Permit ` v , CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT B 12 3120 -00529
D ATE PERMIT ISSUED: #: 10/2 3/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09422 SW WASHINGTON SQUARE RD K06 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: SELECT COMFORT
Project Description: Alteration of (31) fire sprinkler heads.
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: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 65 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 4,385.00
Owner: Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MAC ERIC H COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
Contact #: PRI 503 - 684 -2928
Phone: FAX 503 - 684 -9657
Reg #: LIC 64077
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/11/2007 $83.95
[TAX] 8% State Surcharf 10/11/2007 $6.72
[FLS] FLS Pin Rv 10/11/2007 $33.58
Total $124.25
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 .246.• .s• or 1.800.332.2344.
Iss d By: � i i dpi Permittee Signat Vilik ,, IfWMIIIII
. 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.
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Fire Protection System e ��� � G � � � u �7-�5a
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Building Permit Application FOR OFFICE USE ONLY
R eceived
Da : n^ 7 r
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'' City of Tigard o 7 P ermit No.: -ele: S
13125 SW Hall Blvd., Tigard, OR 97223 = �,
/1 0�
Phone: 503.639.4171 Fax: 503.598.1960 Plan n evtew � Other Permit:
Date/B : ins,.
TIGARD Inspection Line: 503.639.4175 Date Ready/ :y: 2 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: ere Supplemental Information
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
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El I- and 2- family dwelling Commercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
I=1 Master builder 12 Other: I Number of bathrooms:
94 9N JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 125:T6 c't, " I 1 A k e� n � p New dwelling area: square feet
City/State /ZIP: f A, v c( Dr.. - L /` Garage /carport area: square feet
r Cl 1
Suite/bldg. /apt. no.: Project name: c e It L eo r Covered porch area: square feet
Cross street/directions to job site: W Deck area: square feet
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.
' Valu ation: $
A Y P,IOi� , heals -to C�v �,� r -�;l 1 3g5
Existing building area: square feet
' r '.>! ■. ' 444 I_ JA / Si _ II' I_
I
New building area: square feet
[83 PROPERTY OWNER I ❑ TENANT Number of stories:
Name: P ? I Y Vt I >1 j + ort Uy / e , Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
%APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: 5,,, c oA� A C l, I4 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: ( ) I Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
• Business name: *ju jt A - {-.}- g y - p�. - - OA (Please refer In fee schedule 95 ,
V" C` Permit fee: J
Address: ' D 9 5 ,'IA/ A , b bt x r h�t�' 7 9 ,
State surcharge (8% of permit fee):
City/State /ZIP: (P
) Jr FLS plan review (40% of permit fee): �j
Phone: ( 3) 0Ct i 1 _ C.j Sc 1 q —7 Z Z � Fax: ��JJ
) /_`"' Q�,�_G) Yl 7 (Due upon application.) 3 �
CCB lie.: I Total permit fees:
/
Authorized signature: // Amount received:
--" e�'` e This permit application expires if a permit is not obtained
Print name: E Ql t� ,�-h� `'D Datel0 — -D 7 within 180 days after it has been accepted as complete.
V I t ] � � - * Fee methodology set by Tri-County Building Industry
Service Board.
I: \Building \Permits \FPS- PermitApp.doc 03/23/06 440 -4613T( I I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
El Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration � 11+ heads: Plan review required.
El Repair }}
Number of sprinkler heads: J
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ L' 85
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand 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 $381.50
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 3 g5, 3U
Permit fee based on project valuation (see fee schedule): $ ' f
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $ .
FLS Plan Review (40% of permit fee): $ ? 57
TOTAL: $ / ,3 5.,2
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Plan review requires a completed application andIsets 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.
http: //w w.ci.tigard.or.us/ city_ hall/ dcpartmcnts /cd /docs /I Pcrmitlpp.doc 2
CITY OFTIGARD e..
BUILDING DIVISION / �.- PERMIT #: BUP2007 -00529
13125 SW Hall Blvd.; Tigard, OR 97223 DATE ISSUED: i0/2312007
Phone: (503) 639 -4171 �' f •
Inspection Requests (24 Hrs.): (503) 639 -4175 dafk 1.1.
INSPECTION WORKSHEET FOR DATE: 11/19/2007 TIME: 7:01AM PAGE: 39
SITE ADDRESS: 09122 SW WASHINGTON SQUARE RD K06 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SELECT COMFORT
DESCRIPTION: Alteration of (31) fire sprinkler heads.
OWNER: WASHINGTON SQUARE LL C. PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 -684 -2928
Inspection Request Scheduled For: Date: 11/19/2007 Pour Time:
C••e # Inspection Description Confirm # Contact # Message
999 Spiinller final 059870.01 503.684 -2928 N
Corrections /Comments /Instru tions: '
. ( \&)■-`5-e---70Q—___ —
4
1\74 e
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'
Ili PASS PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
IM FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• Y Inspector: Date: V Phone #: (503) 718- ZsPZ
.
CITY OF TIGARD ,,.
BUILDING DIVISION PERMIT #: BUP2007 -00529
13125 SW Hall Blvd., Tigard, OR 97223 ATE ISSUED: 10/23/2007
Phone: (503) 639 -4171 . 0
Inspection Requests (24 Hrs.): (503) 639 -4175 P._ .
INSPECTION WORKSHEET FOR DATE: 11114/2007 TIME: 7:02AM PAGE: 57
SITE ADDRESS: 09422 SW WASHINGTON SQUARE RD K06 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SELECT COMFORT
DESCRIPTION: Alteration of (31) fire sprinkler heads.
OWNER: WASHINGTON ON SQUARE LLC, PHONE #:
CONTRACTOR: WYATf' FIRE PROTECTION INC. PHONE #: 503 -681 -2928
Inspection Request Scheduled For: I Date: 11/14/2007 Pour Time:
'(I) Code # Inspection Description ,/ Confirm # Contact # Message
i
910 Sprinkler rough -in /test 059550 -03 909-297-8505 N
e u •
Corrections /Comments/ Instructions:
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OM 1
ij /'ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -. ) Inspector: 1/ v" Date: i1 ‘ 1a Phone #: (503) 718-..2y 2_y
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: BUP2007 -00529
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 10/23/2007
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' '` L
INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7 :02AM PAGE: 38
c
SITE ADDRESS: 09422 SW WASHINGTON SQUARE RD K06 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SELECT COMFORT
DESCRIPTION: Alteration of (31) fire sprinkler heads.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 - ?8
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 . Sprinkler rough -in /test 058799 -01 503 - 684 -2928 N
Corrections /Comments /Instruction :
_Lto_7" s$�'t
❑ PASS I "AARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
`�� FAI �' LL FOR INSPECTION El ADDIT,ION L FEES ASSESSED
1
Inspector: ebb Date: 11 1 D 7 Phone #: (503) 718 - ....L
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: F17P2007- 00579
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/23/2007
Phone: (503) 639- 4171 ����
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/30!2007 TIME: 7 : 02AM PAGE: 29
SITE ADDRESS: 09422 SW WASHINGTON SQUARE RD K06 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SELECT COMFORT
DESCRIPTION: Alteration of (31) fire €prinl4er heads. •
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503.681 - 2918
Inspection Request Scheduled For: Date: 10/30f2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 058615-07 909- 297 -8505 ht
•
Corrections/ ommens /Instructio s:
,/t KAT 5
( .31(0 .
❑ PASS 4PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�� Inspector: `� `' Date: I ) � Phone #: (503) 718-