Permit i
� `"
CITY OF TIGARD PERMIT
PERMIT #: BUP2003 -00318
DEVELOPMENT SERVICES DATE ISSUED: 6/10/03
e - • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09491 SW WASHINGTON SQUARE RD A -4 PARCEL: 1S126C0 -01107
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: 5N : 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: $ 3,346.00
Remarks: Fire protection for tenant improvement.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQ. RD. TIGARD, OR 97223
PORTLAND, OR 97223
Phone:
Phone: 684 -2928
Reg #: MET 00004593
FEES LIC REQUE) INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 6/2/03 $81.70 Sprinkler Final
[TAX] 8% State Tax 6/2/03 $6.54
[FLS] FLS Pin Rv 6/2/03 $32.68
Total $120.92
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Issued By: L ' ec,(1761_;)
Pe rm ittee
Signature: �1 (� ,� 7YV
Call 639-4175 by 7 p.m. for an inspection the next business day
JI! ,. .
' 1,
• g Ca`L16I1 14"9"1" 1-3-03 1!..515 Building Peru
Date received: 6 d3 Permitno.:
,,y City of Tigard JUN 0 2 200
- I Project/appl.no.: Expire date:
CityojTigard Address: 13125 SW Hall Blvd, 19114 (1,) *RIPARD
Phone: (503) 639-4171 BUILDING DIVISION Date issued: Receiptno.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi-family 0 New construction ❑ Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: £ w I 0. ,/�t, I I I. • ,,/ LAMM Bldg. no.: Suite no.: /,
•
Lot: Block: Subdivision: 0 Tax map /tax lot/account no.:
Project name: ! n
Description and location of work on premises/special conditions: A.0- ii 1" 2-C Vii) g
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: l'1 as' I I, •11 LL-C, (Floodplain, septic capacity, solar, etc.)
Mailing address: sp. Q. p,. mw 1 & 2 family dwelling:
Eal �� State: 0' ZIP: • 'L$ 1 Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
r APPLICANT Garage /carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $ 5, 3A-ra .
Existing bldg. area (sq. ft.)
Business name:
1. Fir ?rate J New bldg. area (sq. ft.)
A• , - ss: q. • ' MIME! dr_rar
� State: ZIP:
11223 Number of stories
Phone: (, ; • . C 2$ Fax: (A4-. E -mail: Type of construction
CCB no.: 4-01 group(s): Existing: 1
New:
City /metro lic. no.: 4-593 Notice: All contractors and subcontractors are required to be
ARCI I ITECT /DESIGN licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: 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: ZIP: 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 0 Visa 0 MasterCard
work will be complied with, whether . • c 1 . herein or not Credit card number: / /
Expires
Authorized signature: ``�/ a ate: 6/Z/03 Name of cardholder as shown on credit card
Print name: pc l- 'A'I -Y P b H-�L $
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)
r )
Fire Protection Permit Check List
A.) ❑ New ❑ Addition ❑ 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: 30
Additional description of work:
. +Ty` pe of System' faith,plete A, B aW0app ; L; ; ; .:j.;' )Th
A.) Sprinkler Wet Al- Dry CI
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 3 34-(0.
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: $
Project Valuation Subtotal (A, B & C) $ - 3 34-(,•. °O
Permit fee based on valuation (see chart): $ S I •,°
8 %o•State Surcharge: $ . (o• `
• FLS Plan Review 40% of Permit: $ . V 32 • Boa
TOTAL: $ I W • q 2
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:\dsts \forms \FPSchecklist.doc 11/21/01
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION', r Business Line: (503) 639 -4171 MST
BUP U ``''
�3/
Received Date Requested - a 3 AM PM BUP
Location q w/ ' S Q �- 0 Suite MEC
Contact Person / Y .Q Ph ( ) 6 8q 9 PLM
Co. - or Ph ( ) SWR
BUILDING Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: . SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
we Sprink er
Fire Alarm
Susp'd Ceiling
Roof
Other:
�k. 'AS ART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In /
Water Service '
Sanitary Sewer 1�
Rain Drains
Catch Basin / Manhole /
Storm Drain
\—)
Other: 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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA D ate a ' 7 3/ O ` Inspector
Approach/Sidewalk Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL