Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00619
�l�l DEVELOPMENT SERVICES DATE ISSUED: 12/9/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S133AD-02200
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE ZONING: R -7
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Add (49) sprinkler heads, at lower level north side.
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: 5 -1 HR : sf N: S: E: W:
OCCUPANCY GRP: E2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 71 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,960.00
Owner: Contractor:
WESTGATE BAPTIST CHURCH WYATT FIRE PROTECTION INC.
12930 SW SCHOLLS FERRY RD 9095 SW BURNHAM
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Contact #: PRI 503 - 684 - 2928
FAX 503 - 684 - 9657
FEES Reg #: LIC 64077
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 11/30/200E $81.70
[TAX] 8% State Surcharl 11/30/200E $6.54
[FLS] FLS Pln Rv 11/30/200E $32.68
Total $120.92
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 questi. . by
calling 503-246-6699 1- 800 - 332 -2344. /
Issued By: �, ,7-6,1-).-e/7/ Permittee Signature: / , A/
Call 503 - 639 -4175 by 7:00 a.m. for an inspection th. 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 Protec n System `
r
Building Permit Application � w FOR OFFICE USE ONL
� �, � � , � � /J/� r3
City of Tigard RE'_,af56 S 1 DateB �7(f
_ PermitNo.:
_ �1v' -!/�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review R eceived.
Phone: 503.639.4171 Fax: 503.598.1960 h 1 ' Date/By: 409 /i5 0 Other Permit:
Inspection Line: 503.639.4175 �'h'Fl i 2r � Date Ready l� a See Page 2 for i
Internet: w v.w.ci.tigard.or.us ' Notified/Method: J / ( Supplemental Information
.,
....wry ri TI(.Akil
- - - - V L - '.`�tE " UIREDrDATA: 1 AND 3 FAM ILY DWE G�
❑ ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Oo
Ce
Indicate the value (rounded to the nearest dollar) of all
Addition /alteration replacement ❑Other: equipment, materials, labor, overhead, and the profit for the
'" a , : - . 1i . _ -C - ;
TEGORY.OF EONSTRR UCTION ,f - :_3 ° work indicated on this application.
A
Valuation: $
❑ 1- and 2- family dwelling Commercial /industrial
❑ Accessory building ID Multi-family Number of bedrooms:
1:1 Master builder ❑ Other: Number of bathrooms:
a w�s r . �i"�`� _ _��.:. - :r,_.- 'a`".a w,•3;';..,:�..'.: c .t.�;;s`'.::.v ^ >.;:,` q
�. , "�,r rO'i4 .;:V -A' ;�-;P'A . s `. Total number of floors:
.�_ -._ y ; 5 -_ �_:., f 1�' I ON.; - LOCATION . .,' -- ::a»rF; -;� ,: � -,tits
s. 15.. . Gv 4. . r :<: R'Td1:. �a
Job site address: r .. New dwelling area: square feet
- wl�lti \jilU�11\1_�i'_ '
City/State/ZIP: . 1 /j/�, J 0 Garage/carport area: square feet
Suite/bldg. /apt. no.: �" Project nameVesr air '_fit pr 51- Covered porch area: square feet
Cross street/directions to job site: ._ -. 'S C)\—. hj \ Deck area: square feet
Other structure area: square feet
''##=i e9I TA.rCO CHECKLIST
�,e=:. +e rta2�,:lx.;; l' •k•:e:r; - � ::� -, r+�a. - :,' ::. : ...
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
R f;_ *'_ = ),oe: PTION,;:::§y*wzI . v t „ •, fit`! "'2` a ' t 4- work indicated on this application.
-iptpp -ire spv► N }! let2.,5 To t ev.7 c2i 1N1A5 al- Valuation: $ l t V/1
IOVde - ICUs 1 Nog De, v �t � Existing building area: square feet
New building area: square feet
, ,.;.. s .C-- : r. r•. a i:
:`- W - °{ ,, ® �:TE N AN• +° `�" f Number of stories:
_ .- ER- ; � y ` -' - �r��:� �,
.. _. . _. .. . - - ..- .: - c ;.. ; _ ati- ::.'3.e . .T. : {'� ��::... ,_. -.,.v: am. C_
Name: v V�5 ok ' s4e Occupancy groups: i-e, DT s'-r— Ghv Type of construction: S q , i �t
Address: ( ) 1 E 7/ j I 5 �r : l a
City / State/ZIP: 1 / Existing:
•
Phone: ( 3 ) 57 13 z. Fax: (c,.3 ) S 45V0 New:
�: -P' e . „ % i4.=:. ' ,g > :CONTA(; -T P.ERSOW:. ,.J ;4.w ::,�q r, ,,, -, °
^a•_: 'ct:.t••. ;APPLICANT: '--.:,• , ~ i ` s'ti. :n . .. -.._ _ : t , ' - " r• . ,.. TICE NO
• Business name: (93,6 ce �r�tv(�) 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: apply: ppicant is exempt from licensing, the following reasons
Phone: ( ) ,.7 Fax: n : ( )
E -mail: 6. L” I ! Jc ' y4- I I F/, r 1 �M
' .:, l ._ ..is M„ 4i ; ;;•k f$r.. 'ivF,be:a.: -i i15..4 t e , ',,,.
.: :;• ..CONT CTO ; ". R _.,r, :, `
t ...��;;:, a” : , l
i:.c�:,y .^a --.' ,d: .1 ; ��
' G. '' + t ° a!'
< s =tsr
Business name: '��- Pi Iti} Y+✓ Vypoi loN ` (., = , 2 BLJII:DI7VG PERMIT FEES*
X11, � �_: `:.c-. ;:.... +:.:_..
Address: (W fQ�IV f f
ee schedule.
`� O Pleas refer to
City/State/ZIP: 11 wor/A o a., 1-
( /, f 0 Fees due upon application 12-0 6 i 2_
Phone: ( %"�J) 4 {� 4 Fax: (503 ) 0Q4 A ---
Amount received
CCB lic.:
t' r" Date received:
Authonzed signature: 'I �"' This permit application expires if a permit is not obtained
c!‘ within 180 days after it has been accepted as complete.
Print name: \I Ia i .,( Date: //,... _ * Fee methodology set by Tri -County Building Industry
Service Board.
i:'' Building •Perrmts'.FPS- PemutApp doc I :/03 440 - 46 137(11 /02/C0M/WEB)
P■-
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Diescribe=w_ ork be ,,. �,�.,.... �, �.... >= ..;,:;:��:,
1.) ❑ New 2.) Modification to sprinkler heads only:
Addition 0 1 heads: No plan review required.
❑ Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:4
Additional description of work:
'ADD ire! SVANY - 51� N e i c>eA \\
��7 rot
■_� Wet ❑ Dry
Additional Standpipes A-lnN
Information: Hazard Group L1 C� l
Density e /0
Design Area / jOQ •
K. Factor S o e
Sprinkler Project Valuation: $ 2.) a ---
u` resson::5 -stem. ,:.. t : :,,,� ...,..r..:r-
�B.)��.Type "I•� : 1�ood'�Fre�`S, .pp..... .. __ .y ..- -- ��.�s�.r" ..,�'�„. >,- ,k ..
Hood Project Valuation: $
•,rr_:,. -., ., i J ..,. y �. .�;:3Y�' x ;;:i?: A�"�.�4..5s`- �d:W- M��.;` :/, ," :�[• �� , x:`"?,�, -..; = ,Yi�.:
.C): -.Fire Alarm - -�.: -�.. ,. ;�;,��.„�_�. ���:���,- s;;��.��., � _ _, �.,.;r =:�� s. ....
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
.:'f.. - ';: cz'G,V.. +xp,++'- �Qsf?r: ;,;`n + " "'7n," -`. ::Iri . �u�'; 3 , ` .fS,,'�i,, ., iK #= ';V::a; , ':r:_ . .:�`.i i.:':,• ,'. _;�; -:,: 5 :
D.)' Residential; Sprinkler (Sta,.nd,Alone:Sys );�` ' °`''.
fem ��'a: .x::: "^!i -1. ,°i:,t "� '•'e3.r.'.Ei':5 � . . . <
Square Footage: Permit Fee: :..,:;_ ��:.::..,.•,' .:,;...:;::
0 to 2,000 $187.50 � t..� w�- •• ��'' T ` = ;.: ��:•:
� <�zd�t 1 3 ►;
2,001 to 3,600 $ 7 "` -
232.50 _ , ,t
3,601 to 7,200 $292.50 .4
7,201 and greater $381.50 �r ~ 4, ;_ f: "t '' ' :_ =�
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $ 2 C{ L
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $ ./
State Surcharge 8% of Permit Fee: $ (j. SA—
FLS Plan Review 40% of Permit Fee: $ j2 • w ig
TOTAL: $ 12 01. Ct
-- 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.
`Building\Forms\FPS Checklist.doc 12/29/03
CITY-OF TIGARD
BUILDING DIVISION
4011ki,„& PERMIT #: OUP2005-00619
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2005
Phone: (503) 639-4171 a„,„,,Rimili i
Inspection Requests (24 Hrs.): (503) 639-4175 A- '.1.!.. .
INSPECTION WORKSHEET FOR DATE: 12130/2005 TIME: 8:59AM PAGE: 54
SITE ADDRESS: 10730 SW 130TH AVE MULTI CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTOATE BAPTIST CHURCH
DESCRIPTION: Add (49) sprinkler heads, et lower level north side.
' OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 506&42928
Inspection Request Scheduled For: Date: 12/30/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 . Sprinkler final 024205-01 503.572-7392 N
Corrections/Comments/Instructions:
..-------
A t I
.----) ....---- ,
• ,2_--- f 4 A /
v. - k ' •- Ic_..?
& PASS El PARTIAL APPROVAL 0 CANCEL NO ACCESS
_
I FAIL El CALL FOR NSPECTION El ADDITIONAL FEES ASSESSED
0 f 1 ., _, ,A,...„- 6_,
Inspector: Date: " L-- Phone #: (503) 718- l ,
: l---r'
r
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200S- 00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/912005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ipati'll
INSPECTION WORKSHEET FOR DATE: 12/14/2005 TIME: 7:01AM. PAGE: 44
SITE ADDRESS: 10730 SW 130TH AVE MULTI - PURPOSE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: WESTGATE BAPTIST CHURCH
DESCRIPTION: Add (49) sprinkler heads, at lower level north side.
OWNER: WESTGATE BAPTIST CHURCH, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 - 684 -2928
Inspection Request Scheduled For: Date: 12/14/2005 Pour Time:
Code # Inspection Description • Confirm # Contact # Message
910 Sprinkler rough -in /test 023444 -01 503-68e1-2928 N
Corrections /Comments /Instructions:
IIII a gli■
r I, /ii r;� f -0 1r` - Mr
. . - ' )
iirakWinia 17 ,_
v. I I PASS I ARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
Inspector: i� Date: ( hone #: (503) 718 - 7+