Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00077
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DEVELOPMENT Tigard, � 639 -4171 DATE ISSUED: 3/2/2005
SITE ADDRESS: 07080 SW FIR LP 100 PARCEL: 2S101 DB 01000
SUBDIVISION: 72ND BUSINESS CTR -VARNS PARK ZONING: C -P
BLOCK: LOT: 012 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT 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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 13 BASEMENT: sf AREA SEP. RATED:
STOR: 2 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: $ 8,745.00
Remarks: T.I.
Owner: Contractor:
SHROYER RANCHES INC VJ CONSTRUCTION
BY REX SHROYER 18428 STEAM BOAT WAY
PO BOX 1538 WEST LINN, OR 97068
P ILOMATH, OR 97370
Phone: 503 - 515 -6478
FEES Reg #: LIC 106905
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/2/2005 $129.70
[TAX] 8% State Surcharl 3/2/2005 $10.38
[BUPPLN] Pln Rv 3/2/2005 $84.31
[FLS] FLS Pln Rv 3/2/2005 $51.88
Total $276.27
This permit is issued subject to the regulations contained in the Tigard Muniapal 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: :)
Permittee
Signature: ,/ ,�
Call 639 -41 :00 p.m. for an inspection the next business day.
This permi 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 Protection System
Building Permit Appl .. FOR OF I ICE. USE 1',
City of Tigard Received !, --9E114- J/��/� Permit No ° _, D
q 1
13125 SW Hall Blvd., Tigard, OR 97223 Date/B • (J LJ
g
Phone: 503.639.4171 Fax: 503.598.1960 MA R �4 20� / /N�+ +✓r ' . I` :'`-f .. Plan Review - Other Permit
li'
Date/By �� a
Inspection Line: 503.639.4175 „ ■ _ Date Ready/By: Eli ® See Page 2 for
Internet: www.ci.tigard.or.us an( Of I N Noti fied/Method: Supplemental Information
'1301.1-4K 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
lia Add ition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2 -family dwelling 21 Commercial /industrial Valuation: $ —*g, V 0
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 7080 SW f/R Lo€ P New dwelling area: square feet
City /State /ZIP: 71 6 1A -- AZ D , 0 /t 972.2 3 Garage /carport area: square feet
uit /bldg. /apt. no.: A to Project name: T // Covered porch area: square feet
Cross street /directions to job site. Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CH ECKLIST'
Subdivision: 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.
7 f, ` ilz(j(/E/Yex/ /5 Valuation: $ g 741f, O D
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER . ❑ TENANT Number of stories:
Name: S /oyCj? r(J AJ.J„S 8Y ecck 5HR0 ie Type of construction:
Address: PO /59 / 6-5 8 Occupancy groups:
City /State /ZIP: P # /( r 02 ?7■770 Existing:
Phone: (.5 ) 92q 24 9y Fax. ( ) New:
. Et APPLICANT ° ❑ CONTACT PERSON' ;
NOTICE ` , - ,
Business name' (/T co, (/S 7je(JC Ti Oft/ All contractors and subcontractors are required to be
Contact name: (/T ToVtli /Q(/ /C licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address. / ((f 2 ( 57C AT 1,1/.4 -Y jurisdiction in which work is being performed. If the
City /State/ZIP. tea-7 L //V/l/ applicant is exempt from licensing, the following reasons
apply:
Phone: (613) 7 677 Fax:: ( )
E -mail: (/T e UJe JS Teo CT /CTXi• c
• . CONTRACTOR .. -
Business name: VT C,0NITje(JC-T /67, BUILDING PERMIT FEES*
Address: 1� i, /A¢ k 5 "1-6.5(/
Please refer to fee schedule.
City /State /ZIP:
Fees due upon application
Phone:( ) Fax:( )
Amount received .2 1 K , L1
CCB lic.:
Date received:
Authorized signature: This permit application expires if a permit is not obtained
t, within 180 days after it has been accepted as complete.
Print name: Vi TO 0 (/ /t= Date: z/2 7 /oj * Fee methodology set by Tri -County Building Industry
Service Board.
\BuildingWermits\FPS- PermitApp doc 12/03 440-4613T(I 1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
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:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
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.
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RCO NDSCAP IRON I <d - — OWNUNN e
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(DOWN 0.Y) (HELD) 1 I FENCE ------------.4... /
COVENANTS. pIlTONS. RESTRICTIONS, ESE MENTS n0
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BOOK 1 2, A IN
AC PAVING Q FEE DECLARATION 21240 A5 SHOWN HEREON.
Z 1997 IN BOOK 1221, PAGE 830.
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EASEMENT, INCLUDING THE TERMS AND PROVISIONS THEREOF FOR q f
Tu" 2� MCN DRIVEWAY AS RECORDED SEPTEMBER 2, 1981 IN FE NO. TaTpwt SrpNn mcn TM rm.
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FOUND 5/8 IRON ROp 81029990 AS SHOWN HEREON. ,yNm,Qp
LOT 13 1 ` ' • P NO CAP (DOWN 0.7 (HELD)
EASEMENT, INCLUDING TH TERMS ANO PROVISIONS STAID O TO
.9. n STRUCT AND MAINTAIN HIGHWAY SLOPES GRANTD TO STATE O< • 72ND BUSINESS CENTER ll HIGH DIRSIDN AS RECORDED O SEPTEMBER 21, 1982 N OR FEE NO. -'
U ^ �^ 82024337 AS SHOWN HEREON.
BOOK 40, PAGE 2 / `A O, `,, g
/ \ XO Q ACCESS RESTRICTIONS, INOLUDING THE TERMS AND PROVI2ONS
DEED I
JAMES F. CRUMPACRKER - LA N • EASEMENT PER EKCERTON QB THEREOF IN O RECORDED SEPTEMBER 21, 1982 IN FEE NO. 82024337 AS
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NOTES UTILITY STATEMENTm
T TITLE REPORT EXCEPTIONS, PROPERTY DESCRIPTION, AND SURVEY AS SHOWN THE INDERGROUND UTUTIES SHOWN ARE PER FIELD MARKINGS AND RECORD \ \ /
ARE PER STEWART TITLE TRI- COUNTY, ORDER NO. 97144133 -MN. DATED DRAWINGS PROVIDED BY THE RESFECTINE UTILITY AGENCIES. LOCATION OF \ \ / 0IR
DECEMBER 18 1997. NON - OBSERVABLE AND /OR UNDERGROUND UTILITIES ARE S-10.1 FOR '
INFORMATION ONLY AND ARE NOT GUARANTEED TO BE COMPLETE OR ACCURATE. \ MB o TR SURVFYOR'S CERTIFICATE
DEPICTED 2. BOWING RESTRICTIONS, ENCUMBRANCES, AND EASEMENTS WHICH ARE DEPICT
IN THE TILE COMMITMENT ARE SHOWN HEREON. PLEASE REFER TO YOUR TILE / I HEREBY CERTIFY TO STEWART TILE TRI- COUNTY AND LCD & ASSOCIATES, A
ABSTRACT, DEED, GUARANTEE POLICY, TITLE COMPANY, LOCAL GOVERNMENT BODIES. 4 = 2329'11" \ B ,O WASHINGTON LIMITED PARTNERSHIP, THAT A SURVEY WAS MADE ON DECEMBER 22.
LOCAL ORDINANCES. AND OTHERS. IN ORDER TO DETERMINE IF ANY ADDITIONAL • RESTRICTIONS. ENCUMBRANCES. AND EASEMENTS WHICH NAY EAST R - 6$25 \ UTILITY VAULT 1998, UNDER MY SUPERVISION, AND THAT IT CORRECTLY SHOWS T B a
AND IMPROVEM TH
ENTS EREON THE PROPERTY HEREIN DESCRIBED, AND
CB = S52•35•33
3. BASS OF BEARINGS: HELD THE PLAT OF 72ND BUSINESS CENTER RECORDED C 4. 30.00' \ THAT THIS NAP AND THE SURVEY ON WHICH IT IS BASED WAS MADE IN
_ ACCORDANCE WITH •MNIMU STANDARD DETAIL REQUIREMENTS FOR
IN BOOK 40. PAGE 2. WASHINGTON COUNTY PLAT RECORDS.
\ 4 j _ - ' SS - - -- A DOPT . / R C.S.M. LAND TIT LE SURVEYS'. JOINTLY ESTABLISHED AND
U .ME IRE RO
THHERE ERE ARE DTS OF LDING AREA SHOWN HEREON WAS CALCULATED PER OUTSIDE BUILDING \ R ADOPTED BY A. A. A CLASS SS • p ^ S A.C.S.S OR N 1892, NESTS HE URVEY, AND THAT, EXCEPT AS EXCEPT AS SHOVE,
Y
E NOT ENCROACHMENTS OVERHANGS OF ANY IMPROVEMENTS
0 THERE IS A TOTAL OF 32 PARKING SPACES OF WHICH 2 ARE HANDICAP. \ I V.
UPON EASEMENTS, RIGHTS -OF -WAY OR ADJACENT LAND, OR ENCROACHMENTS
Q 4
BY IMPROVEMENTS LOCATED ADJACENT LAND UPON THE HEREIN •
G. THE SUBJECT PROPERTY IS ZONED "Cr (COMMERCIAL PROFESSIONAL). BUILDING SETBACKS n O DESCRIBED LANG.
ARE FRONT = 20 FEET, SIDE = 15 FEET. & REAR 44 25 FEET. \ o
8• CONE CURB , / < \� REGISTERED DS
(Tw) \ ` PROFESSIONAL Q
V 'ND i R EYOR RET
Xis Hs; 1 (A 3
GARY R. ANDERSON .�CJC3 NU
• 1209 -01
16 =Y N3
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 001)77
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171""u� ° IUypupol'iI�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: PAGE:
511112005 TIME: 7.12AM
SITE ADDRESS: 07080
SW FIR LP 100 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
72ND BUSINESS CTR -VARNS PARK 012
PROJECT NAME: LDS CHRUCH
DESCRIPTION:
T.I .
OWNER: PHONE #:
SHROYER RANCHES INC,
CONTRACTOR: VJ CONSTRUCTION PHONE #: 503 - 515 -0478
Inspection Request Scheduled For: Date: 5/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 006393-02 503-515-6478 N
Corrections /Comments/ Instructions:
r---- 101V---'
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
j r
Inspector:
AP �, . Date: ✓ ` i Phone #: (503) 718-
,