Permit 4 /6% / R i A
L�ING PERMI�
F TIGARD
PERMIT #: BUP2004 -00136
'Ile V E L O E
' "'-"' 13125 DE SW Hal Blvd Tigard OR 97223 SERVIC (5S DATE ISSUED: 3/25/04
Sig
03) 639 - 4171
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114AA 00100
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
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: El TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 8,200.00
Remarks: Installation of Smoke detectors, Strobes & Pull Stations @ Portables
Owner: Contractor:
SCHOOL DISTRICT 23J PORTLAND ELECTRICAL CONST INC
13137 SW PACIFIC HWY PO BOX 586
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone:
Phone: 655 -2281
Reg #: LIC 51274684
FEES ELE REQUIRED C INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 3/25/04 $129.70 Fire Alarm Insp
[FLS] FLS Pln Rv 3/25/04 $51.88 Smoke Fire Ala Insp
detector insp
[TAX] 8% State Surchart 3/25/04 $10.38 Smoke detector insp
[FLS] Addl FLS P1nRv 4/21/04 $62.50 Smoke detector insp
Smoke detector insp
Total
$254.46 Smoke detector insp
Smoke detector insp
Misc. Inspection
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.
Issued By: / e / / L- 4. 4T-Z5
Perm ittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00136
il Il DEVELOPMENT SERVICES DATE ISSUED: 3/25/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09000 SW DURHAM RD PARCEL: 2S114A0 00100
SUBDIVISION: ZONING: R - 4.5
BLOCK: LOT: JURISDICTION: TIG
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: El TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 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: $ 8,200.00
Remarks: Portables #1, #2, #3 & #4, installation of fire alarm system.
Owner: Contractor:
SCHOOL DISTRICT 23J PORTLAND ELECTRICAL CONST INC
13137 SW PACIFIC HWY PO BOX 586
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone:
Phone: 655 -2281
Reg #: LIC 51764
FEES ELE REQUIRED INSPECTIONS
Description Date Amount Fire Alarm Insp
[BUILD] Permit Fee 3/25/04 $129.70 Misc. Inspection
[FLS] FLS Pln Rv 3/25/04 $51.88
[TAX] 8% State Surcharl 3/25/04 $10.38
Total $191.96
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
952-001-001I • • h OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (. ) 246 -669° or 1- 800 - 33344.
Issue. By:
. i 9. „ f it '!
• Permittee — ".
Signature: J
Call 639 -4175 by 7 p.m. for an inspection the next business day
I
Fire Protection System
y'
• Building Permit Application F.OR;OFFICE USE' ,ONLY' �j •
City of Tigard Date/Bea O U P . 019 47‘
Permit No ✓ r
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503 639.4171 Fax. 503.598.1960 _, /0�j tl Date/B 25 ` Other Permit:
+ '
Inspection Line: 503.639.4175 'el I' Date Rea.y /By Tuns ® See Page 2 for
Internet: www ci.tigard.or.us Notified /Method Supplemental Information
.: �: ,., - '� � *�•, �.•wntx *'� x ?�a ^y e,':° *x a .��:^ ",`: ?<a ''� ; ,' ,��;,y 'a - ,SO' ° >9� .,�3,.�ci�,: ",v.' ,�_�.; �;,�'> g ar. F M: «? - c
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❑ 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
.. •z, 40c,iA4, riV -a, ;, F, .,, -,' �:, =.f.r, .,,. __� �. - ; s ` ,,,, �; ,,,,` V , ,a,r work indicated on this application.
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�' = �:'x�,�,' - :..,''.� 1, ; r � :: .',a,� . ,. ���;- * °�= u- � s�z ^ � 'rr��.ta�., „ ,�'.,.� 4.: = .,. ,a:�'',v: -'?�x ;a �; r��ic� .,'. %}?%� >i:s`: °x
.. "fk'x 1 "��ib. :�x..�� n� �.
Valuation: $
❑ 1- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
! w11'' ` "" ;�I , _ A ai `. Total number of floors:
..; M .. ,.. , ; ' 0 TOB ST�I E, i1'ND ".I OCATION, :i,;, ': � ,: ;.r : , ,; `, .'
��M s�� ,;:: � � . _e�"� h ��e s„ � , s = -z`w °� «ra�,.�,_� ^,� ^.. ^.nti.,�r =mow. -�,.�� �"�,R.�s, -s, <. v , '��. .te. a .. s ,.
Job site address: 9X0 Ski D -7 P.• New dwelling area. square feet
City/State /ZlP: /', p ore__ Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 0 i 4- f /1"/-5- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
Iii- 4 DATA: - COMMERCIAL TJSE:CAECICLIST
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
� , ,fit_. - -,a x: ,,;.�.r> .:, : _•,, t ; ii ∎ii. ; vai , —,. '- :r<, h. • s ,,,. ; ,. . 1
i`"�' ' �w: :f : ES'CRIPTION.;O °WORK ti "' , , a, •, i . �, ' ;= ' , work indicated on this application.
F Re / 6 5 - Valuation: $
r Existing building area: square feet
New building area: square feet
."'',',1414,,N1 . .. .
«.� q30` -- °V rr: »:, ;(,sir _m,i"k� ^yms.�:, - : . X , „.. ,,,= ,:.,,
x ;- `,❑!P ROPERT Y• '" ` TEN' . ^ Number of stories:
°�OWNER 'Y��'ry ' ° ® ANT �,. � �,
. .,. -, ..», ��<,.,.:1rs �§: §;., MnW «.s`�s` . °�-':x�.;z't�' a�,.,.,�,., xi,.�.'da, +=x's .� , -°,�, •skt.-..�:.iF.: ��iti•��s�.s`atw "•�,.,
Name: �jhye® �' jJ G p,5772fe% Type of construction:
Address: 77 Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax:'( ) New:
s g'? .,%.. z- , n F,04,s� ^rrviro,r ya ",a 3. zXr.it tebv,- > •ail, .. x,. s: _ 's ` ,.; ,A, :
'Y' i1 - ;; . ;, ,_- ',APPLICANT',` , '
-a4 ,_, :,,;i: `� ❑s CONTAC T PERSON _;.' : -
-1<: , "s ' ' ', St o4 x -- : ..ssM';5., h,, :
' . ,` t t . 'rte;: v ,1_ .. .�;4A, , : . ;.,• '4v.} : . , , ., " '44..4.4' „ 'r '%.14' , "_, - ' .
Business name: 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: Junsdiction in which work is being performed If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax: : ( ) y' , T / zU
E-mail: / � Q
;Si�y''� ;'':ai t.:s, ^• „^`,- : -a,. *,'r ..at=1 ` ' F -=,�' s` :, ^z % ^`� - � r ; f- , ,,`f "a:` c ;�r.,-. x =' :<. ,:3, _, r`_ J / "
; ret;',':yz, r..; F;:'i :.. , F y '-;,,, reAl R:ACT s , �w z ? :• , . , ,.e;
Business name: � $H7 &% $' 6 9z C. IkJi 7: / ...../c,,, �.. .. , _ . - „
B TERIVIIT FEES*
Address: M/9 7� � T l 0 3 >< „j g � please refer to fee schedule
City/State /ZIP: J D, p
G 071) ( d 9? o y�
"�” `1 � Fees due upon application I ?!
Phone: ( 23 ) &,55 Z 249 ( 1 Fax: (5 b3) ( SS— 5-633
S 7 6. Amount received
CCB hc.: "
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: lie A 484217 CA- Date: 3-26
-2 6 °b ( * Fee methodology set by Trt -County Building Industry
v �� Service Board.
i \Budding\Permits \FPS- Perm,tApp doe 12/03 440- 4613T(I1 /02 /COM /WEB)
Fire Protection Permit Check List
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N ,.D;escrib ��.,v.�_:z..� . ° �.�..¢ > « __',� _.;,.�' �W, <.,
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
x':'u't ; ^.,�� .b, r`.�'` „ �: •w" d „, bb ?,_ q `9"" .,..,�,,�, 'a'• ,;, � :;' ,. € ^' `: 't.; "' - .s - _ . _ ;.z »,c�r, .' .;.;;,'rr. ,.t
P
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' 7 "' Asa., ; Y;'. x: t �''• ` '.i, :..r t;, . - Y. f :, ,u$'pi:''.. 4'' , .r;,Y'�;r = `z x ••: §', oz> "r' ^3 „ u,.a`.F "` , r.3 ;:';
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
,;,,,, °'ii, =n,., =l. " »p :.„'„,, ,.:# *'f�'`:'":,r:.�-'. .µ,em. .�'s "in:. ��h"r.'.`,'Yx""; - �{ ,.v- .s;. ';'�.
h ;'�'�F { �'r� - �'�,3:. �'; �.,�FntT,.z ✓� '� �.,Y } �.e : :'`.>.' {k»' :.� ^° � . ,�. �sq n3
_,ifk kTypeTati :io eVlif$ufP.Peession System ,..�` : �•';:. , •_�.,:;, .'. _ -
Hood Project Valuation: $
, �-� "':,4 "'.a »�.rr.'v'fr�. ^,G ^« _ " ,�3��;; ,,�,' » n.^„ar. ;:.��- .��;,;, �s.�,,�rc.,- . -,3�<, , ,'= '3,5 "" - '_ t >,•. .'�'.» 7' : _
�C:� ',' a,' ,�� �u� �,Y�y." �;a{ �.. {- "'f..ti.t _.;2�r'�xuii: t =' - - tr, -r: ?"� �'�' "„ , F � • � ,> "s`�'*'�'�p ,z . '�� - 't;
�F><re�A�la'rm < , ''�: '�. �� ,x ,�.�,'''' , ���- :� ���,��,.� � =`° .m � M���se
)a � „ e�� tr `�- _ �� . .>�; �� r'��. <w d' , _. ;""r'.''''E;ai: �:� ' ,`�u�,_r. a,�e -.: < -� '�': °:' '
Submittal shall Battery Calculations ❑ Yes
include: Individual Component E
Cut Sheets
Fire Alarm Project Valuation: $ 62.0 o •
.<.�< h ”" `m'.;"' : %� ,' A.: i. "' }a"' : F ",E?'".m t `",�. § '"" ei ''" t ' "". °.`� s� ' -' z E1 , •`S<° .>M ,,a tail ry'=' ". F ,.' a? . „ ` :F: ;F.�; ;
�D ;' er; k Mon stem) l i •V:t':.
.) �:R�esid�ntilal;S�prmkl s „��(S _ � ��. w �.�m r.� �y .,e ..�_�)�- ���e�', °;��» ;: •.. ��6��
Square Footage: Permit Fee:
0 to 2,000 $ 187.50
s : ';•, :�
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.
i \Building\Forms\FPSchecklist.doc 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
s, BUP 7 e-i- - C)c)/ (d
Received Date Requested ' .-- AM PM BUP
Location � � A .....4. � .� /L Suite MEC
Contact Person Ph ( ) ,v Z 8 .6" '--- PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear - � Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof ; ■_ 4t'
Oth ! j'
w , •,Ipp7 IF
PART NG FAIL
/- i
= I
Post & Beam
Under Slab
----- e*±_
Rough -In ��
Water Service Al.,,,
Sanitary Sewer ��� • i /
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL