Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00190
-'Jli� DEVEL ICES -639 -4171 DATE ISSUED: 6/6/2005
PARCEL: 1S126CA-01000
SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C -G
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG
Project Description: TI, 2 Type I hoods fire suppression syst.
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: 2N : sf N: S: E: W:
OCCUPANCY GRP: A2 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 118 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 1,095.00
Owner: Contractor:
WASHINGTON SQUARE PLAZA GUARDIAN FIRE PROTECTION
BY THE CAFARO COMPANY 1012 SW A ST
P 0 BOX 422 CORVALLIS, OR 97333
FLOone: RHAM PARK, NJ 07932
Phone: 541 - 752 -2258
FEES Reg #: LIC 100355
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/6/2005 $62.50
[TAX] 8% State Surchan 6/6/2005 $5.00
[FLS] FLS Pin Rv 6/6/2005 $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. A ENTION: Oregon law
requ • :. e .flow the rules adopted by the Oregon Utility Notification Center. Those r es are set forth in OAR
9: - 001 -0010 throw. • OAR 952 - 001 -0100. You may obtain a copy of these rulo or dire •uestions to OUNC by
ailing 503 - 246 -6699 o • 4 0 -,332 -2344.
sued By : I � IA1 � ! / Permittee Signature:
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 Fire Protection System
. Building Permit APPR EI VE FOR
OFF ICE usE: ONLY
City of Tigard 1/ Date/By: P ermit No.: /, /
!, , ,, _DD ..-„,„
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie e i Phone: 503.639.4171 Fax 503.598.1960 0 4 n ° l l1 �/ Other Permit:
1005 � ° N l l I t � Date/13 : i ■
Inspection Line: 503.639.4175 B CITY OF T I . ��� Date Ready /By: 3 'wr %��� p See Page 2 for Internet: www.ci.tigard.or.us GAR r Notified/Method: � a / Supplemental Information
°i . „ to ,v,,a ro.Y T A - 4 OF WO 9 e 1 ; . RTsQu m i D ►A _ .AND 2 E . 1 f DWELLING , - r
r � �,�,, �� 1Ca st' 1'� .?__ sue. +.� "' . � :d�� . .te a a ,,xr .. k , .r, -a v-. ,� : _ s
Miew-construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all ;\
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
i ' °` t � this �t o CAtJ' OR %` r C O § 4 ti M TIO1 work indicated on thi application.
❑ 1- and 2- family dwelling commercial /industrial Valuation: $
El Accessory building ❑ Multi - family Number of bedrooms: ,
El Master builder ❑ Other: Number of bathrooms: k
s W, A f Total number of floors: ��
Rf x �� ,s JOB SIDE 7lY It ; O. AT ' i1 f A D L / ,,: ' § WA—it ,.
Job site address: 9�� . 5 , e.� 2/ . , 4,6— New dwelling area: square feet
City/ State/ZIP: -IT �" - ( Garage /carport area: square feet
Suite/bldg. /apt. no.: ,4 Project name: � /4 ��
A c7 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQ .1 RFJ! DAT;k COM RI E'.
, - TH .. .
11+I,MEC��[TSCIIiECI{IIST '
Subdivision: l 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
' � a - DE SCRIPT O , OTi O RI� 6 j g � ` J work indicated on this applicat �., •
r -,ie f _51:s a.: 5 e i 0., - 7 1-- st , /9 c
Valuation: $ if. /�i
—______ Existing building area: square feet
New building area: square feet
PI OPEI+TY�OWNER � x ® tEN A Number of stories:
Name: • Type of construction:
•
Address: Occupancy groups:
City/State/ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
�
�� „x CAN, a s .� : �,�. , � � � >���_,`:' •
1 , +i` 4 ,,� ,, ,', T:•EEILSON:, ,, ;;: : `°'°::,_ _ %, - ..,,, , }..
t s.. ��<. � .�'�.s' cam. � ,. � , " .'...; . �S� � � * :.,3�r*: :. »a a � h.,. ��' >,r = i �a � ,t.:�. r 'S � ,;R t� ° �. t�
.3,<v,�e.,4 �. h�» t�, »::J* :�4 _cr' � ' g . : '°"'� ^ri °�.�F � � � � �; �,�t ... c ; � �
Business name: c,,,�,,,„i t }Z„/ J.�2 i, r r ✓v'/ - All contractors and subcontractors are required to be
r
Contact name: 1:::) licensed with the Oregon Construction Contractors Board
'�``� �� r� � v�v � under ORS 701 and may be required to be licensed in the
Address: A9 /),, S Lv 4 k ll i jurisdiction in which work is being performed. If the
City/ State/ZIP: 2 (.. C ,, 7 3 3 c, apply antis exempt from licensing, the following reasons
Phone: ( ) '7s'1 .. 5.---,- S' Fax: : ( 5 ) S At y S 9 •
E -mail:
» �V i i s - ti C EI RAC"TOR� i« , . 1 t l p i.� 1
Business name: G¢ e - l4 -4 S >j.. /% /I vr ,- , te: ' BUZI.DI e V /MIT FEES* .
Address: (� Sc ...v / x C »r s �rrr Y z » . . :__; ._
!T r
Please refer to fee schedule.
City/State /ZIP: aL %,(4s cL
Phone: ( ) L Fax: Fees due upon application
( )
Amount received
CCB lic.: tG70 t
Date received:
Authorized signature: ` This permit application expires if a permit is not obtained
(� t[ within 180 days after it has been accepted as complete.
Print name:
c 1 4 # 4...-A„, , � r Q t C9,(...4 C9,(...4 Dater � � * Fee methodology set by Tri- County Building Industry l Service Board.
i:\ Building \Permits\FPS- PermitApp.doc 12/03 440- 4613T(11 /02 /COM/WEB)
- •
Fire Protection Permit Check List
ili7,10IYYPItliMblitrgAgAAV . „.„ „ sprinkler heads only:
LI Modification to spri
1.) 0 New 2.) Modi
Addition U 1-10 heads: No plan review required.
LI Alteration 0 11+ heads: Plan review required.
• LI Repair
Number of sprinkler heads:
Additional description of work:
Ve
,t,T,,,,,,areava.fgAufirretaiitetei --- ,
Z14,Y,Pqr-VA:- 'W:g4 W:Virt•TVAK,V,.,'`f:'
111 Wet fl Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
001302 „11
Hood Project Valuation:
•
irCRO_AL*
Submittal shall Battery Calculations LI Yes
include: Individual Component LI Yes
Cut Sheets
Fire Alarm Project Valuation: $
- • tvijoi.041'45*,Nif
Square Footage: Permit Fee:
0 to 2,000 $187.50
4
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 & $
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 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:\Building\Forms\FPSchecklist.doc 12/24/03
. .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00190
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/6/2006
Phone: (503) 639 -4171 i, u „ uql °9�iirylfii1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7 :10AM PAGE: 61
SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK:
SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE:
PROJECT NAME: BAJIO
DESCRIPTION: TI, 2 Type I hoods fire suppression syst.
. OWNER: WASHINGTON SQUARE PLAZA, PHONE #:
CONTRACTOR: GUARDIAN FIRE PROTECTION PHONE #: '541 -752 -2258
Inspection Request Scheduled For: Date: 6/14/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
920 Suppression trip test 009166 -01 541-762-2269 Y
FI 6Jrc--- 00V- 1 '02 C c OD .
Corrections /Comments /Instructions: i
0 1
l
v \.
I ❑PARTIAL APPROVAL III _ NO ACCESS
/PASS
_ FAIL _ CA L FOR I SPECTION 111] ADiITIONAL F ES ASSESSED
' f I ,
Inspector: 1 Date: I 9 `: Phone #: (503) 718 -