Permit * CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00011
` rl' DEVELOPMENT SERVICES DATE ISSUED: 1/24/2005
�� 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09432 SW WASHINGTON SQUARE RD K -2 PARCEL: 1S12600 -00300
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: 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: 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: $ 2,161.00
Remarks: Fire sprinkler TI, add and relocate fire sprinkler heads for TI.
Owner: Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TI ARD, OR 97223
one.
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler inspection
[BUILD] Permit Fee 1/11/2005 $72.10 Sprinkler Final
[TAX] 8% State Surcharl 1/11/2005 $5.77
[FLS] FLS Pln Rv 1/11/2005 $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 ) 24. -..!9 or 1- 800 - 332 -2344.
lssu By: 1 , __., 4 / iLl:!
Signature: /�GC�
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
r93 a. Was 1,0140.- J
, Fire Protection System
Buildin i `Permit App 6 - �1' it , n 6� �1 FOR OFFICE USE ONLY
g PU - 1. i It
City Of Tigard Received B : �Q Permit No 4 I L� o —a4
13125 S W Hall Blvd., Tigard, OR 9 A p� Plan Review p,
Phone: 503.639.4171 Fax: 503.598.1960 I JAM 1 1 200 d ; A DateB i Other Permit: _
Inspection Line: 503.639.4175 I Date Ready/By 0 See Page 2 for
Internet: www.ci.tigard or us OF Ty Q Notified/Method: Supplemental Information ,I,
CITY '_ ' ,' ViSION ,,,. - - ._, - .....
, ' Y, _. . - 't
'•. ; REQUIRED DATA: -I- AND
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed
Indicate the value (rounded to the nearest dollar) of A ❑ Other: equipment, materials, labor, overhead, and the profit for the
<'- r•; ' - • • 1:;.. t work indicated on this application.
'� - ` � - 4 -�- `- :.= - .w ° CATEG ORY :OF, ' CONSTRUCTION : - ° =�-_�
�?r= - - Valuation: $
❑ 1- and 2- family dwelling Commerciallindustnal
El Accessory building El Multi-family Number of bedrooms
❑ Master builder ❑ Other: Number of bathrooms
• , . JOB - INFORMATION 'AND LOCATION " - Total number of floors:
Job site address: 443l \N ` `Nv3�t , Q\y „k � ` • New dwelling area. square feet
V �
City / State/ZIP: ' i � "11-vo Garage/carport area. square feet
/
Suite/bldg. /apt. no.: Project name:k\le Covered porch area: square feet
Cross street/directions to job site: \�'�( I /`` 1kTin\i ‘ A • \H^ Deck area: square feet
MO V Other structure area: square feet (�
' REQUIRD DATA: COMMERCIAL -USE CHECKLIST
E -
Subdivision: I 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
/; fir. . , " ' DESCRIPTION OF WORK work indicated on this application.
Pbab ki K blv,a� r , BAIY) �
41e. ww 1 } V Valuation: $ 1, I
c.pA lj.p� - ok - h IQ) ' Existing building area: square feet
V` �� t `� New building area. square feet
•' .- ROPERTY, `OWNER.: I ' ❑. TENANT Number of stones:
Name: tonN s& c re ��� Type of construction• i Address: re—A_IIN
( 12 1n Z Occupancy groups. //i/�
City/State/ZIP: t71-�0e4\)1�i f\2^ CgC P Existing:
i
/- : g
Phone: (4tr)p) • Q -®p Fax: ( ) New
• '._. `'1 } °l A PLICANT =' ❑ - CONTACT” PERSON ) NOTICE
Business name: ` � � S � `, og J Al] 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:
/ � 'CONTRACTOR - �^ �
Business name: \ 1 a y 11 v. 1 Ypi t V Q� V _ *
�J ..... _, -
v v � r v l 1 + '1 A fl � BUILDING P F EES
Address: ( RA V t i Please refer to fee schedu
City/State/ZIP: I I ► Jt Q 2_ 811
1 i Fees due upon application
Phone: (� �� f �� ) 1 A • 1,0 -� g Fax. ( 'N5 ) Va • 01 01051 Amount received
CCB lie.: u)L-4911
�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.
p t o p, Print name:4,1,1N Date: 0 ` • 1 1 . O) * Fee methodology set by Tn -County Building Industry
1 Service Board
1 \Buildmg\Pcnnns\FPS- PemutApp doe 12/03 440 -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:
❑ Addition ❑ 1 -10 heads: No plan review required.
Alteration .. 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 12_
Additional description of work:
POW 10 fl r & NODS .
- Type of System (Complete'A, B, C or D
Commercial Sprinkler •
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ j j
B.) Type I =•Hood Fire Suppression System ;
Hood Project Valuation: $
C.) Fire Alarm - -
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
•D.) ResidentialSpr"inkler (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.
Project Valuation Subtotal (A, B & C): $ 1, ) 1\D
I
Permit fee based on valuation (see attached chart): $ Z • 10
Permit fee based on square footage (D) (see fees above): $ ,l
State Surcharge 8% of Permit Fee: $ C- 1
FLS Plan Review 40% of Permit Fee: $ • tz-
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\FPS Checklist doc 12/29/03
r
•
Site Address:
Letter of Transmittal
44- AIl'h Building Division
City of Tigard
DATE RECEIVED:
TO:
DEPT: BUILDING DIVISION
FROM:
COMPANY:
PHONE NO.: By:
RE:
(Case number, site address, etc.)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor /roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other (explain):
REMARKS:
For Office Use Only:
Routed to Permit Technician: Date: Initials:
Fees Due: $ Date: Initials:
Reprint Permit (per Plans Examiner): Yes: No:
Notified Applicant: Date: Initials:
1. BuIlding\Forms \LetterTransmtttal doc 1/6/04
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Burliness Line: (503) 639 -4171 MST L� 7
Received Date Requested { AM PM ✓ BUP
Location 9 /3� ti.) Suite ! < MEC
Contact Person Ph (2a, 9-9 - - 73 a5 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing adal
Insulation NI r
Drywall Nailing
Firewall -'
Fire �rinkl� ' .11 .� ilLt
Fire Alarm
Susp'd Ceiling ' I
Roof J
Ott•
r 'ASS PART FAIL
LU ING
& Beam
Under Slab 0 Rough -In �
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 Li Reinspection fee of $ • ed before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call r reinspe• ion RE: ► Unable to inspect – no access
Fire Supply Line 6 6- 1117 911
ADA
Approach/Sidewalk Date Insp - or Ext
Other:
Final DO NOT REMOVE this Ins record from the job site.
PASS PART FAIL