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Permit , n CITYOF TIGARD BUILDINGPERMIT ..�I, / h DEVELOPMENT SERVICES DATE E IS ISSUED: 4/ 16/04 4 - 00171 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S12600 -00300 SITE ADDRESS: 09609 SW WASHINGTON SQUARE RD L -2B 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: : 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: $ 500.00 Remarks: Rairse (2) sprinkler heads. 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 inspection [BUILD] Permit Fee 4/16/04 $62.50 Final Inspection [TAX] 8% State Surchart 4/16/04 $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 -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: 96e _4.6(....f..-0-- ez..zie.A..., Pe ittee Signature: Call 639 -4175 by 7 p.m. for an inspection the next business day Fire Protection System FOR OFFICE USE ONLY building Permit Application Receive O , Building Date/B 1 � Permit No Illo r(i "00/7 A Planning • ppro • I Other City of Tigard Date/B Permit No . 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Date/B Permit No Phone: 503- 639 -4171 Fax: 503 -598 -1960 - - - 1 1 '- f Post - Review Land Use -- 1 I Date /B • Case No. Internet: www.ci.tigard.or.us contact Z See Page for 24 -hour Inspection Request: 503 - 639 -4175 Name /Method Su • leme al Information TYPE OF WORK REQUIRED DATA: ❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING gr 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 Et Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, matenals, labor, overhead and profit for the work indicated on this application ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation $ JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths: Job site address: Q [l-7 _ s o r- Total number of floors. .. . New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: TAt_ T &_. n-__5. Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) 0 jUry c 0 0 1 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, matenals, labor, overhead and profit for the work indicated on this application RA-6 — T•nf, OcOASt S �� Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) Number of stories ❑ PROPERTY OWNER 1 ❑ TENANT , Type of construction Occupancy group(s): Existing: Name: New: Address: City /State /Zip: NOTICE: All contractors and subcontractors are required to be Phone: Fax: licensed with the Oregon Construction Contractors Board under ❑ APPLICANT ❑ CONTACT PERSON 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: BUILDING PERMIT FEES* - . E -mail: Please refer to fee schedule. CONTRACTOR Business Name: t, A'f T F 16-4.._ peovraoki Fees due upon application $ Address: /d.i c" S, (A ) , ti-,,,a k City /State /Zip: 9 02_ ' Z.7.--- zj Amount received ...... $ Phone: �? (64.-z Fax: (03)(54 -.1657 Date received: CCB Lic. #: 64077 Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: l��ea� 180 days after it has been accepted as complete. (ZiCidik2 -0 120141.__ •Fee methodology set by Tri -County Building Industry Service Board. (Please print name) i \Dsts \Permit forms \131dgl'crmitApp doe 01103 , . Fire Protection Permit Check List 4 Describe work to be done: A.) ❑ New B.) Modification to sprinkler heads only: ❑ Addition ig 1 -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler 1"� heads: �ewie -�G� it2P�cst Z Additional description of work: —�-�� _ _ q k3 c) knef - 5 1' 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: $ .gyp 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 $381.50 Sprinkler Project Square Footage: sq. ft. Project Valuation Subtotal (A, B & C): $ . — Permit fee based on valuation (see attached chart): $ (02 .SO Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $- S .00 FLS Plan Review 40% of Permit Fee: $ TOTAL: $ . Sv 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 02/28/03 CITY OF TIGARD - 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 / INSPECTION DIVISION Business Line: (503) 639 -4171 MST Cj� 4 c 7( Received K3 �� Date Requested 4 / Z t PM BUP Location %o j Still tV rT E- 01\ -'t W MEC Contact Person Ph ( ) 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 Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling (71 Roof Other: 1 -•• Othe PASS PART FAIL • RING ` Post & Beam fr 1V Under Slab ' '4 � 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: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL