Permit q CITY TIGARD BUILDING PERMIT
PERMIT #: BUP2008 -00134
COMMUNITY DEVELOPMENT DATE ISSUED: 5/2/2008
T►GA E) 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 BD - 00300
SITE ADDRESS: 08015 SW HUNZIKER RD ZONING: I -
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: PERFORMANCE CONTRACTING
Project Description: Fire suppression
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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 1 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 12,000.00
Owner: Contractor:
LOSLI E HOWARD TRUSTEE AND WESTERN STATES FIRE PROTECTION
SEABROOKE, CAROL ET AL 13896 FIR ST STE B
BY PERFORMANCE CONTRACTING, IN OREGON CITY, OR 97045
CHARLOTTE, NC 28217
Phone: Contact #: PRI 503 - 657 -5155
FAX 503 - 657 -5182
Reg #: LIC 104570
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/17/2008 $134.00
[TAX] 12% State Surch 4/17/2008 $16.08
[FLS] FLS Pln Rv 4/17/2008 $53.60
Total $203.68
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
c Ni �A 271/7
Issued By: ,-- / � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application o ma y S ,.�?-
L fir. 3u r i t >� �L5 kt '3F r
Fire Protection System s a t r r? I� i �� C vi � I Sl 1051 w bi :i ; ?. ". + uw
r ,' y 11 g i� t ti�§�/ S Re ceived Perm No
,_ Ci}� of Ti and u
f , a " a `J g Date /By: �7 l/ •
Plan Revte "W�
1 3125 SW Hall Blvd., Tigard, OR 97121 K i 7 2 o n • �[
p �. Phone: 503.639.4171 Fax: 503.598 . � C / / A Z9 0 • ther Permit:
4� 9.60 Dates : J
s;•,.a r,, Ins Line: 503 Cri \ J T.14 i1'.D Date Ready :y: lur ® See Page 2 for
4T 1 G A R L7 N N ot ified / Method: O/ C/O T Supplemental Information
.'$ice' >.�'�4':N`� Internet: www.tigard or.gov B�,li�I'. 1 +��I ! E1;�:.e�.A 677:
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wry reiA
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/repiacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling % Commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMA TION AND LOCATION Total number of floors:
Job site address: %C.,\ c '' j c,J i - 1 ' k e- K - - 1 - %' ,- aJ.,; cJ. New dwelling area: square feet
City/State /ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 1-L _ b , v , j ei R; i . _ Covered porch area: square feet
Cross street/directions to job site: ( € ' c- j Deck area: square feet
J Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE
Subdivision: 1 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.
1\101..)..._C i �- 7C r c S.i
--s S ,16\N y S L -� ✓ /1 e ....J Valuation: $ / c f C C)C�
t c1 ,l-er re.f...vvi ,, ,, ( kr .r z■ r VA.� G1.c.j Existing building area: square feet
A ) a s, r y.\G.�,2,‘s ex t NNV.a, S v Si-c%r New bui area: square feet
:PROPERTY OWNER I ❑ TENANT Number of stories:
Name: F ' 1 Type of construction:
Address: 50 \S S w r • •k -Z. ic) . Occupancy groups:
City/State /ZIP: ,sey.. - , OYZ Existing:
Phone: ( es) ( 2' - 5Ci 3 Fax: ( ) New:
a APPLICANT . ❑ CONTACT PERSON NOTICE
Business name: iNZ.S4'erv- Sk.-..k e,:c �\rz. P•'Ljev_TwN. All contractors and subcontractors are required to be
Contact name: �c�+-'e.: 1A--; \ \ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: i 3S3a RN S jurisdiction in which work is being performed. If the
City/State /ZIP: L j - 2;,, , t } - 9 S applicant is exempt from licensing, the following reasons
apply:
Phone: ( .63) (✓ - S 5 1 Fax :: (SYS ) tS "7- r) I
E -mail: "Ec rec, t4-;11 e IrJ:,£p.
CONTRACTOR BUILDING: PERMIT FEES*
r air
(Please refer to fee schedule)
Business name:
.�k -{g-R , 1-P . C�e- .r/1/ j7LJY h1't ai Permit fee:
Address:
State surcharge (12% of permit fee):
City/State /ZIP:
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.)
CCB lic.: /o 4' 70 Total permit fees:
Authorized signature: ) A ( l A received:
c_____) This permit application expires if a permit is not obtained
Print name:
J r ( ( I Date: q// - 7 / (U a- * within 180 days after it has been accepted as complete.
Fee methodology set by Tri- County Building Industry
Service Board.
1 : \Building\Permits \FPS- PermitApp.doc 03 /23/06 440-46 I 3T( 1 I /02/COM/WEB)
•
CITY OF TIGA6D ♦'
BUILDING DIVISION PERMIT #: BUP2008 -00134
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/200t3
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 S n . 1. J .
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 08016 SW HUNZIK.ER RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PERFORMANCE CONTRACTING
DESCRIPTION: Fire suppression
OWNER: E HOWARD TRUSTEE AND, LOSLI PHONE #:
CONTRACTOR: WESTERN STATES FIRE PROTECTION PHONE #: 503-657-6165
Inspection Request Scheduled For: Date: 6/23/2008 O Pour Time: _
Code # Inspection Description Confirm # Contact # Mes ..g: �/,- a�/�
299 Final inspection 071716 - 01 971 Y (')
Corrections /Comments /Instructi ns: 1
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&L C- 9790 -> 00/ 7 c / 2 45( 6V * 6e ( 1 1 /4 9
Al fr" 7 \ ,.
t o PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: v `' Date 6/Z0 Phone #: (503) 718 - p L
CITY OF TIGARD t _A
BUILDING DIVISION . ,. � ED BUP2006 -0(11 4
13125 SW Hall Blvd., Tigard, OR 97223 - ISSU: 51112000
Phone: (503) 639 -4171 �� �/ , 0/ Inspection Requests (24 Hrs.): (503) 639-4175 .
INSPECTION WORKSHEET FOR DATE: 6/20/2006 TIME: 7 :02AM PAGE: 32
SITE ADDRESS: 00015 SW HUNZIKER RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: PERFORMANCE CONTRACTING
DESCRIPTION: Fire suppression
OWNER: E HOWARD TRUSTEE AND, LOSLI PHONE #:
CONTRACTOR: WESTERN STATES FIRE PROTECTION PHONE #: 603-657-6155
Inspection Request Scheduled For: Date: 6 /20/2006 Pour Time: -- ..
Code # Inspection Description Confirm # Contact # Me
• rer
i
299 Final inspection 071635 -01 971 - 4033141 Y ! DI
Corrections /Comments /Instructions:
e
5'
0 (1 4 --
❑ PASS ❑ PARTIAL APPROVAL CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ()?___. . Inspector: \t‘ Date: ID/.
Pho #: (503) 718- 7 •
P
20 ,34
Inspection Contract No. 00 `
File No.
FIRE ?ROTECTION SERVICES DIVISION
9th & Columbia Bldg. GH -51, Olympia, WA 98504 -4151
FIRE ALARM SYSTEM
REPORT OF INSPECTION
Date / 41-413'
Name of Facility: P C'
Occupied as: 04614 �`
Address: Y'' f- /u..�_z� � ,� - City
County: xo .:-) Zip ?7 ZZJ Telephone
Building Designation (if more than one building) // ) , -writ- fQ�.w Jed-)
Inspection by: d��� G� Gr,eaa`Z- Title i•vru.
Date of inspection: - -_ •
1. Type of. Test: Monthly ❑ Quarterly ❑ Semi - Annual ❑ Annual
2. Type of system: Noncoded ❑ Common coded ❑ Selective coded Dual coded ❑
(as pertaining to chapter 212 -14 WAC)
3. Local Fire Department: a T V. ,C( x.
4. Fire Department Official Contacted:
5. Test Received at Fire Department: Yes Y No
6. Master Box Reset A.M. rJ P•M.
;WT
7. Comments, explanation of nsatisfactory results, action'taken, etc. Atv:UwroA.s
�tl s in r /.4 /lam- y%
SFM 222, Rev. 5/78
ORIGINAL FORM TO BE RETURNED TO STATE FIRE MARSHAL.
1111b 1
EQUIPMENT TESTED
'UM . 1 I,Y ,; .
TYPE OF EQUIPMENT UNITS TESTED DATE CHECK MANUFACTURER
Yes Np N A
8. Control Panel 1 la_ jar r uo JO 12
9. Manual Station ( . W� ✓ a u4- `e.t.a..;
1
t/
10. Heat Detectors
f
11. Smoke Detectors 4/ ti-id ��` l ki
Audible Alarm
12. Devices t 67 V, tjt.e.e.70,-ic
Visual Alarm o2. � / L/ ej 1,, 0CIC
13. Devices l
14. (Code Transmitters
Automatic Door.
15. Releases
-
16. Trouble Indicators �3
17. Master Alarm Box
Z
o Y;.3 tz 74 -� 18. batteries � . �.,
19. Charger ( ( 73 . l
4a3 4% f5 . (0 . 3 V a e......t 4.67...i
20. tiesterviamr
21. Ventilation Control
Fire Department
22. Interconnection
W p a Ikea,
23. Interconnection ( Z, / Z e F $
Exterior Sprinkler
24. Electric Alarm Bell •
Sprinkler Water
25. Flow Switch
- Sprinkler bate V ve
26. Supervision Switch
77. Annunciators •
28. Automatic Time Delay of General Alarm s Minutes. None Installed
29. Test of alarm system on emergency power, satisfactory? Yes --- No.
30. This is to certify that this fire alarm system has been properly inspected for
reliability covering the•itews listed in this report and is consistent with NFPA
Fire Alarm Maintenance Standards.
A. Signature of Owner or Representative
B. Signature of Fire Alarm Firm Representative.7, y ,
C. Name of Firm Western States Fire Protection
13896 Fir St., Suite B
D. Mailing Addr Oregon Ci , OR 97045 Phone No. 3a
E. Electrical Contractors License #. C �- f d 6 5 -17
F. Specialty Electricians License # (7/ 9 ( C,Cif—