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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00178 Mik - 13125 SW DEVEL ACES -639 -4171 DATE ISSUED: 5/4/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: Fire sprinklers (36) 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: 3N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 86 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: $ 4,000.00 Owner: Contractor: WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC. BY THE MACERICH COMPANY 9095 SW BURNHAM 9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223 i'none�' ( 10§ 7 62R-8865 Phone: 684 -2928 FEES Reg #: LIC 64077 Description ' Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 4/25/2005 $81.70 [FLS] FLS Pln Rv 4/25/2005 $32.68 [TAX] 8% State Surchari 4/25/2005 $6.54 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: ' � , _ .er Permittee Signature: • 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 Protection System 7,/6 SD.-5 b WK'S �� S� , A pi, 4 Aullding Permit A elV ED FOR OFFICE USE ONLY • Citv"of Tigard Received ateiv i EZElgaignk 13125 S Hall Blvd , Tigard, OR 9 7 23 Di ) � plan Revie T. SW Phone: 503.39 4171 Fax: 503 598 196/AT 2 P Lo ■ � 1il DaWBy: `%(/ S OS Other Pemut: Inspectior. Line: 503 639 4175 Date Rea. I� V / El See Page 2 for Internet: wux'.ci tigard or us CITY OFT IGA RU C. Notified/Method:_cj OS - ! Supplemental Information BUILDING DIVISION 1 e o rs -_ _ . _- TYPE OF WORK " . . _ - : - REQUIRED DATA 1- AND 2- FAMILY DWELLL\G ❑ Nio 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 CONS CTION - work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling Com mercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: - : JOB ! SITE INFORMATION . AND LO - CATION' r ` ' -- ` 7 "'4 `ti' Total number of floors: Job site address- Oi { \p \M v i N \TD 14 V A.vA IL • New dwelling area: square feet City /State/ZIP: T 1 vi a V 1 ` P 0(1 2.25 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: g.e,N . _j1)( 0l Covered porch area: square feet Cross street/directions to job site: NATON Skst r-e, Deck area: square feet PAM Other structure area: square feet :RE( IRED DVA 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 :21: " '•° �' ' z .4-24 indicated on this application. •: -. _ _ 1 D ` E ' SCRIPTIO 1, N , 'OF, I W L ORK_ � •; .,, , i = � , ?_ :,;t work indicat NCI) �re, S V1 i lL` '- Y1 �it.7 -e A- p1 A� Valuation: $ 4/ 000 P Existing building area: square feet New building area: square feet ‹'. -- PROPERTY OWNER • I .= ' 0 TENANI;""-ig !.'0 Number of stones: Name: PP R- WIo7I'1i N uToN Nl avar ? I \,s Type of construction: 3 ? Address: Occupancy g rou p s: / 0 , 6 07 El, City /State/ZIP: Existing: 2 -n g' I Phone: ( ) Fax: ( ) New: APPLICANT _ ❑ CONTACT PERSON �' '51 - .. '• - 'NOTICE Business name: (,,v (()11 thkei'1"Dp--, ) 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: ( ) Fax:: ( ) E -mail: r : .t F. rj�E.Y .. - , CONTRACTOR ;<,i . = . ir = :�:z- ' r^ • Business name: M IY-E p e' w ) C'/ - • BUILDING PERMIT FEES* Address: O<,J"1 S ?)\)11\1 harm Please refer to fee schedule. City /State/ZIP: I I I j1 ) ( �� 6 \ - 1 2 -Z � Fees due upon application 1b , W • NZ Phone• (•il )' • Ai . 1A-2.3-2, Fax: ( S ) \Q ,4- - a S,, Amount received D CCB lie.. 01 Date received: Authorized Signature: ©� This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name•ki ,A,,, r �r1� Date: 0 4.. VC) . 0 • Fee methodology set by Tn- County Building Industry Service Board. I Bu.Idmg Perscs FPS- Perrr__App cat . ='C3 ano- a613T(i Il02ICC1M/wl3B) • 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 0)4'0 heads: No plan review required. ❑ Alteration 11± heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: Type of System (CompletelA,B, C or D as applicable): A.) Commercial Sprinkler' - ti .., .. _ . ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ +- 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.) 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 S381.50 Sprinkler Project Square Footage: sq. ft. Project Valuation Subtotal (A, B & C): $ 4 COO — Permit fee based on valuation (see attached chart): $ $ i . t7 Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ y .64 FLS Plan Review 40% of Permit Fee: $ 32 . kQ( TOTAL: $ 12_0 _ 42 _ Plan review requires a completed application and 3 sets of plans at submittal. Plan revievT — 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. 1jLLl].P L' I i r-, FPS Checl-l:st doc 12/29/03 CITY OF TIGARD BUILDING DIVISION PERMIT #:, BUP2005 -00178 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 514 /2005 Phone: (503) 639 -4171 kargfridll Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8/23/2005 ' TIME: 7:05Am PAGE: 66 SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H-4,5 CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: BEN BRIDGE JEWELERS - DESCRIPTION: Fire sprinklers (36) heads. OWNER: WASHINGTON SQUARE LLC, PHONE #: 503. 639-8865 CONTRACTOR: WYATT FIREPROTECTION INC. V PHONE #: 684 -2928 Inspection Request Scheduled For: Date: 8/23/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 999 Sprinkler final 014056 -01 503 -684 -2928 N Corrections /Comments /Instructions: . • Ski F 0_1)( • • • • • • • PASS ❑ PARTIAL APPROVAL. ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 9_4_// - Date: / — .)-3 -0 J Phone #: (503) 718- •