Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2003 -00686
iAc DEVELOPMENT SERVICES DATE ISSUED: 12/11/03
..� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12282 SW SCHOLLS FERRY RD PARCEL: 1S1346C -00300
SUBDIVISION: GREENWAY TOWN CENTER 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: M 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: $ 997.00
Remarks: Revise 8 to uprights add 1 dry (new).
Owner: Contractor:
•
BPP RETAIL LLC LARSEN FIRE PROTECTION CO
BY BURNHAM PACIFIC PROPERTIES LYLE LOUIS LARSEN
ATTN: JOHN WATERS 16410 S HIRAM AVE
SAN DIEGO, CA 92101 OREGON CITY, OR 97045
Phone:
Phone: 655 -5456
Reg #: LIC . 118596
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 12/11 /03 $62.50 Final Inspection
[TAX] 8% State Surchari 12/11/03 $5.00
Total $67.50
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: L(_6__—
Pe rm ittee
Signature: V ffirat-4.)1C)
Call 639 -4175 by 7 p.m. fo inspection the next business day
12/10/2003 15:03 FAX 5035981960 CITY Ut liVAAU
Fire Protection System
Building Permit Application FOR OFFICE USI: ONLY
Received Building a 0 _
RECEIVED Date/By: Permit NOVI ") "" 6r.2 tofb
City of Tigard Planning Approval Other
Date/By: Permit 14o.:
13125 SW Hall Blvd. DEC 11 20:3 Plan Review Other ..
Tigard, Oregon 97223 Date/By: . Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 '4 . l ' -'1r0.ili;' _Dte/y: Post-Review
Land Use
Internet: www.ciligard.orIGITY OF TI GAR a ....1111 1.!:. Cue No.
Contact kris.: 1 El Ste Page 2 for
24-hour Inspection RequeBUSTS163.943176S!ON . Name/Method: 1 Supplemental Information
V.::1;'::;1:5AVI: a: . .r%..,..., .'1) •iT.i......;:;:i.:;:,:.v.:::.,;:::.r.....;:2,,,,i,,..,,,;:;;;..v.,p: .::...;:.;;;,.:-...;r'...:.:,,,Iv.,.,:: . , .17111.,.,Y. ..1/ i,',"....,V4;. .11 :;
.11FrO. '._..,„.' t.',W,A7Plk,..:';J
O New construction • Demolition ;!:,:ir:lq:
IR Addition/alteration/replacement 1=I Other:
• ''' :..'":,::: .• 2, 0 . •.' 4 41'ir ::',.":::;'•:...;:::-.-i';',:':: Note: Permit fees* are based on the total value of the work performed. Indicate
I/ I & 2-Famil dwellin - II; Commercial/Industrial the value (rounded to the nearest dollar) of all equipment. materials, labor,
overhead and profit for the work indicated on this application.
• ACCCSSOMEUildill 1 In Multi-Famil
• Master Builder III Other: Valuation s
:4::....40BISITEZIK) ' • 0 ' ' i0.10BiaLOP.AT1ONMIZ::::.:".;v. No of bedrooms:_ No. of buths:_
Total number of floors
Job site address: 12212 i.4./ . oU,S. kl_Lior New dwelling urca (sq. ft.)
Suite #: Bldg./Apt.#: Garage/carport area (sq. ft.) .
Project Name: p 1 -a-__/-A sc...,i,k),11----&A Covered porch area (sq. ft.)
Cross street/Directions to job site: So..t fli Sc11-0 I-1,S Deck area (sq. ft.)
F /27 7 PUV In/A Other structure area (sq. ft.)
SOLA. S I roc, S'ill-LrisT Ci—os, G-7 -1.-0 ::.!.;',...;' s.!::•:-.:•: O'` ,;: .: ; 7; iii;',;. %.;;Iiii,4i ;,;:v.r.1-..;;:■
li.1'0011l111.1'.': 2 • ' it - cf 4 . — L a . .1 A , w ., , ' '' ' • :i.:.. 0 1 . :!,I . ,
)( t4(' ft CF..441-1)4 tn. So 1A .,...:,0 :•.itt ••• ,. •,, . • - • •.. • .-r..;; A ,..,..
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Subdivision: Lot #:
Tax m. ./. areel #: Nor Permit fees' aro based on the total value of the work performed. indicate
,..!...'-'.■.::. r:::::::::'■; ,: ..Pirio v 0 • 7 . 0 7 /7, i.,:,'& r r;,..,.,t101.i,.....,: the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Ill WInSa. Ct) ,j \ It DJ • , e)24 a s4
- u,r L-.. -an„, vo a 4 a r WO I n/ Valuation $ _721:14_
Existing building area (sq. ft.)
4 I I Di/ / — '' ' A/ F7(4.- L ce, • 2 New building arca (sq. ft.)
d. r(7..• . 7V 1 rrl ' rI-.0 V -071 Number of stories ._—L----
7.0 %it:e4 ., . • 4 . . .11 ' '..,.. • Ill I;i:f . :1 - 1 , 5iii';.;17il 7...0,4..V..:04.......f);.:';:. Type of construction
Name: Occupancy group(s): Existing:
New:
Address:
City/State/Zip: --- ,
,
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
Iltr[LiTTE17.W.1/4 .1%••••agM.71;5 provisions of ORS 701 and may be required to be licensed in the
Business Name: =74 fzi /La. 0 . jurisdiction where work is being performed. If the applicant is exempt
Contact Name: R V-e.--lle-/.../ /1-6N... from licensing, the following reason applies:
Address: /6 , t 0 S - i, I it AV • •
City/State/Zip: 'LL- C_frt D ki_ 6 i 1 41--
Phone: Gi, 7 . -.. - Fax: 03 - - - 4. ii ' .
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Business Name: i_Atz_s, p)itz.. efizTvz Fees due upon application $ .
Address: 5 Mrin g '
City/State/Zip: Amount received s
Phone: I Fax: Date received:
CCB Lie. #: I I b..5 Cp
Authorized ,•• ■. - i 2 I 0 , Notice: This permit application expires if a permit is not obtained within .
Signature: _ Date 180 days after it has been accepted as complete.
/24/ V-e-tice 6(.1 Fee methodology set by Tri-Coontv Building Industry Service Beard.
(Please print name
i:%Dsta \Permit FormaUltIdgPennitApp.doc 01/03
.___
12/10/2003 15:03 FAX 5035981960 CITY OF TIGARD
. , .
Fire Protection Permit Check List
Describe work to be done:
A.) ra' New B.) Modification to sprinkler heads only:
(=I/Addition 0 1-10 heads: No plan review required.
liN Alteration U 11+ heads: Plan review required.
CI Repair Number of sprinkler heads: 9.
Additional description of work: yLevisc (.e)) re-rilvtaNzi to LAP1 , ir
ci.....c, ttavuov t.'7 - a Pi..(1
Ap9 ) -N614) , r4 coat-C
Type of System (Complete A, 6, C or D as applicable):
xy':'Ci3iiiiii,eiOiatSPiiii.k100.... I':::::: ::,:::":.:, • -.,,;,' -', • ' ..: -:: :.: ' . ;I:, , .: :' I
Wet 54 . Dry Ca
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ cicur
EL) S tern: : ...: ,.:::.;..:!....,:.:,-:,.. 6;!::.
Hood Project Valuation: I $ At/ /ic
:'::?:::•:!.':.:.:::::
Submittal shall . Battery Calculations Yes •
Include: individual Component Yes U
. Cut Sheets
Fire Alarm Project Valuation: $ Ai/Pa
Square Footage: Permit Fee: :.:: :::::;.j]::::'::',';:i!:
____0 to , 000 $187.50 :-: '.!.::;'
i.,. :10 '.
2,001 to 3,600 $232.50 ri
3,601 to 7,200 - $292.50 :':',. :::',i:: '.,Ei:,!:::•!!''.::
7,201 and greater $381.50
Sprinkler Project Square Footage: /V/A sq. ft.
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see attached chart)j $ . G 2, /
Permit fee based on square footage (D) (see tees above): $ 79.
State Surcharge 8% of Permit Fee: $ 5gre
FLS Plan Review 40% of Permit Fee: $ ,..isot5z
TOTAL: $ <J97g5; (0/52"—
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.
BdstsVorms\FPSchecklist.doc 02/28/03