Permit •
4, .1 BUILDING PERMIT
CITY OF TIGARD PERMIT #: BUP2005 -00634
I� DEVELOPMENT SERVICES DATE ISSUED: 12/12/2005
s�' ��, II 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09510 SW WASHINGTON SQUARE RD H - ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Add /relocate 10 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: : sf N: S: E: W:
OCCUPANCY GRP: 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: 4t3a 07j, DO
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
TIGARD, OR 97223
Phone: Contact #: PRI 360- 699 -4403
FAX 360- 699 -4485
Reg #: LIC 70822
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 12/12/200: $62.50
[TAX] 8% State Surcha 12/12/200; $5.00
Total $67.50
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 - 001 -0010 through OAR 952-001-0110. You may obtain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
ll W Issued By: 4 Permittee Signature: 41._■1/ �/
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.
Fire Prot %tion System
Building Permit Application .. coil Ic l• l t O
City of Ti and „ s� /� to // ° 1�' �I O� ab 6 y
`.1 g�'' Permit ..
13125 SW Hall Blvd, Tigard, OR 97223'
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 "" • i Date/By Other Permit:
Inspection Line: 503.639.4175 rqi: J! 'I I 1, Date Ready/By. funs: ® See Page 2 for
Internet: www.ci.tigard.or.tu Notified/Method: /rJ Supplemental Information
,; - • j • - PE,,OF: VyORI(, .w `„')" :. • , . , - ; . '; , .' y REQUIR ID DATA. 1- AND 2- FS►MIJ.Y;DWELLING '
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Addition /alteration replacement ❑ Other: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
- . - , •_ • ' ` i CATEGORY'Oi CONSTRUCTION - ' . , work indicated on this application.
El 1- and 2- family dwelling jCommercial /industrial
Valuation: $
CI Accessory building El Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
_ /-1.&•-•••-• 0 - - JOB SITE, INFORMATION AND LOCATION', , . .' - ; .. Total number of floors:
Job site address: . `',' - W `A„`_ j i.4 1 raj t'yj - L ; lera , D New dwelling area: square feet
City/State/ZIP: j 1 ��, ti j / 4`a sic ���, • a� Garage /carport area: square feet
Suite/bldg. /apt. no.: K.) r Project name: 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: 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.
_ 7 �-
Valuation: $ �
• C.: t,:, t, u �) - L Z.. c Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT -. , Number of stories:
r �
Name: d A' L ( ( tvkri-) / Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing: !_ ' e- - ' —d—_
Phone: ( ) Fax: ( ) New: N. t ' r
' APPLICANT ❑ CONTACT PERSON - , • NOTICE .
1� � Business name: r_ t c i-- , 1. • _ L- _ f ( -_( C pl \ ) All contractors and subcontractors are required to be
Contact name: + L ` licensed with the Oregon Construction Contractors Board
__-... r - C ' �'�—(� under ORS 701 and may be required to be licensed in the
Address: 4 7c 0 IQ= E PA , 11/410 '- (-AAP AL (, jurisdiction in which work is being performed. If the
City /State/ZIP: V,) kJ( �('j� 4 1g�,�i J applicant is exempt from licensing, the following reasons
_ apply:
Phone ( S) Z Z Z ' 6 :, 0.r.., 1 Fax:: ( t )) 6-, r (ci 44 Yy j
E -mail:
CONTRACTOR " ' . - -
Business name: ! .t.- i C= T �-- • - -- :, - •BUILDING PERMIT FEES*
• Address:
Please refer to fee schedule.
City /State/ZIP: -
Phone: ( ) Fax: Fees due upon application
( )
CCB lie.: Amount received
7 3Z
,...-- ---// �� " � - Date received:
Authorized signature: �� 7 This permit application expires if a permit is not obtained
_ within 180 days after it has been accepted as complete.
Print name: ,1 ' - " ll._ i 6�` Date: I Z 17_ ' ;`- • Fee methodology set by Tri -County Building Industry
Service Board.
i \Butldmg\Pennits\FPS- PennitApp doc 12/03 440- 4613T(I I /02/COM/WEB)
- -I.
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
�De`scibe ��ork to' a .... -�- .rte, -., �. _� �: -�- = ;�- { - ;�� - •�� -� ,; � _..,F.., ;. .., . ;.�,
}� �.+ a]. ' � • �t �, J %,I 1�.F � f. _, •�.
,. i �' V i done . r:. l C- tYr- a . ` y + - °_x •� - - iYr y 'd:. -' „ ^'� "n� Fl �''`' + .y
1.) ❑ New 2.) Modification to sprinkler heads only:
Addition El 1 -10 heads: No plan review required.
El Alteration ❑ 11+ heads: Plan review required. •
❑ Repair
Number of sprinkler heads:
Additional description of work: •
Type`of System(CompleteFA: o� D as applicable):. T =:; '•,. rg
%," Commercial,Sprinkle , . f .. z - . � s' 4 7Y :
El Wet 0 . Dry
Additional • Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
. ,
Hood Project Valuation: $
tY:.L .,f •, if�:r � -f .v --1'L' J� {: .:� f' *-.
•
, '.� -). �•.7Y . l {.•�y - 1iAu � Y1i.M:1=+.r' Rn.nti.�. t.
- '•"�� % „�'. : f� v:�t.� - r st -..� y�"S���rTEtJ ., ..
7 - � -� r;�� -- ... .' %�
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
• rr v:
:c r' - .; �, . Fr_ - ' 'rZ'.. }.ti!'�ti"'`', ..n , ' -d•i; i . ,,. � tt �;� �o-S,::ita ` -,•a • 7•-1; .� :.. • . 7z•
. )Y Residential Sprink (Stand AloneiSystem)_�u • �t :. :: =:- • : :•: ` . •,.t'
Square Footage: Permit Fee: •
0 to 2,000 $187.50
2,001 to 3,600 $232.50 = t
y'a +'
3,601 to 7,200 $292.50 ▪ ti
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): $ �z _ A •
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ da
FLS Plan Review 40% of Permit Fee: $ •
TOTAL: S 7 . 3 0
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\Permits\FPS- PermitApp.doc 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00634
V 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1212005
Phone: (503) 639 -4171 A.
Inspection Requests (24 Hrs.): (503) 639 -4175 ..&- °-_..
INSPECTION WORKSHEET FOR DATE: 12/14/2005 TIME: 7 :01AM PAGE: 57
SITE ADDRESS: 09510 SW WASHINGTON SQUARE RD H - 1 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: REGIS
DESCRIPTION: Add/relocate 10 sprinkler heads.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360 - 699 -4403
Inspection Request Scheduled For: Date: 12/14/ 200, Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 023402 -01 503 -222 -6001 N
Corrections /Comments /Instructions:
1 at - - 7 - - - - - - - - - - - - - -
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1
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SS n PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
II �
Inspector:
� . �� Date: (Z4 l Phone #: (503) 718 - ?
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