Permit CITY TIC�►� BUILDING PERMIT
A PERMIT #: BUP2006 - 10005
,� DEVELOPMENT SERVICES DATE ISSUED: 3/31/2006
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I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 C B - 01802
SITE ADDRESS: 13405 SW PACIFIC HWY ZONING: C -
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: fire suppression hood
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: Asti 0 FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: sf N: S: E: W:
OCCUPANCY GRP: B 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: $ 1,850.00
Owner: Contractor:
BARUCH, ISAAC TRUSTEE UNIVERSAL FIRE EQUIPMENT
BY PACIFIC PIZZA CO 8049 SW CIRRUS DR
1905 NW 169TH PL STE 201 BEAVERTON, OR 97008
BEAVERTON, OR 97006
Phone: Contact #: PRI 503 641 - 8702
• FAX 503 - 643 -1472
Reg #: LIC 86723
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 3/31/2006 $62.50
[TAX] 8% Sate Surcha 3/31/2006 $5.00
[FLS] FLS Itln Rv 3/31/2006 $25.00
• Total $92.50
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: Permittee Signature:
7
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.
I 13yoS Gll i4-tvy
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Fire Protection System
. BuildinE Permit ADDREOEI , m.3 rolz 01.-Fic 1.: tisi.: ()NI.,
, A
City of Tigard Received
Date/B ,e,A, - 8 49 0 ., 4, Permit No. Bo pa 001.0- km05
13125 SW Hall Blvd., Tigard, OR 97223 iE It s . 4'1 .•- i i 6 Plan Revie
Phone: 503.639.4171 Fax: 503.598.196 - Datem . ..../ - vg Other Permit:
Inspection Line: 503.639.4175 ‘ ' _ii 1,1. " I 1 Date Ready/By. B See Page 2 for
Internet: www.tigard CI OF GAR' — — Notified/Method IliM Supplemental Information
BUIL ING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2-FAMILY DWELLING
New construction 0 Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
0 Addition/alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
CATEGORY OF CONSTRUCTION
72
El 1- and 2-family dwelling Commercial/industrial Valuation: $ :15
0 Accessory building I 0 Multi-Family Number of bedrooms:
0 Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:i3V S''' s. Re ic-r e____ od-L.4..27 New dwelling area: square feet
j‘9 Iv a nii 97 za.3 Garage/carport area: square feet
City/State/ZIP: /
Suite/bldg./apt. no.: I Project name:Ali 140,,,s ge7 f --- 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map/parcel no.:
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
S Valuation: $ / ? 5 2
-,s-firs c5cc- at- OO keSq 7
Existing building area:____ALiare feet N
Sys
1 ...%
New build' ea: square fe
gjth 44 149-494 I
0 PROPERTY OWNER XTENANT Num of stoREGFIVED
-
I
Name: --..,7F 'C.._ 1.0 ; aa-e,,,- T e of construction:
LDi 1 T :: ::
Gv 1 2 O
1 0D N
Address: 1 31 c..0 s 5;3. 1 /71-i-i y ccupancy groups: PI y z
City/State/ZIP: 1 ya.,2 -r at - 77zz3 Existing: BC:
s
Phone: ( &.3) 6 -4 7V-4.D ?t) Fax: ( ) New:
pCAPPLICANT A CONTACT PERSON
&
Business name: L tv et 0 .. , i f7 e„. ilyt de,-1- 1 ,7 .c, All con ors and subcontractors are uired e
licensed with e on Construction ctors Board
Contact name: r e. hi
under ORS 701 and maybe required to be licensed in the
Address: gC cNt Y.-2 Ci (' r LI s Or. jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City/State/ZIP: r?,12. 4 0C_ fi' 70 s:". apply:
Phone: (.3 ) 6 I / _ Q-70 7,_ I Fax: : EZ3 )6 cf3 —/ Tz_
E-mail: P °
CONTRACTOR CVez• 0 C a 6
Business name: f i V ..ei sy9— f F 2,4.e )7c'17 0,....1.74-C., BUILDING PERMIT FEES*
Address: 'go etc) ,5 C../ re & at% Please refer to fee schedule.
City/State/ZIP:Ba A . a-ivith_-, or_ 9 .
Fees due upon application
• Phone: (0 c‘i....S=702,_ / 1 .
Fax. (ard 3)16 t e? . 7C
CCB lic.: gi6 7 2
4
Date received:
Authorized signatur : C 2 ,0 , - Amount received
This permit application expires if a permit is not obtained -
within 180 days after it has been accepted as complete.
Print name: Ce7 1444 I Date: 2_-21?-0 • Fee methodology set by Tri-County Building Industry
Service Board.
I: \ Bui IdingTam its \ FPS-Perrn itApp.doc 12130/05 440-4613T(11/02/COMMEB)
e 1 • s y .
City of Tigard: Fire Protection Permit Checklist '
' P4e 2 .Supplemental Information • 1 ; j
Describe work to be done: � ;
1.) ►.d 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 g5o
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 2 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 \Permits\FPS- PeTmitApp.doc 2
CITY -OF TIGARD 8.
BUILDING DIVISION PERMIT #:;606, _ to D Q
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED:
Phone: (503) 639 -4171 i t t ai i ii f Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / ,3 (-tQ S /9 CLASS OF WORK:
SUBDIVISION: (/ LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: I PHONE #:
Inspection Request Scheduled For: Date: 3 -1 7 -6( Pour Ti
Code # Inspection Description Confirm # Contact # Message
q-A, )14.4 ( o) a_v `-tcas"a-
Corrections /Comments/ Instructions:
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[✓ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDIT ONAL EES ASSESSED
1111 i
Inspector: Or Date v � Phone #. (503) 718- ���