT Number of stories: (
Name: G Type of construction:
Address: 1 -2 . Occupancy groups: Ot.._.aR -� y .
City /State /ZIP: Existing: I kAv& t Al —er)
Phone: 1 Fax: ( ) New • „. APPLICANT , ": ❑ CONTACT PERSON NOTICE
Business name: : -€.. ( -, U}t_ + ! v ,, c- All contractors and subcontractors are required to be
Contact name: v qN y �„_ CD1S -rn -� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6,oxp se ✓YI a rrt" iQ-v-e- S O jurisdiction in which work is being performed. If the
City /State /ZIP: \i ham) l �(� 66 applicant is exempt from licensing, the following reasons
Phone: (37) 693 - q9 Ob Fax: : ( ) 'Z� el " 2d g
E -mail: (f-Ye 012_ Lil --- 3z-
CONTRACTOR
Business name: ���?� BUILDING PERMIT FEES*
Address: �D F�p� - 2_ . - 3 6 1 Z
l ,.,_ �- `'t `1.-
Please refer to fee schedule.
City/State /ZIP
Phone: (9j 3) Z� - 1•- - I ( ) Fees due upon application 2-- J
Fa x:
Amount received
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: O v v\.C:5 y(, V■ Date: g/ 6 * Fee methodology set by Tri- County Building Industry
Service Board.
i \Building \Permits \FPS- PermitApp.doc 1 2/03 x40.4613T(11101COM/WI:II)
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.
EL Alteration K11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: lab
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: $ iv) (=QS
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.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
TOTAL: $
Plan review requires a completed application and 3 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.
1.\Building \Permits \FPS- PermitApp.doc 2
CITY- OF TIGARD 6`'`i
BUILDING DIVISION PERMIT #:,, Oa,- b D D YS _
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
At
Inspection Requests (24 Hrs.): (503)639 -4175 . ''`��II
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /(D 2 6 7 ✓i 1ad CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3— 9 — O 1° Pour Time:
Code # Inspection Description Confirm # Contact # Message
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G L.,L-- 1 1/4 a-4_, ) - 7 O lc-- • / 3 Pf
Corrections /Comments /Instructions:
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P ASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
n FAIL 111 CALL FOR I _ SPECTION ❑ ADDITI • NAL FEES ASSESSED •
Inspector: � e _ Date: 3 IF . I Phone #: (503) 718- .7-A----23
CITY. "OFTIGARD 6 q f
BUILDING DIVISION PERMIT #: ( 2 0 06 • — 00 $5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 - 4171A .'L
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1 Co qoz U 7 aZ 41d k` `— CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: o? - / I - b Pour Time:
Code # Inspection Description Confirm # Contact # Message
9 l &" I u , • , 9114-914- 36 o 3 y l o(•
Corrections /Comments /Instructions: •
ID 41111
' IL_ 00 - ii. - - 1P- -- A
WWII
•
n PASS 1 PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL 1 I CALL FOR I SPECTION ❑ ADDITIONAL FEES ASSESSED
.1 -I p/�
Inspector: `/ Date: l k 1 Q Phone #: (503) 718- A-25