Permit CITY OF TIGARD PERMIT
A. PERMIT #: BUP2003 -00525
DEVELOPMENT SERVICES DATE ISSUED: 9/24/03
. , � I - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09530 SW WASHINGTON SQUARE RD H -10 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: B 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: $ 5,000.00
Remarks: Modification of fire sprinkler heads for TI.
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 #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 9/5/03 $91.30 Sprinkler Final
[TAX] 8% State Tax 9/5/03 $7.30
[FLS] FLS Pin Rv 9/5/03 $36.52
Total $135.12
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: .�� �
Perm ittee
Signature: ,' g_:..:
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
re Protection stem
A l E FOR OFFICE USE ONLY
Building Permit App �
I t - Received i Building /
• Date/By y ®3 l Permit No.: /' rX .'� SoZs
1
City of Tigard ' ` � Planning Approval Other
Date /By: Permit No.:
13125 SW Hall Blvd. `�� Plan Review Other
Tigard, Oregon 97223 Date/By 9- /` – DJ $0 Permit No..
" +;+'
Phone: 503- 639 -4171 Fax: 503 - 598 -190 t'' Post - Review Land Use
d.or.us
Internet: www.ci.tigard.or.us 1 . ; ...;:. : !,-i-- ' Date /By Case No.
g Contact wus ® See Page 2 for q
24 -hour Inspection Request: 503-639-4175 Name /Method 1 t�' Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition I & 2 FAMILY DWELLING
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note Permit fees* are based on the total value of the work performed. Indicate
❑ I & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application
❑ Accessory Building ❑ Multi- Family \
❑ Master Builder 111 Other: Valuation $_ •
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: e 30 V'4a runortth 1 stuare, Total number of floors
� v New dwelling area (sq. ft.)
Suite #: Bldg. Apt. #: Garage /carport area (sq. ft.)
Project Name: A P plc, Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application
TEr■JANCr TNl PeOVC_•t-3.5c
Valuation $ 5, —
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER I ❑ TENANT Type of construction VA)
Name: w e Wash I G1 9,0-.1 L
Oh .5L.[ Occupancy group(s): Existing:
1 New:
Address: "P.0. 23 (0.35
City /State /Zip: \ i0�ard I 012... (Al 28 I
NOTICE: All contractors and subcontractors are required to be
Phone: Fax:
❑ APPLICANT ❑CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax:
E-mail: BUILDING PERMIT FEES*
Please refer to fee schedule.
CONTRACTOR .
Business Name: , ct tt? v \G. Fees due upon application $
Address: Glpq c, ∎ .\i \ I . - p,w,*nlnOXY1
City/State /Zip: o,.rri (ye._ Ocl 2 23 Amount received $
Phone: (S 4- . 2Gt $ f'ax: ( %4 . q ( Date received:
CCB Lic. #:
Authorized `/� Notice: This permit application expires if a permit is not obtained within
Signature: Dater 180 days after it has been accepted as complete.
tGl +N2 RC) 1 • *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
I: \Dsts\Permit Forms\BldgPermitApp.doc 01 /03
I
Fire Protection Permit Check List
Describe work to be done:
A.) Li New B.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
ZLAIteration Li 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: .SD
Additional description of work: -r r /\ (712.0,te_NUzt.i.
tz,eq Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet a_ Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ S WC) . OD
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes Li
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 $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $ 5 t 0DO . 00
Permit fee based on valuation (see attached chart): $ cj,\ . 30
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ . 30
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ 1 3S .12-
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.
is \dsts \forms \FPSchecklist.doc 02/28/03
■
Building Permit Fee Chart
'r
Project Valuation Permit Fee Tax F&LS 1 Total
8% 40%
12,000 62.50 i 5.00 25.00 92.50
2,001 3,000 72.10 5.77 28.84 106.71
3,001 4,000 81.70 6.54 32.68 120.92
4,001 5,000 91.30 7.30 36.52 135.12
5,001 6,000 100.90 8.07 40.36 149.33
6,001 7,000 110.50 8.84 44.20 163.54
7,001 8,000 120.10 9.61 48.04 177.75
8,001 9,000 129.70 10.38 51.88 191.96
9,001 10,000 139.30 11.14 55.72 206.16
10,001 11,000 148.90 11.91 59.56 220.37
11,001 12,000 158.50 12.68 63.40 234.58
12,001 13,000 168.10 13.45 67.24 248.79
13,001 14,000 177.70 14.22 71.08 263.00
14,001 15,000 187.30 14.98 74.92 277.20
15,001 16,000 196.90 15.75 78.76 291.41
16,001 17,000 206.50 16.52 82.60 305.62
17,001 18,000 216.10 17.29 86.44 319.83
18,001 19,000 225.70 18.06 90.28 334.04
19,001 20,000 235.30 18.82 94.12 348.24
20,001 21,000 244.90 19.59 97.96 362.45
21,001 22,000 254.50 20.36 101.80 376.66
22,001 23,000 264.10 21.13 105.64 390.87
23,001 24,000 273.70 21.90 109.48 405.08
24,001 25,000 283.30 22.66 113.32 41928
25,001 26,000 290.80 � 23.26 116.32 430.38
26,001 27,000 298.30 i 23.86 119.32 441.48
27,001 28,000 305.80 24.46 122.32 452.58
28,001 29,000 313.30 25.06 125.32 463.68
29,001 30,000 320.80 25.66 128.32 474.78
30,001 31,000 328.30 26.26 131.32 485.88
31,001 32,000 335.80 26.86 134.32 496.98
32,001 33,000 343.30 27.46 137.32 508.08
33,001 34,000 350.80 28.06 140.32 519.18_
34,001 35,000 358.30 I 28.66 143.32 530.28
35,001 36,000 365.80 29.26 146.32 541.38
36,001 37,000 373.30 29.86 149.32 552.48
37,001 38,000 380.80 30.46 152.32 563.58
38,001 39,000 388.30 31.06 155.32 574.68
39,001 40,000 395.80 31.66 158.32 585.78
40,001 41,000 403.30 32.26 161.32 596.88
41,001 42,000 410.80 32.86 164.32 607.98
42,001 43,000 418.30 33.46 167.32 619.08
43,001 44,000 425.80 34.06 170.32 630.18
44,001 45,000 433.30 34.66 173.32 641.28
45,001 46,000 440.80 35.26 176.32 652.38
46,001 47,000 448.30 35.86 179.32 663.48
47,001 48,000 455.80 36.46 182.32 674.58 .
48,001 49,000 463.30 37.06 185.32 685.68
49,001 50,000 470.80 37.66 188.32 696.78
1
I: \dsts \forms \feechart.xls 10/01/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION ' Business Line: (503) 639 -4171 MST 3 -00
S
BUP
Received Date Requested /(' AM PM BUP
Location 75 w) • S4-- (1 Suite MEC
Contact Person � Ph ( ) 6 e - ( - a-q a-e 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 l 5 ,L,,, p e_ C 1,
Framing LP C/"�
Drywall on -
Drywall Nailing U i �
Firewal
n e
ire arm
Susp'd Ceiling
Roof •
Other: - — -
in
PART FAIL
BING
Post & Beam
Under Slab •
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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE •❑ Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 0 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site: .
PASS PART FAIL