Permit ` r rp CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2004 -00456
�Ac DEVELOPMENT SERVICES DATE ISSUED: 10/4/2004
- ,� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09650 SW WASHINGTON SQUARE RD G -15 PARCEL: 1S12600 -00300
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: M 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: $ 1,860.00
Remarks: Modification of (14) sprinkler heads.
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
one
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 9/24/2004 $62.50 Sprinkler Final
[BUILD] Addl Permit 9/24/2004 $25.00
[TAX] 8% State Surcharl 9/24/2004 $5.00
Total $92.50
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 -00 1 • 'ugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling :13) 246-66 or 1-800-332• .
�-
Issu d By: & __ 1 1 1 _I , I ►
Permitt- - -./
Signature: ; r -rlf /(
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
, Building Per ■ 1 [ion FOR OFFICE USE ONLY
R � � Date/B _ (/ t C;/ • Permit .. . -- C.4.2
City of TI and Planning Approval Other
y g 200k Date/By Permit No •
13125 SW Hall Blvd. SEP 2 Plan Revi w Other
Tigard, Oregon 97223 C ��� ��3 T _ . Date /By `Y' '� Permit No
Alma Phone: 503 -639 -4171 "!, 'J � A Post - Review Land Use Date /By Case No.
Internet: www.ci.ti al�l�NtDI{VG°i ®fVISI• c.
g W_ Contact .�] El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method i 1 � Supplemental Information
TYPE OF WORK REQUIRED DATA:
New construction
❑Demolition El & 2 FAMILY DWELLING
Addition/alteration/replacement Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed Indicate
❑ 1 & 2- Family dwelling dommercial/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 ❑ Other: Valuation .. $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
to Total number of floors .... • ••...
Job site address: i / ,0 M a . New dwelling area (sq. ft.)
Suite #: BBld. /Apt. #: Garage /carport area (sq. ft.)
Project Name: V.letA f}Nf j1fS 1 f rS 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: I 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,
TeNA m a � � T/ � overhead and profit for the work indicated on this application
'V 1 Valuation. $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER ❑ 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 70l and may be required to be licensed in the
Business Name. ( . e.e, GoNiYztt flt-D2.) 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 Nanic. w IVIT}' V l e! 1)VD- / � 1 ' T / Fees due upon application $
Address: 4Dt6 SM VrNN
City/State/Zip: TIVM -V/ l q1L777 Amount received . S
Phone: ( IAN Fax: (03» 4- Alibi Date received:
CCB Lic. #: (p4-0
• \uthorized Notice: This permit application expires if a permit is not obtained within
Sicnature // ,,,v' Date: 7 /24bi 180 days after it has been accepted as complete.
2I J4 20 _ QtD { • Fee methodology set by Tri- County Building Industry Service Board.
c,isc print name)
i `I ),ts \l'crtnit Foni: ' ' , „ 01 03
Fire Protection Permit Check List •
-
Describe wo ` o be done: B.) trr�r
A.) ❑ New ) Modification to sprinkler` heads only:
❑ Addition ❑ J.-10 heads: Nd *?feview °required.
Alteration ar 11+ heads: Plari`
❑ Repair
Number of sprinkler heads:_ 14
Additional description of work:
TOO Nit rt._,01
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: $ I r(A
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): $ I mm()
Permit fee based on valuation (see attached chart): $ (0Q _ cQ
Permit fee based on square footage (D) (see fees above): $ .i
State Surcharge 8% of Permit Fee: $ 5 -00
FLS Plan Review 40% of Permit Fee: $ 2_5 . 0
TOTAL: $ G2, .
Plan review requires a completed application and 3 sets of plans at submittal.
Plan review fees are required at submittal.
"New" `,re protection systems require that plans bear the original seal of an Oregon
licensed fire suppression engineer, or NICET level "3" technicians.
':;checklist doc 02/28/03
CITY OF TIGARD 24 -Hour
BOOING • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP % Ob 6645 -
Received Date Requested — AM PM BUP 4.' 14
Location � �� C{l/9•-, Q . Suite MEC I !
Contact Person 1R / k Ph (�lo sue. ' ' / - .3 5.3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 1L! 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 And
Susp'd Ceiling Roof avel
Other:
• PART FAIL M4
BING 41)
Post & Beam
Under Slab �� I !
Rough -In �� n iv _1111IP j
Water Service I I
Sanitary Sewer
Rain Drains
Catch Basin / Manhole Add
Storm Drain . �.
Shower Pan vim`,
Other:
Final
F(A
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
�1 PART FAIL
RICAL
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 0 Please call f reinsp- on RE: r , Q A r i a o inspect — no access
Fire Supply Line !
ADA 41 \\ * 1
Approach/Sidewalk • Date Inspector A`IErk _ ,r��� Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL