Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00086
'l4 DEVELOPMENT SERVICES DATE ISSUED: 3/8/01
'' . ,�� I- ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S126C0 -01107
SITE ADDRESS: 09455 SW WASHINGTON SQUARE RD
SUBDIVISION: WASHINGTON SQUARE 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: SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: : sf N: S: E: W:
OCCUPANCY GRP: TOTAL AREA: 0.00 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: $ 3,900.00
Remarks: Tenant Improvement
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
PO BOX 21545 9095 SW BURNHAM
SEATTLE, WA 98111 TIGARD, OR 97233
Phone: Phone: 684 -2928
Reg #: LIC 000640
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough - In
PRMT CTR 3/2/01 $81.70 27200100000 Sprinkler Final
5PCT CTR 3/2/01 $6.54 27200100000
FIRE CTR 3/2/01 $32.68 27200100000
Total $120.92
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 -1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246 -1987.
Pe rm itee
Signature:
Issued By:
Call 639 -4175 by 7 p.m. for an inspection the next business day
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-Building Peri tot CiAli
� ' I City of Tigard 3/0 I e( .1'‘- -G ,V l. n b °A(4(.,( I Permi l(�drtp�LC' / — C O Q
' ^'� y g ` Prolect/appo.: Expire date
City q/Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 - 4171 Date issued. By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ New construction U Demolition
❑ Addition/alteration/replacement )sk Tenant improvement J Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: 9 ' S S S. u� . E-It f3 &V) IJ SQ I Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: BIA1�I. - P■. - ky...-.AdZ
Description and location of work on premises /special conditions: I FN/ 1- `Y \ KOJE_L`II t s , T 39 H1 ('S
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: P P \,� v, L LC (Floodplain, septic capacity, solar, etc.)
Mailing address: / P.o . /c , ?-31. 1 & 2 family dwelling:
City: -T 15 IState: ' ZIP: 1'2_S( Valuation of work $
Phone: J I Fax: IE-mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
•
APPLICANT Garage /carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
—
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $ 3 900
Business name: W yp�� F kE 1 1C� Existing bldg. area (sq. ft.)
Address: New bldg. area (sq. ft.)
�� s S - tom) LRIJ Number of stories
City: —R & /'h2 tD I State: b ZIP: ei 7 ZL 3
v S I Fax: (,9( -y(,S7 I E -mail: Type of construction
Phone: 6 - 2`1Z v
Occupancy group(s): Existing:
CCB no.:
b401 ? New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
r Address: jurisdiction where work is being performed. If the applicant is
r City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP: Amount received $
Phone: Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information
attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complied with w • the pe f herein or not. Credit card number / /
gp / � i Expires signature: _ D ate: , 3 / to ! Name o f c ardholder as shown on credit card
Gxp
Print name: RA CU /g 0 RO t{ Cardholder signature $ Amount
Notice. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6 /00 /COM)
Fire Protection Permit Check List
A.) ❑ New ❑ Addition a Alteration LI Repair
B.) .Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads: 3q
Additional description of work:
•
Type of System (Complete A or B as;.applica. "ble):
A.) Sprinkler Wet ❑' Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 3 9 oO'
• B.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $ 5 CO ,
Permit fee based on valuation (see chart): $ AI ,10
8% State Surcharge: $ (, . S4.-
FLS Plan Review 40% of Permit: $ • 32 , s
TOTAL: $ 11n. qZ
•
is \dsts\forms \FPSchecklist.doc 10/04/00
�..1 TIGARD BUILDING INSPECTION DIVISION Z• //
2.4 -Holt Inspection Line: 639 -4175 Business Line: 639 -4171
2 BUP ,00/
Date Requested �/�?'� AM PM BLD
Location 9 Sr,./ GcJa }4 59 ( . Suite MEC
Contact Person Ph SL) L i 2-92Y Y PLM
Contractor Ph SWR
BU Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: - -
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
ire S klers C,G✓*A--
Fire Alarm
Susp'd Ceiling I ' I
Roof
Misc:
Final
PASS FAIL
PLU
Post & Beam
Under Slab •
Top Out
Water Service
Sanitary Sewer
- Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
•
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL
Service
Rough In
. UG /Slab ,
Low Voltage
Fire Alarm
Final
. PASS PART FAIL •
SITE
Backfill /Grading
Sanitary Sewer
- Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /
Approach /Sidewalk Date '1 10/ Inspector /� l � . � _ E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
✓7 -3r
.CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hou.r Inspection Line: 639 -4175 Business Line: 639 -4171
/L B 0� - (� r'
Date Requested 1 / AM PM BLD
Location P /5) 54 K S7 MEC
Contact Person PLM
Contractor Ph SWR
- ILD Tenant/Owner s _° �` j , . • ; M ELC
etaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN "
Crawl Drain Inspection Notes:
Slab
SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear L ( �d
Framing ��
Insulation
Drywall Nailing
Firewall •ci L.:4- �� (
e larm - 1 _
Susp'd Ceiling C 7fa✓�"�- L )
Roof ��//O° .lti� P •
PASS PART -
3 V"
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service s'jQ S ' — � � V`_, •
Sanitary Sewer [
Rain D rain_ s c"\&41-1-
Final
PASS PART FAIL
MECHANICAL
-
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final ' •
PASS PART FAIL
ELECTRICAL •
Service
Rough In
UG /Slab . -
Low Voltage
Fire Alarm
Final
PASS PART . FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk fe 4/ \ d
Other Date / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection. record from the job site.
if &12
CITY OF TIGARD BUILDING INSPECTION DIVISION MST •
24 -Hoir Inspection Line: 639 -4175 • Business Line: 639 -4171
BUP . io —(i„ br6
Date Requested `�' AM PM BLD / .
Location ,J Sw 4d t Sy Suite MEC ,FAV
w.•
• Contact Person 6 .41 rz c•- f Ph /ray Zy z-.r • PLM
Contractor Ph SWR
BUILDI Tenant/Owner . ELC
Retaining Wall • ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
re Alarm
Susp'd Ceiling .
Roof
PART FAIL
P . ' ING
Post & Beam
Under Slab
Top
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL •
MECHANICAL
Post & Beam
Rough In
• Gas Line • - -
Smoke Dampers
Final -
PASS PART FAIL
ELECTRICAL
Service_
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
. - PASS . PART .. FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain • [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk r
Other Date 17/A 6 / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record, from the job site. .