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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2004 -00501 �1�� DEVELOPMENT SERVICES DATE ISSUED: 10/20/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1S136DC -00500 SITE ADDRESS: 11626 SW PACIFIC HWY SUBDIVISION: ZONING: C -G 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: UNK : sf N: S: E: W: OCCUPANCY GRP: 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: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 2,100.00 . Remarks: Add (4) & relocate (2) sprinkler heads. Owner: Contractor: REGAL CINEMAS VIKING AUTOMATIC SPRINKLER CO BY ACT III 3245 NW FRONT AVE 7132 COMMERCIAL PARK DR PORTLAND, OR 97210 KNOXVILLE, TN 37918 one: Phone: 227 -1171 Reg #: MET g 0 4 0 g 0 3 02 2 816 FEES LIC REQUIRED INSPECTIONS Description Date Amount Sprinkler inspection [BUILD] Permit Fee 10/20/2004 $72.10 Final Inspection [TAX] 8% State Surchari 10/20/2004 $5.77 Total $77.87 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: _ . _41.-Air St e Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection System BuiIdilld Permit Application FOR OFFICE USE ONLY City of Tigard Received Permit No.: k O US O 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /..,',c tt w:` Date/I3 : Other Permit: Inspection Line: 503.639.4175 6. • Date Ready/13y: See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information TYPE OF WORK 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 171 Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: S 21 OD"— ❑ 1- and 2- family dwelling riQ Commercial /industrial El Accessory building ❑ Multi- family Number of bedrooms: ID Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION ' Total number of floors: Job site address: 11 Cot S.. - PAC: C' G Nar l y New dwelling area: square feet City/State/ZIP: bGAR.O Oil • ��2, / State/ZIP: Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: Tt GAtZa CA N E.-N. A Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST 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. • Valuation: $ 2 too 0 p0'p i, RftsLOL A G Pe.-1.3 U S1JT ' S■?0.10141.E CLS I t,] 2 SMDO@ - 1.S.D 'E. NTti� O C. tt St . P. Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: S ra` ` �.rbS Type of construction: Address: i 1 (a'L& 5 . W` '7f4 cl Q, 1 ,....).7 Occupancy groups: . City/State/ZIP: — 7", % r cT Existing: S J '?2 : g Phone: ( ) Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE Business name: \L i 12/: u Cr k tA.r t) tA.AT'1 C S ∎..1 LeR Cr— All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board W 4� N C. V.) I ►35 under ORS 701 and may be required to be licensed in the Address: .1tA S kl t .1 . . ZO NT AV E • jurisdiction in which work is being performed. If the City/ State/ZIP: applicant is exempt from licensing, the following reasons 1�O - L 5 v. 011 . �1'Li 0 apply: Phone: (So3) 221 -11 l 1 I Fax:: (So3) Z-L - 1 S5Z- E -mail: CONTRACTOR Business name: V t 1ua c Aug o M/%_'t"b C. S PIL:t ►-tk -Lf;CL C,v • BUILDING PERMIT FEES* Address: S Atv.c. A5 A130■ E Please refer to fee schedule City/State/ZIP: Fees due upon application Phone: ( ) I Fax: ( ) Amount received CCB lic.: 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: W A y o vat u9Z o 1.1 Date: \ 0 _ ‘s , 04 * Fee methodology set by Tri- County Building Industry Service Board. is\ Building \Pennits\FPS- PemtitApp.doc 12/03 4404613T(11/02/COM/WEB) Fire Protection Permit Check List M � Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition 1 -1 0 heads: No plan review required. �]C Alteration El 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 oa.o • Na Density Design Area K. Factor 5.1, Sprinkler Project Valuation: $ 2 o o °�' 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): $ i 2 .1 O Permit fee based on valuation (see attached chart): $ Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ 5 •'1'i FLS Plan Review 40% of Permit Fee: $ TOTAL: $ 11. 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 \Buildin 12/24/03 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST INSPECTION DIVISION Business Line: (503) 639 -4171 BUP °� Received Date Requested / _ ( fa AM M BUP Location 1 ° I / - - - _ uite M Contact Person Ph ( ) ?it PLM Contractor Ph ( ) BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Al!! Susp'd Ceiling �� !l' Roof . 5% ■ Other: G %.' -ASS PART FAIL • L - ING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer 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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please - for rein-. section RE: �11 ❑ Unable to inspect — no access Fire Supply Line •'�`� ADA e' • Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL