Permit a CITY OF TIGARD
PERMIT
PERMIT #: BUP2008 -00223
D ' COMMUNITY DEVELOPMENT DATE ISSUED: 7/9/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09561 SW WASHINGTON SQUARE RD B01 ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: STRIDE RITE
Project Description: Fire sprinkler alteration
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: 29 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,167.00
Owner: Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 684 -2928
FAX 503 684 - 9657
Reg #: LIC 64077
FEES
Description Date Amount
REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 6/30/2008 $76.80
[FLS] FLS Pln Rv 6/30/2008 $30.72
[TAX] 12% State Surch 6/30/2008 $9.22
Total $116.74
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 • ■ b calling 503.246.6699 or 1.800.332.2344.
Issued B . / e '__ �`� Permittee Signature: _ `I
'�
Call 503.639.4175 by 7:00 a.m. for an inspection t at 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.
- [ - 024 - Da. c2( <e_ ei-s c i ce p {
Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
/n
III a 1 1 ne SW Hall Blvd., Tigard, City of Tigard / Dat ved O(A8i of - 1/ ermit No h .4171 R ECEI Plan Revie'iuw� r Other Permit
Phone: 503.639.4171 Fax: 503 598.1960 Date/B : 'll"
Inspection Line: 503.639.4175 JUN 3 Date Ready :y. — ions ® See Page 2 for
TIGARD Q 2008
Internet. www.tigard- or.gov Notified/Method 7/kF 4'7 Supplemental Information
C CIT . I _ ■ �T • TIGAHD L, REQUIRED / DA T
DATA: 1- AND 2- FAMILY DWELLING
. _
❑ New construction • Dem it I , 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 CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling N'Commercial/industnal
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 5 , i/J Was li ml 96- a New dwelling area: square feet
City/State /ZIP: F 1 0g. q '724 Garage/carport area: square feet
Suite/bldg. /apt. no.: I Project name: s- - 7f k L 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: 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
DESCRIPTION OF WORK work indicated on this application.
4 Valuation: $ ' 6 7 cu
M lifillffriMr Existing building area: square feet
(/jll�/]� fl1 e � � New building area: square feet
_ L PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
FD APPLICANT ❑ CONTACT PERSON NOTICE
Business name: ' .....i. �i � � 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: ( ) I Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: . (Please refer to fee schedule
A Al • A Permit fee: •�/ 4'0 `I
Address: O q S S (.J 73 i "„�' ' k M o /O 2, z
City/State /ZIP: � /�, State surcharge (12 /o of permit fee): 9
i C W q - 7.2 0 )3 FLS plan review (40% of permit fee): 3T 7 z
Phone: (53) a 9 .2 P' Fax: 413 ) ,gL.f 94, 67 (Due upon application.) 3� .
CCB lie.: 6 L.F ✓J IA Total permit fees: I 16 74
Authorized signature: Amount received: f ( (, 7/
�� 411111 This permit application expires if a permit is not obtained
Print name `: i A ' _ '41 Date. ,, — i i. — O 8 within 180 days after it has been accepted as complete. ilig * Fee methodology set by Tri - County Building Industry
Service Board.
1 \Budding\Permns \FPS-Permit pp doc 03/23/06 440-4613T(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: I 3
Additional description of work: ,
i e na , { o prove 6
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 7j to '7. `''
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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 $381.50
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 'j
s P
Permit fee based on project valuation (see fee schedule): $ , "
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ u
FLS Plan Review (40% of permit fee): $
TOTAL: $ 1 I (o .
Plan review requires a completed application and 2 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.
http / /www ct.tigard or us /city_hall/ departments /cd /docs /FPS- PernutApp doc 2
CITY OF TIGARD r
BUILDING DIVISION PERMIT #: 13UP2008 -00223
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/9/2008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 60
SITE ADDRESS: 09561 SW WASHINGTON SQUARE RD B01 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STRIDE RITE
DESCRIPTION: Firs sprinlder alteration
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503. 6842928
Inspection Request Scheduled For: Date: 7/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Spunkier rough -in /test 072688 -01 603- 684 -2928 N
Corrections /Comments / Instructions: .
•
•
n -ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
, n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONACFEES ASSESSED
Inspector Date: 7 / I `c c( Phone #: (503) 718- '�
CITY OF TIGARD r ,
BUILDING DIVISION PERMIT #: 13UP200S -00223
13125 SW Hall Blvd., Tigard, OR 97223 ., DATE ISSUED: 7/912008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7 :00AM PAGE: 33
SITE ADDRESS: 09561 SW WASHINGTON SQUARE RD 801 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: STRIDE RITE
DESCRIPTION: Fire sprinkler alteration
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 613 - 2928
Inspection Request Scheduled For: Date: 7/10/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 072415.01 503.684 -2928 N
Corrections/Comments/Instructions: �(}/1 L
r C/() L4S -o t� / e .5 " L��1�'1 C 7 - . J A2Y-e /e -r4- a J O r r Gl t
( S. e O' e kl e � J
•
❑ PASS RI PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ ,FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: l 5-5 Date: /0 Q( Phone #: (503) 718 - ����