Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00381
� DEVELOPMENT SERVICES DATE ISSUED: 8/16/2004
'' ., II 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 570 PARCEL: 1S1266C -01506
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: 2FR : 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: $ 2,250.00
Remarks: Fire protection: 28 sprinkler heads.
Owner: Contractor:
WISCO INVESTMENT SERVICES CO AFP SYSTEMS INC
111 SW FIFTH AVE# 1100 19435 SW 129TH
PORTLAND, OR 97204 TUALATIN, OR 97062
Phone: 503 - 222 -4375
Phone: FAX- 692 -1186
Reg #: 150a692-908€1.03459 3459
FEES LIC REQ6 INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 8/6/2004 $72.10 Sprinkler Final
[TAX] 8% State Surchari 8/6/2004 $5.77
[FLS] FLS Pln Rv 8/6/2004 $28.84
Total $106.71
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: - ► ^ _. .
Permittee
Signature: ! ! ► ; �� `I 1; 1 i ,,
Call 639 -4175 by 7 p.m. for an inspection the next business day
119 /4 St lit/it ' S Q RD - .S7d
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� ul � l ily ermit App Ic t10 FOR OFFICE USE ONLY
City of Tigard AUG 0 b 200 Receiv ^��� Permit No.: .i()Fa 91f , ' I
13125 SW Hall Blvd., Tigard, OR 97223 Plan�Revie V
Phone: 503.639.4171 Fax: 503 .5 �l OF TI (aARD U4ne Att) ; r\ Date/By: 8 / .. O���A Other Permit:
t �I
Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: fur :// ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: /Y Supplemental Information
' r `: " TYPE .OF .WORK " ; . . - • REQUIRED DATA :.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
9:LAdditio ]terationn placement ❑ Other: equipment, materials, labor, overhead, and the profit for the • • CATEGORY. OF CONSTRUCTION_ , work indicated on this application.
1:1 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: 47024 540 i #4 4 5. 0NGToN j' . RD. New dwelling area: square feet
City/ State/ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: 5719 Project name: r 02. 272 ( Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUD2EDLDATA::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
.. iESCRIPTION, OF` WORK . ' , work indicated on this application.
I � CL�Pr�� N'>1 � t F- J1Ll.CT Valuation: $ 2
‘)e-rz i4 f� I S Existing building area: square feet
C'1
New building area: square feet
PROPERTY`'OWNER'' : • ` r c , •; TENANT Number of stories: S
Name: Y S C k E ' _ f 'r fi UQ- ± &nt . ( ) . r 'c t ezym Yal Type of construction:
Address: 1 1I 3 r ■ ( /9Vt c ) . 8 C Occupancy groups:
City/ State/ZIP: 'Pert/aye /) }
/y`l 11 9720q Existing:
Phone: ) Z7�Oyd Fax:() 227.-ZS07 New:
0 . APPLICANT' 0' CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/ State/ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
' .CON .. . • TRACTOR_;
Business name: �FP E1�� f N C . BUILDING PERMIT FEES*
Address: 14' 6 4 C �„, Please refer to fee schedule.
City/State/ZIP: 'I ` AL . C2 C .
qq Fees due upon application
Phone: ( '9S) � IZ^ p 12 0 p� 1 Fax: (5 75)) ( 1 l 1c
Amount received
CCB lic.: C S S.4 t
Date received:
Authorized signature: 1 )\./k\•
�} ( �\ A CAI This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: 1 ICk,4 ('\... a 1N' Date: 1 -3b -&k * Fee methodology set by Tri- County Building Industry
Service Board.
i:\ Building \Pennits\FPS- PermitApp.doe 12/03 440.4613T(11 /02/COM/WEB)
Fire Protection Permit Check List
De's-cribe,work.to be:done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
® Alteration E 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: M
Additional description of work: eads: M Pe - i2 i=?P t
of S stem, ,Com ,lete A B, C or :D as applicablOi
oinnierciaLSprinkler
[2• Wet ❑ Dry
Additional Standpipes --
Information: Hazard Group Ls LN—
Density • I
Design Area —
K. Factor c.
Sprinkler Project Valuation: $
�B. .T pe:1- Hood;F rerSuppress on`System : `.
Hood Project Valuation: $
Su i :, 'ttal shall Battery Calculations ❑ Yes
inc I e: Individual Component ❑ Y=
Cut Sheets
Fire Alarm Project Valuation. $
IY Res d'enf al:S rinkler St . d, Alone S stedi; :;;;
Square Footage: Permit 'ee: A .
0 to 2,000 :7.50.
2,001 to 3,600 .232.50
3,601 to 7,200 $2 .50
7,201 and greater $381.
S inkier Project Square stage: sq. ft.
Project Valuation Subtotal (A, B & C): $
' - rmit fee based on valuation (see attached chart): $
Pe 't 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 revs-
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 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
• INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Gas Date Requested AM PM BUP
Location - / l� 2 (.L) i4 `� Q • Suite 3 JO MEC
Contact Person l 41.E -G Ph ( ) PLM
Contractor Ph ( ) 6cl9-- '9 / SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall Fire Sprinkler Pg C(.1 k v �—
Fire Alarm
Susp'd Ceiling ,
Roof t 1 O
Other:
PART .r• t
BING
Post & Beam
Under Slab •
Water Service Z l�`) R �� n- t �-� ( `Y
Water Service l l/
Sanitary Sewer •
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: /
Final
PASS PART FAIL
f ,
MECHANICAL r , "
Post & Beam • -
Rough -In
Gas Line
Smoke Dampers --
Final p gg1
PASS PART FAIL r U►
. 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 cal or rei pection RE: ) Q Unable to inspect — no access
Fire Supply Line
{
ADA
Approach/Sidewalk Date Inspector � Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL