Permit r „
CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00057
44, DEVELOPMENT SERVICES DATE ISSUED: 3/9/04
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112DD -00900
SITE ADDRESS: 15680 SW UPPER BOONES FERRY RD
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: 5N : 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: $ 1,950.00
Remarks: Fire suppression system for Type I hood. Hood is existing.
Owner: Contractor:
FERRYMAN, H E FIRE EXTINGUISHER SERVICE CTR
9110 NE HWY 99 PO BOX 1391
VANCOUVER, WA 98665 BEAVERTON, OR 97075
Phone:
Phone: F- 626 -9993
Reg #: 643 -3309 00069384
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Pert Fee 2/18/04 $62.50 Sprinkler Final
nu
[TAX] 8% State Surcharl 2/18/04 $5.00
[FLS] FLS Pln Rv 2/18/04 $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 -00 ; "•'• • OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling ' 03) 246 -6699 or - 800 -33, 344.
Issu : d By: / ' Arm--
Permute- Ad
Signature: x
Call 639 -4175 by 7 p.m. for an inspection the next business day
5 I 6 s w vp' (.11 DoaNei
Fire .Protection Sy ECE"I ED
Build Permit Applicatiion 8 2 FOI OFFICE USE ONLY
City of Tigard � R� De Received ed - r���`�J"' Permit No.. � � J� - etQ 7
13125 SW Hall Blvd., Tigard, OR 97221 -N 0, TOGA Plan Review
Phone. 503.639.4171 Fax. 503.598.1 9 IS'O ' '' Other Permit
r G D1V :� � I �� DateB y 3 /y�oy � f �
Inspection Line: 503.639 4175 B ,, ^' Date Ready /By L 'r C4 Jun ® See Page 2 for
Internet: www.ci.tigard.or us Notified/Method 4 , Supplemental Information
4-00Q� 0ntotle 3• -ci/ Get.
TYPE OF WORK , : . - REQUIRED DATAi'.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
•iAddition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
'CA'TEGORY OF CONSTRUCTION . ' work indicated on this application.
_
❑ 1- and 2- family dwelling '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: 1 5 P''- r t �xleS rv-y New dwelling area: square feet
City/State/ZIP: , i 4 O5 e . ' i 1� R
G Zaas Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name. Covered area square feet
Cross street/directions to job site: ' C i f 5- Deck area: square feet
i Other structure area: square feet
REQUIRED DATA:.COMMERCIAL - USE .CHECKLIST
Subdivision: 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.
j N S i-e, I c2 6 iced F l R.Q.- S P preS i o N Valuation: $ I Q s 0
5 y -r--P Existing building area square feet
New building area: square feet
,. ,14PROPERTY-.OWNEliP , - - ❑•TENANT'- ,' Number of stones:
Name: 4. E , ge k)/ r j 4 ,J Type of construction: / r; Re 5 y5- _
Address: 9//Q ijej. W y 99 Oc groups:
City/State/ZIP: Vl�i.l[!ou t W» 91 6a, S" Existing:
Phone: ( ) Fax: ( ) New:
- - > . ❑ APPLICANT ' • ° ❑ CONTACT PERSON .
1 � . � - NOTICE
Business name: _ Qt: £ li K0i,f A64e6. ere_ All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: 8 r` a N 6 Ile V bet-k,
under ORS 701 and may be required to be licensed in the
Address: 3 (- ' W 2 9 ' iLt f junsdiction in which work is being performed If the
City/ State/ZIP: ct_ve r� ()y e 9 TO0$ applicant is exempt from licensing, the following reasons
apply:
Phone: (5"0 Li 3 3 30.:( Fax: : ( SD.) '% i 7 34,
E -mail:
. . CONTRACTOR' . -"1 ' .
Business name: S 6,..
BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City/State/ZIP: n
Fees due upon application VA • J`
Phone: ( ) Fax: ( )
/- Amount received
�CCB lic.: iv % 8
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Pnnt name: • / e , ^ N 5 A e r , h 4 Date: . `r ?7 t f + Fee methodology set by Tn -County Building Industry
/ Service Board
I \Building\Pcnmis \FRS- PeimitApp doe 12/03 440-4613T( I /02/COM/WEB)
• ,
• .•
Fire Protection Permit Check List
1.) P New • 2.) Modification't only:
0 Addition 0 1-10 heads: No plan review required.
0 *Alteration 0 11+ heads: ' Plan review required. •
0 Repair
• Number of sprinkler heads:
Additional description of work:
A) Commercial Sprinkler
•
• ' • ",
Er Wei . 0 Dry
Additional Standpipes •
Information: Hazard Group •
Denkty • -
Design Area • .
K. Factor
Sprinkler Project Valuation: $
Hood Fire Suppression System
Hood Project Valuation: $ (
- • ' - - • • ;
Submittal shall Battery Calculations .0 yeS •
include: Individual Component 0 Yes •
Cut Sheets
Fire Alarm Project Valuation: $
, •
1)4,12 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 5 () '
'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: $
TLS.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:\BuildingWorms\FPSchecklistiloc" 12/24/03
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
7 BUP , %� ii-DOO s l
Received Date Requested 3 /q A� M / -' PM BUP
Location X56 go aff/L /3 , r�iG 4 Suite MEC
Contact Person Ph ( ) 5q LA I PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ���� ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Other
I •
- PART ✓FAIL
• BING
Post & Beam
Under Slab
Rough -In
Water Service
-
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL p I l
Post Beam '
Rough-In
-In
Gas Line � c
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 p (�J / A
ADA
Approach/Sidewalk Date ° Inspectorl3 , /1 DCA � 6 C ~
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL