Permit y
CITY OF TIGARD PERMIT
iklys PERMIT #: BUP2005 -00349
j y; � DEVELOPMENT SERVICES DATE ISSUED: 9/13/2005
'' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S135DD-03301
SITE ADDRESS: 11945 SW PACIFIC HWY 250 ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT: 002 JURISDICTION: TIG .
Project Description: Fire protection.
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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 938 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: $ 17,517.00
Owner: Contractor:
TIGARD PROPERTIES INC TYCO FIRE & SECURITY
8320 NE HWY 99 6305 SW ROSEWOOD ST.
VANCOUVER, WA 98668. LAKE OSWEGO, OR 97035
Phone: 360- 574 -6255 Phone: 503 - 683 -9000
FEES Reg #: LIC 149921
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/26/2005 $216.10
[TAX] 8% State Surcharl 7/26/2005 $17.29
[FLS] FLS Pin Rv 7/26/2005 $86.44
Total $319.83
Th is 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 - . • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -• 01 -0010 th •ugh OAR 952 - 001 -0100. You may obtain a copy of these ru or direct questions to OUNC by
calli g 503 - 246 -66' 9 •i s 332 -2344.
Iss -d B • i . i / , Permittee Signature:,_ ft , `_, W L!TL /! 1
Call 503 -639 -4175 by 7:00 a.m. for an inspe « io• that b , si ess day.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Fi iiit' S s Q ` I/0J
e rotection System
uildin2 Permit Application �d
I roR owlet.: usi.: oNi
' City of Tigard RECEIVED Received — 1 �.- %� .` /
Date/B .
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review, I / �
Phone: 503.639.4171 Fax: 503.598.19 /A-.': ,. - i 1\ D . t � „✓ Other Permit:
Inspection Line: 503.639.4175 J 2 6 2005 4,; .� —. Date Ready : • 7� 0 � Jens: 10 See Page 2 for
• Internet: www.ci.tigard.or.us Notified/Method 4 V Supplemental Information
CITY { (TIIG/ARQD \ , c J 0` 0 � 4A/ )4.42).--
BUIt� l �OF" W IC N REQUIRED D A: 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
❑ Addition /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 CI Commercial /industrial Valuation: $
❑ 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: 7 111 y s 5 Lc/ WGY4 ri, 4 2 co New dwelling area: square feet
M ew ew 04,1 V R f (aAJ e 7 'Z Garage /carport area: square feet
Suite/bldg. /apt. no.: v Project name: •r k 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: I 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: $
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( )
New:
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: A.DT S V , i(y .s yS vin.3 All contractors and subcontractors are required to be
Contact name: K e� • h ,,,z4 u ) / licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 26-t:S' 5 4/ / ' b ? dr/ de— jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: Reeiver ✓l, c2R.1(JUy ° 1 / 7006 apply:
Phone: (9501 / L Z�Z I Fax: : ( 953) f 6q _ 7110
E -mail:
CONTRACTOR
Business name: SG) 141..e• 111 J� ') A 110t/ C. — BUILDING PERMIT FEES*
Address:
• Please refer to fee schedule.
City/State/ZIP: Fees due upon application
Phone: ( ) I Fax: ( )
CCB lic.: z 5,952 / '° r 1 ) �/ '7 Amount received
v� Date received:
Authorized signatu e: ) ��' / This permit application expires if a permit is not obtained
�/ within 180 days after it has been accepted as complete.
Print name: 1 l/I a 1),,,, Date: 7— 2.6 --(,r • Fee methodology set by Tri -County Building Industry
Service Board.
i:l Building \Petmits\FPS- PermitApp.doc 12/03 4404613T(11 /02JCOM/WEB)
•
A
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) a 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: I $
C.) Fire Alarm
Submittal shall Battery Calculations Q Yes
include: Individual Component E Yes
Cut Sheets
Fire Alarm Project Valuation: $ j '7 51 — 1
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.
I:\ Building \Pamits\FPS- PermitApp.doc 2
CITY OF TIGARD
rx e
BUILDING DIVISION PERMIT #: BUP2005.00349
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 I 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .� °;II��
INSPECTION WORKSHEET FOR DATE: 9/14/2005 TIME: 7:09AM PAGE: 89
SITE ADDRESS: 11945 SW PACIFIC HWY 250 CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.1 LOT #: 002 TYPE OF USE:
PROJECT NAME: JO - ANN FABRICS
DESCRIPTION: Fire protection. i
OWNER: TIGARD PROPERTIES INC, PHONE #: 360- 5746255
CONTRACTOR: TYCO FIRE & SECURITY PHONE #: 503.6839000
Inspection Request Scheduled For: Date: 9/14/2005 Pour Time: .20
e` # I e Despripton Confirm # Contact # Messa•e
299 S> ectio
015606-01 in ection 1 503 - 469-72 Final 503-469-7212 ir, � a1 a 1 c.,...es — KRA
orrectio s /Comments /Instructions:
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I ,,,ss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ Date: 9 /$Phone #: (503) 718-