Permit CITY OF TIGARD
BUILDING PERMIT
...•„„,,d, ,„,., DEVELOPMENT SERVICES ^��~��~"���" "�"�~"� " =°�~v»�u~�"�~� PERMIT # ^ BUP96-0641
~�� �,� /D125SN/ Hall Bhvd.. Tigard, ORQ7223 (503)839-4171 • DATE ISSUED:' 12/30/96;
PARCEL:. .2S110AA-00300- . f .
SITE ADDRESS'.~: 14145 SW 105TH AVE . . , .
^SUBDI.VISIQN. ..:`- ' ^ ' ~ ' ~ Z8NING:R-12 ^'
8CK
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^^^^^^^^^^ ^^^^^^^^^^^^^
_
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION-
CLASS OF WORK. :FPS ~ FIRST.. . . : 1500 sf N:1HR S:1HR E:1HR W:1HR
I
.
TYPE OF USE. . . :COM SECOND...: 0 sf PROTECT OPENINGS?
TYPE OF CONST.:5-1HR. ,. , . .. . :p.^ . 0-sf, NI-. . S: .r. E: ,. W�
OCCUPANCY GRP.:I1.1 TOTAL : 1500 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOADT / ` 29,�`^ `° BASEMENT�� .".. 0 sf ..� AREA SEP. RATED:
STOR.: 0 HT: 0 ft GARAGE...: 0 sf OCCU SEP. RATED:
BSMT?:' . MEZZ?: `, ,` ` REQD. SETBACKS . . . � '� REQUIRED, ' ' .
FLOOR LOAD....: 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y SMOK DET..:
DWELLING UNITS: 0,' FRNT: 0 ,ft REAR:. 0. ,ft.. FIR ALRM: HNDICP ACC:Y
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE.$:' 5810 .
Remarks: Fire suppression system for addition to Sunrise Healthcare
Owner: - FEES
SUNRISE HEALTH CARE. . . ' -'. type amount by date recpt
14145 SW 105TH PRMT $ 56.50 BON 12/20/96 96-288037
' . . ' FIRE. $ 22.60 B0�� 12/269/96 96_288037
' TIGARD OR 5PCT $ 2.82 BON 12/20/96 96-288037
Phone #: .
Contractor: - ,- . .
DISCOUNT FIRE SYSTEMS, INC.
7402 SE JOHNSON CREEK BLVD.
PORTLAND OR 97206 ----- -
Phone #: 777-5030 $ 81.92 TOTAL
Reg #.': 45441 .
' ' -' . . , REQUIRED INSPECTIONS --
Thi�pg[mit'is'issoedsVbject to the rogulat ions .cVntainod. in, the'. , ' ,Gprink,aer, .,,Rough_. '
' Jioard Mun���J�nde State'ofOre� �odo��od�D�z�bp�� .. ~ELorink��e'��Fina� ••.. • '
e laws., `^� '' • • • ' � ` ' , ' - • ''��'`'
"pp^^""°^ �^^'"='� -'~!�' ' ' � � ,
plan� ' 1.oxpicoifwonki�mt otarted,�` " ' _ ' ~' ''•
within 180 days of bsoaoce orit�Work`is suspended ^formmm� • - ', ~ _
than IN days. ' ^ . ____
• ___
r . �--
_
Permittee Si atu e _ ~/��.._,,~_ __,,
^ � 5.. '` . ,
Issued By: �°�. �'v�����wwx v~�� � __
. ` ' ` . � _ .-% . Call for iospectign��, 639-4175, ` y_,
'
,
:` 4 r ,4 12 /1`8/816 14� 2,7 `. .$`b'.0 =7287 r' CITY' OF TIGARD __ MO02/003 '.
Fite Protection Permit Application Check*
-45
Plan Che
;!75' TIGARD a\ab Commercial or Residential �F
3125 SW HALL BLVD. 191 a .._.� :.,,...�,.::,�. Recd By ____44._______
iGARD, OR 97223 ^ ' ' : �� Date Recd 1 z 4 /
Pri nt or Type r' '
Inca , . e ta o r illegible applications will not be accepted to DST
/z ��9t�
303) 639-4171 Fact. 304 g� pp ted Date ' p
,Q� .tom 9(p — 0 -3� s led L� _ 9 z ```�'
Name of Development/Pr — — ���`�'` 1
Job 5 Luem r i Se I )..a I /-I Cam Type of System (Complete A or B as applicable)
Address Address S 5./..) /us f k . A.) Sprinkler •.. Wet. - Dry 0
1
Name Standpipes
Owner Mailing Address Additi Hazard Grou J ¢� /
Ly t
City /state Zip Phone information Density
•
Name 4G,-4-4--.---..----2 Design Area i 30
Occupant lin Address K Factor
Mai
City /State Zip Phone . . Sprinkler Project Valuation $ ce
COT Business Tax or Metro # Exp. Qate B.) Fire Alarm
Contractor Name - Submittal Shall Include Battery Cal ulatlons - YES ❑
t
(Sprinkler or MBitingA, � J OHNSON CREEK BLVD Cu i u l Component YES ❑
Alarm //
, Company) City / State ho - Fire Alarm Project Valuation $ -
77 7 C O3()
Attach Copy State Const. Cont Board Licit Exp. Date - � Project Valuation Subtotal ( A or B) $ . q �„t ; . 1) ,
Current COT Business Tax. or Metro* _ Date . Permit fee based on valuation $ 50
Licenses 10 - ! /� - (see chart on back)
Name
. '.. ' 5% Surcharge $
Architect Mailing Address F-7,2-, -A
F LS Plan Review 40% of Subtotal $ •_ 0 � �x/
City/State Zip Phone TOTAL $ ..2_1 `�� // �
Describe work A.) New 0 Addition ■ Alteration 0 Repair 0 PLANS MUST 8E suBncliii), apprp 43 and a permit issued prior to installation_
to be done: Three sets of plane id
and site pion (and vnity'nap) required which snows location of
nearest
) B.) Basement 0 Hood/Vent Q Spray Booth 0 hydrant
.
B ateme Partial 0 Exitway Booth I Nimbi/ acenowleoge that I have read this application. that The information given la
correct, that I am the owner or authorized agent or the owner. and that plans submitted
are in ex<mptiance wirh Oregon State laws.
Additional Description of Wont: -
ature of OwnerjA • ant , Date
I/; ; . . / Jam,,, ( , / 9 -
A . ) In Existing Building 0 New Building;; . ontact Perso Name - .. Phone
Building 7yt,/ key 777-, 6
Data B.) Comercial Residential 0 — `
m FOR OFFICE USE ONLY:
Plat # • - • - T . --
No of stories: I ,}: M '. :d . s " ^` '-
•
panty Type of Cons n ` - .
H a-2--r ef �o V .. ' '.•.
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