Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00526
� DEVELOPMENT SERVICES DATE ISSUED: 10/14/2005
..� I- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09359 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire sprinklers. •
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: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 43 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: $ 1,500.00
Owner: Contractor:
WASHINGTON SQUARE LLC PATRIOT FIRE PROTECTION INC
BY THE MACERICH COMPANY 4708 NE MINNEHAHA ST
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98661 -1843
- PRAT?' c R 503g-6"3.8865
Phone: 360 - 699 -4403
FEES Reg #: LIC 70822
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/5/2005 $62.50
[TAX] 8% State Surchari 10/5/2005 $5.00
[FLS] FLS Pln Rv 10/5/2005 $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. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -I ! -If : hrough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
call g 503 - 246 -• •99 or 1-1,i 0-33
Iss -d By: _t 4_,;,,, / Permittee Si natur
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 ire Protection System
Building K ermit Application S FOIR OFI:l I: isi•: oNL.I .
City of Tigard 'I J Rhea �� , F a �
13125 SW Hall Blvd., Tigard, OR 97223 C Plan Review /r;�
Phone: 503.639.4171 Fax: 503.598.1960 "- � : , Date/B . Valk, OtherPemut:
Inspection Line: 503.639.4175 Date R : • /M �� ® See Page 2 for
Internet www.ci.tigard.or.us OC � 6edethod 13 w Supplemental Information
j
Gil- 0 5 i , / i : 512
` .�.i �I '' 4" II rt .TA. 1- AN Y,DWELLIING . r - .) ° � .1! :��r ,3. . y ,.,. •
❑New construction ❑ De iL 'or , P it e- • are ' ased on the value of the work performed.
�,,/ 0/V Indicate the value (rounded to the nearest dollar) of all
,,t'_I Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. , - 1CATEGORY, OF CONSTRUCTION - f _ work indicated on this application.
❑ 1- and 2 -family dwelling Commercial /industrial
Valuation: S
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- . JOB, SITE. INFORMATION,AND I:OCATION'.' e . -- , - T ,.;;: Total number of floors:
Job site address: q l W tc s 1 146 T rp 1J 'Sc.. eD . New dwelling area: square feet
■
City /State/ZIP: 744 44 C• , C, Z _ 9 S Garage /carport area: square feet
Suite/bldg. /apt. no.: `1" ( Project name: S T A, 0 Covered porch area: square feet
Cross street/directions to job site: . Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
. DESCRIPTION OF WORK , —,, _ „ • - _
work indicated on this application. /�
Aor) eeLoC1�TE . - .. , l� (d_ezS L� / Va luation: $ 1 ISC,d
1.1 __AA/ '4� 1�( 1. /G ✓ ` L l � STS -7-c,
Existing building area: /7 7.3 � square feet
New building area: / square feet
• %PROPERTY OWNER 1 TENANT . Number of stories:
Name: <- c Type of construction: gy?/
Address: ZI1d ( i )'7h, t-k 4v r t S . Occupancy groups:
City /State /ZIP: sE jT l \J4 a d'4 Existing: pi?[.. p,
Phone: y) '3 IS I S -7S Fax: ( ) New: "L / /
- APPLICANT . •',_. 0 CONTACT. PERSON " .
NOTICE ,.. -y .. -- '
Business name: — r - Ti err F ZE V T ..7e, 1 i I i c . All contractors and subcontractors are required to be
Contact name: Epp ru µDS licensed with the Oregon Construction Contractors Board
� � IA under ORS 701 and may be required to be licensed in the
� �� Address: $ c E i4, IAA jurisdiction in which work is being performed. If the
, / q86 6 , applicant is exempt from licensing, the following reasons
Cit y / / State/ZIP: Y j /' C . vim F �1 apply:
Phone: (/;11,) ZZ Z — (C2c ( Fax:: C$
O) 'Q — i'1
E -mail:
. - CONTRACTOR • - ;r - y
Business name:,pl )---1, ZP 1 1 ( , - BUILDING PERMIT FEES* ' . ". - :
Address:
Please refer to fee schedule.
City /State/ZIP: -
I Fees due upon application
Phone:( ) Fax :( )
Amount received
CCB lic.: 'Q OZ
Date received:
Authorized signature: This permit application expires if a permit is not obtained ,..,.;r;:."-------------
within 180 days after it has been accepted as complete.
Print name: 1E Pr. CaLc, l kJ I Date: (c o S • Fee methodology set by Tri -County Building Industry
Service Board.
i \Buddmg\Pennib\FPS- PamiWppdoc 12/03 440.4613T(I1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) 0 New 2.) Modification to sprinkler heads only:
Zr Addition 0 1-10 heads: No plan review required.
x r Alteration 12- 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: (S
Additional description of work: -
Type 'Of SYStinf(CiiiiiiletiA,B;;C-
.• „ - ; , • — ,
• "•-• - -.--: • -
• • A.)CommercialSprinkler.
/ 21 - Wet Oi
Additional Standpipes
Information: Hazard Group
Density 4Z4f>
Design Area C9C x!(
K. Factor e co
Sprinkler Project Valuation: $ SZZ,
•-11)TYPil Hood Fir ssion System
Hood Project Valuation: I $
" = 1. - /, - - . • - • •
- • •
• • - • r t
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
Sprialder(StandAkine;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 $381.50 . . .•
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: $
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.
1:\BuildingTermits\FPS-PermitApp.doc 2
CITY OF TIGARD �/� _
BUILDING DIVISION PERMIT It* P"�bQ -� 06 _,C
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Atip
Inspection Requests (24 Hrs.): (503) 639 -4175 _41: 1111.11 ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: q 3 , 5 1 tofi- , CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: �
DESCRIPTION: 4 /' • ,
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ) F 170c Pour Time:
Code # Inspection Description Confirm # Contact # Message
09 4,4"___pci 360 - 6o/ -7 93 ()
Corrections /Comments/ Instructions:
•
•
•
Mig
, ElarMir
A RN 11 EFAIWP—A°F. ~�
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR IN PECTION ❑ ADDITIO AL F ES ASSESSED
Inspector: Date: R � Ins � p Phone #: (503) 718-