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Permit
C OF TIGARD PERMIT #: BUP2005 -00212 ,'l DEVEL R9 ICES -639 -4171 DATE ISSUED: 6/9/2005 13125 SW PARCEL: 1S135BA-03302 SITE ADDRESS: 10520 SW CASCADE AVE ZONING: I -P SUBDIVISION: OFFICE DEPOT LOT: JURISDICTION: TIG Project Description: Relocate 42 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 45 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: $ 5,000.00 Owner: Contractor: MARX, ERNEST L + BARBARA R FIRE SYSTEMS WEST INC TRUST 600 SE MARITIME AVE #300 2140 VELOZ DR VANCOUVER, WA 98661 Phone: BARBARA, CA 93108 Phone: 360- 693 -9906 FEES Reg #: LIC 49732 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 5/20/2005 $91.30 [TAX] 8% State Surcharl 5/20/2005 $7.30 [FLS] FLS Pln Rv 5/20/2005 $36.52 Total $135.12 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 Ce. - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy oft ese rules or • ire t que tons to OUNC by calling 503-24)6699 or 1- 800 -332- 4. I l • Issued By: s 4 , 2 4e,t Permittee Signature: I' 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. INF (4,5'2 c) ( jAi' 0 -1 4 ( eflWi tc) Fire Protec . t. ,, Bu Permit App Date received 7f Permit no.gG(S72QV3 �JU �Y : . -1- 1 City of Tigard . r b : City of Tigard Address: 13125 SW Hall Blvd E a ssued: By: I Receipt no.: Fax: (503) 598 -1960 MAY 2 0 2005 Case file no.: Payment type: Land use approval: 1 &2 t: y: Simple / • �plex: 1�, � u 1 r OF TIGARD r.�ric z � ::� iZ:.w � . , � I 0 1 & 2 family dwelling or accessory '1S1Commerciallindustrial 0 Multi - family O New construction 0 Demolition 0 Addition/alteration /replacement Tenant improvement N RFire sprinkler /alarm 0 Other: . 'JOB SITE, INFORMATION • - _ - Job address: OFF•iC.6 'Depcsr lo522, 50 CrAl9C:AiD . ' *D Bldg. no.: Suite no.: Lot: I Block: 'Subdivision: I Tax map /tax lot/account no.: Project name: 0 ir FtC.G 'DC-,Po 12- U]NAL. OF FICZ Tj Description and location of work on premises /special conditions: eeLC a.T6- 5 ?P4 > ILLe R - He/NOS ::- . , OWNER. • r ,. • ' FOR SPECIAL INFORMATION, USE CHECKLIST Name: S.D. 7 p ,,i (Floodplain, septic capacity, solar etc.) Mailing address: 1?0. SoX X35 2 1 & 2 family dwelling: City: oe_-- ,t O IState:oa. IZIP: 972,ajf Valuation of work $ Phone: (to3) _ fax: 7.r�99- -mail: No. of bedrooms/baths Owner's representative: (jci,)6DeLL- N, Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) x.. .:' . r, r ° APPLICANT • • , '':1,',. Garage /carport area (sq. ft.) Name: ws PEST' Covered porch area (sq. ft.) Fl 2� 5 Y . S , t E y Mailing address: SG Vt+��tc_t-1^toke AVE ,g3v Deck area (sq. ft.) City: J j . o j e _ I State: t- P I ZIP: 0tivo, / Other structure area (sq. ft.) Phone:3w G. .p ,, Fax:5o3 ,. . -mail: Commercial/industrial/multi-family: J A Y CONTRACTOR Valuation of work $ 5;r Existing bldg. area (sq. ft.) Business name: T ILL .S' /ST' ' -1, C-' S T ' New bldg. area (sq. ft.) Address: Number of stories City: I State: I ZIP: Type of construction Phone: I Fax: I E -mail: Occu Occupancy group(s): Existing: L.1 T t+tA O.a CCB no.: co ►�? r! . L-i G d$ �l� 2 2 Y i9 �l i " ' t� P Y g P( ): New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ' - ARCHITECT/DESIGNER ,•'. '_ licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: State: I ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: -, ENGINEER • Name: Contact person: Fees due upon application • $ 135. 12 Address: Date received: City: 'State: IZIP: Amount received $ Phone: Fax: E -mail: • Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this ❑ Visa O MasterCard work will be complied with, whether specified herein or not. Credit card number: Expires Authorized signature: Date: Name of cardholder as shown on credit card $ Print name: Cardholder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6100 /COM) Fire Protection Permit Check List A.) ❑ New Addition ❑ Alteration ❑ Repair • B.) Modification to sprinkler heads only: Describe to 1-. 1 -10 heads: No plan review required. be done: 2. 11 +' heads: Plan review required. Number of sprinkler heads: 42— Additional description of work: Type of System (Complete A, B or C as applicable): A.) Sprinkler Wet 'El, Dry ❑ Standpipes Additional Hazard Group ucl Information Density a,to Design Area K. Factor c. Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Project Valuation $ C.) Fire Alarm Submittal shall Battery Calculations Yes LI include: Individual Component Yes ❑ Cut Sheets Fire Alarm Project Valuation: $ Project Valuation Subtotal (A, B & C): $ Permit fee based on valuation (see chart): $ 8% State Surcharge: $ FLS Plan Review 40% of Permit: $ 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. is \dsts \forms \FPSchecklist.doc 11/21/01 Fire Systems West LETTER OF TRANSMITTAL 600 SE Maritime Avenue, Suite 300 • Vancouver, Washington 98661 Date: 6 -1 -05 Job NO 1 -11 -8597 WA. CL# FIRE SW1 140B1 • PHONE 360- 693 -9906 Attention: PLAN REVIEW RE: 1) FFiC6 €5 CC TO: CITY OF TIGARD fl L ® � 1u u G Fin pt OF TIC WILDING DIVISION WE ARE SENDING YOU', Attached Under separate cover via the following items: Shop drawings Prints Plans Samples Calculations Copy of letter Change order COPIES DATE NO. DESCRIPTION 5 6 -1 -05 SET FIRE SPRINKLER PLANS 5 SPRINKLER HEAD DATA SHEETS THESE ARE TRANSMITTED as checked below: For your approval Approved as submitted Resubmit copies for approval For your use Approved as noted Submit copies.for distribution As requested Returned for corrections I Return corrected prints For review and comment FOR BIDS DUE 19 PRINTS RETURNED AFTER LOAN TO US REMARKS: PLEASE RETURN PLANS TO THIS OFFICE AT YOUR EARLIEST CONVENIANCE WITH YOUR APPROVAL AND OR COMMENTS. COPY TO FILE SIGNED , CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2005 00212 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/9/2006 Phone: (503) 639 -4171 : "r Insp <', ; Requests (24 Hrs.): (503) 639 -4175 Aar INSPECTION WORKSHEET FOR DATE: 7/8/2005 TIME: 7:10AM PAGE: 75 SITE ADDRESS: 10520 SW CASCADE AVE CLASS OF WORK: SUBDIVISION: OFFICE DEPOT LOT #: TYPE OF USE: PROJECT NAME: OFFICE DEPOT DESCRIPTION: Relocate 42 sprinkler heads. OWNER: MARX, ERNEST L + BARBARA R, PHONE #: CONTRACTOR: FIRE SYSTEMS WEST INC PHONE #: 360- 693 -9906 Inspection Request Scheduled For: Date: 7/0/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message Mie aepeeth n 360.693 9906 N �4 q F( 61Y �- St i or-ct a2. d ((©lei ^'� I Corrections /Comments/ Instructions: 10 ' ((--- NO (1 aV _ _ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I I FAIL (l CALL FOR IN PECTION ❑ ADDITI NAL F ES ASSESSED .-- vii Inspector: 'l Date: 6. Phone #: (503) 718 - ,