Loading...
Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2003 -00028 DEVELOPMENT SERVICES DATE ISSUED: 1/17/03 s�s� 4=- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12930 SW SCHOLLS FERRY RD PARCEL: 1S133AD -02200 SUBDIVISION: ZONING: R -7 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: $ 2,120.00 Remarks: Install fire sprinkler piping only. Owner: Contractor: WESTGATE BAPTIST CHURCH FIRESTOP CO 12930 SW SCHOLLS FERRY RD 9384 SW TIGARD ST TIGARD, OR 97223 TIGARD, OR 97223 Phone: Phone: 620 -6140 Reg #: LIC 63846 FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough -In [BUILD] Permit Fee 1/17/03 $72.10 Final Inspection [TAX] 8% State Tax 1/17/03 $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: •. . L < ► .Ar, ,( &/) Pe rm ittee .� Signature: /c Call 639 -4175 by 7 p.m. for an inspection the next business day 1 ,„ Fire Protection System 3 `f Building Permit Application FOR OFFICE USE ONLY Received �� � ' Building , e Date/By: f — / d � 1 7 Permit No.: �O� —OCD Cl Tigard Ti and Planning Approval Other Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503 -639 -4171 Fax: 503 -598 -1960 /�a n m :N ,�gtelli+`� Post Review Land Use _�, e _ f Date/By: Case No. Internet: www.ci.tigard.or.us Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503 -639 -4175 Name/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: 'New construction ❑ Demolition 1 & 2 FAMILY DWELLING ❑ Addition/alteration/replacement , ❑ Other: CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate ❑ 1 & 2- Family dwelling Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. _ ❑ Accessory Building Multi- Family ❑ Master Builder ❑ Other: Valuation $ JOB SITE INFORMATION and LOCATI9N No. of bedrooms: No. of baths: Job site address: (Z9 3D So- g0dv(,Gs /ON A. Total number of floors New dwelling area (sq. ft.) Suite #: I Bldg. /Apt. #: Garage/carport area (sq. ft.) Project Name: 4 f 15t 'T)S r Cfo Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) /3o 1 / ScdvIb3 l A • REQUIRED DATA: COMMERCIAL - USE CHECKLIST Subdivision: Lot #: Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate / e DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, !/v5 6 i S�, /Nle y� POA1G misthe overhead and profit for the work indicated on this application. rxri /ot2 e,�aey ,di?/04 r0 CODVe tfrfror Valuation $ 2 / l 2 0 Existing building area (sq. ft.) C 1 �� P 1 (9v �) New building area (sq. ft.) / Number of stories El PROPERTY OWNER I ❑ TENANT Type of construction Name: 14/011-441V Occu group(s): Existing: 'G J�,�'PTTS� Mimi New: Address: /2930 SW- 4C/4 b City /State /Zip: T /(, A0) OAC- 172Z3 NOTICE: All contractors and subcontractors are required to be Phone: Fax: licensed with the Oregon Construction Contractors Board under g APPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: F/ Re-ig 7'17 P cro ' jurisdiction where work is being performed. If the applicant is exempt _ Contact Name: ljRue& b • J' '4 -RJoa from licensing, the following reason applies: Address: 93$4 4-0. T Eo � C 24 ' City /State /Zip: j" /<,,eib / 00, 97223 Phone: (0 20- e 140 I Fax: BUILDING PERMIT FEES* - - - - E -mail: Please refer to fee schedule. CONTRACTOR Business Name: fhei R DP ` t ' Fees due upon application $ Address: 9354 S'Gt1 -1 /G4 Cr City /State /Zip: % /(�A /J / 0 RE. 97fl Amount received $ Phone: (oZo 40/4 O Fax: 6 Date received: CCB Lic. #: 0384 (o Authorized Notice: This permit application expires if a permit is not obtained within Signature: ` ` _ - . - Date: �1 ��G'03 180 days after it has been accepted as complete. �5Rct e-c Pgt A �c -sa� *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03 li f Fire Protection Permit Check List A.) ta ❑ 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: (N 5 o /,//N G J( // 4 5 Poi tX 1 reg- PaoTrenoA. To eofiirver o @a z. ekm frP 4-11,,Gy Type of System (Complete A, B or C as applicable): ,'.. A.) Sprinkler Wet ❑ Dry Standpipes AJ© Additional Hazard Group ®RD • # 2 Information Density . /SO4 Design Area tN77�� /4 K. Factor c Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System /1hW Hood Project Valuation $ C.) Fire Alarm Ma-- 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 I CITY OF TIGARD 24 -Ho BUILDING Insp: Line: (503) 639 -4175 INSPECTION DIVISION Bu in : '" Lin - 503 639-41 MST ( ) 41, .3 - 2 Received / - 1 / Z = 3 D ate Requested r AM PM BUP Location I u. / _ - ' _ Suite MEC Contact Person 'Lc.a -vt. £ C/741YL Ph (4 522 7. 9 PLM _ Contractor Ph ( ) SWR M rfflIM Tenant/Owner ELC 41 ii i a t Foo ing Foundation ELC VAMP . Ftg Drain Access: Allirr ELR Crawl Drain , 'a Slab Inspection Notes: SIT Post & Beam _ Shear Anchors Ext Sheath/Sh: Sheath/Sh \ �� C) _ / Framing j t ) c - Framing u Insulation rU' � �f� w` S (—� L ,( Drywall Nair • i ^ 1 °��`� A Firew -. U ire Spnnk /' iim pp v - Fire Alarm ;^� Susp'd Ce g U " A ( - Roof NJ . f Other: PART FAIL - ING r .-t `\'- Q .-"r" - s —sa-- Post & Beam p fl (� p ` ` ; Under Slab L�_S 1'7._ Jam` ...e____..& ...e____..& C r 5 S '^ Rough -In Jc Water Service �. � ',.....A —_ � C� ^� Sanitary Sewer A Rain Drains C , J� -{� --\"...6...__.-4- "�� S 1 Catch Basin / Manhole (�l� r c l'Ir2,00.„,w 0001S' Storm Drain Shower Pan Other: Final ,2� -_ T PASS PART FAIL r MECHANICAL 4? C'N/L. ' Post & Beam . Rough -In - Gas Line , • Smoke Dampers - - Final 'C�1 � �- PASS PART FAIL ry ELECTRICAL giNNIMI 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 call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA �/ \ -- i i /d 4- (2 c- \A Approach/Sidewalk Date Inspector Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL