Permit A , C ITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00506
° w ,�l� , , , DEVELOPMENT SERVICES DATE ISSUED: 12/13/02
A. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13727 SW PACIFIC HWY 100 PARCEL: 2S103DD -00400
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: : 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,550.00
Remarks: Hood fire system
Owner: Contractor:
WILSON'S TIGARD RETAIL CENTER UNITED FIRE AND SAFETY
BY BOMCC ESCROW ADMINISTRATION 4611 NE MARTIN LUTHER KING JR
TX1 -2495 PORTLAND, OR 97211
DALLAS, TX 75201
Phone:
Phone: 503 - 249 -0771
Reg #: MET 0 0ED IN 0 o 0 g 0 3 30 29 9 � 3
FEES LIC REQUIRSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 11/20/02 $62.50 Sprinkler Final
[TAX] 8% State Tax 11/20/02 $5.00
[FLS] FLS Pln Rv 11/20/02 $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 (50)»7466699 or 1- 800 -33 -2344.
Issued d ,v
I . / /
Perm ittee
Signature: y pp}- ( •
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
Fire Protection System i - l p -d'ez--
wilding Permit Application
Date received: ' ! 2 0 - — Permit no.: ?, U j ' „,00 a —. SOL
• . )4,:�yr, City of Tigard
- Address: 13125 SW Hall Blvd 'ige0 Project/appl.no.: Expire
11oE�J date: `
City of Tigard
Phone: (503) 639 -4171 Date issued: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type: I
Land use approval: Nnv 2 0 202 l &2 family: Simple Complex:
_- U 0
?i':I'E OF PERMIT
•
❑ 1 & 2 family dwelling or accessory ,R" rmmercial/industrial 0 Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement LI Tenant improvement ❑ Fire sprinkler /alarm O Other:
JOB SITE INFORMATION
"lC
Job address: - -- -m& Bldg. no.: Suite no.:
Lot: Block: Subdivision: 3 _ I • 0 0 Tax map /tax lot/account no.:
Project name• t1 < . vwagn ca
Descri rtion andlocation of work on premises/special conditions: I_Isuast ti Mt� V 4 4
■fidtg
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.) /
Mailing address: 1 & 2 family dwelling:
City: State: ZIP: Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
=MN
1w t sr. �)Rf��MAM. Covered porch area (sq. ft.)
Mailin_ address: WalliMME111 Deck area (sq. ft.)
EI$P�' IM `liZIP: Other structure area (sq. ft.)
Phone: — Q -D7n E -mail: Commerclallindustrial/multi- family:
rr � -_
CONTRACirOR Valuation of work $ 1 55D- .0
•
Existing bldg. area (sq. ft.)
ii
Address: N/ New bldg. area (sq. ft.)
Number of stories
City: , s I ZIP:
Type of construction
Phone Fax: E -mail:
Occupancy group(s): Existing:
no.: New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. if the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this o Visa 0 MasterCard
work will be complies • , whether r - cified erein or not. Credit card number: Expires /
Authorized to ..k. • ri Date: I (— Name of cardholder as shown on credit card
Print name: P r L � a r Cardholder signature $. Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ro0/COM)
Fire Protection Permit Check List
A.) oNew ❑ Addition ❑ Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads:
Additional description of work:
I'kie v\ r 9.154 can ' n K I lne.r� Ho
T nS�� �
Type of System (Complete A, B or C as applicable):
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $ b F JY ) �I
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
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.
is \dsts\forms \FPSchecklist.doc 11/21/01
. CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
: 31,s MO0� BUP G�� — od.S7
Received L Date Requested / — / 7_. AM PM BUP
Location / 3 7x7 e0 t1jde Suite MEC
Contact Person Eeti Ph ( ),2t49 71 PLM
Contractor Ph ( ) SWR
` �12111W Tenant/Owner ELC
Foo in•
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: L e c _ 0 CZ) Q AL J � SIT
Post & Beam -� l
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm l y 4,CLO
Susp'd Ceiling
Roof r
Other: `!1
F' • .
477)1 PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final s\
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date i' / I ' /o2_.. Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL