Permit C BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2004 -00018
, .�1� DEVELOPMENT SERVICES DATE ISSUED: 1/30/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09693 SW WASHINGTON SQUARE RD C -9AB
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: $ 2,000.00
Remarks: Fire sprinkler TI, 22 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 Rough -In
[BUILD] Permit Fee 1/20/04 $62.50 Sprinkler Final
[TAX] 8% State Surchari 1/20/04 $5.00
[FLS] FLS Pln Rv 1/20/04 $25.00
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 -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.
l Issued By: i �
Perm ittee
Signature:
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Bulk ling Permit Application OFFICE USE ONLY
D DateReceived Qp,A, Building Permit No. / Q
Other
: O� t7 \ / i, i / / U
City of Tigard RECEIV Planning A • proval y g Date/By: Permit No.:
13125 SW Hall Blvd. A' Plan Review Other
Tigard, Oregon 97223 UAL 2 0 201 Date/By: Z 6 . &� Permit No.:
Phone: 503- 639 -4171 Fax: 503 - 598 -1960 kg°1001A Post- Review Land Use
Internet: www.ci.tigard.or.us o -;. r -' 1 Date/By: Case No.
g a • Contact Ju�►e ."- ® See Page 2 for
24 -hour Inspection Request: 503- 639 -t_O T41G Dl Name /Method: /� leo, Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 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 RI 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 ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: 4 7 br-1 3 5.1 43, utincli IN lo,- ,p ' t Total number of floors
5 :J "� New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: Shoot, n l i (d , 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,
7 overhead and profit for the work indicated on this application.
j P. 4 v� ivi ff >ievAear - ZZ l Z® —
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER 1 ❑ TENANT Type of construction
Name: NGi,9.4r1 . L1.,L . Occupancy group(s): Existing:
New:
Address: 'P.O• x ( 23(o SS
City /State /Zip: '<<saard / 01e, a
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:
BUILDING PERMIT FEES*
E -mail: Please refer to fee schedule.
CONTRACTOR
Business Name: v re. Pro*eC* 3 1, UY1C.. Fees due upon application $
Address: ck e- 6. kA) . ebu ui. ho r - 1
City /State /Zip: Tq Ole. ci — 22
, �j Amount received $
Phone: ( 4- • ZA 2 Fax: 6s4---. ci In S - 1 Date received:
CCB Lic. #: I 1 I
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: ,„„0,13! n / ,,, ' Date: / /�� � 180 days after it has been accepted as complete.
ill aPAces RlAtZ *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
is \Dsts\Permit Forms\BldgPermitApp.doc 01/03
C;
Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads,: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
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: $ 2,000 . -
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): $ 2 COD .-
Permit fee based on valuation (see attached chart): $ (02.
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ 5.00
FLS Plan Review 40% of Permit Fee: $ • • 2.5. 00
TOTAL: '$ g2.Sb
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
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
4
Received Z L 1 . 2 3 Date Requested / /eV AM PM BUP
Location �� v(/ �! — COQ Suite 9 MEC
Contact Person 2// Ph ( ) PLM
Contractor ��f�� ���� c 1 Phh A ( � ) - SWR
BUILDING V Tenant/Owner e��� re_ / f4 Cal, 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
Fir- . -
Fire Sprinkler
ire arm
Susp'd Ceiling
Roof
O. - • -
F • - -
PAS ' 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: Unable to inspect – no access
Fire Supply Line
ADA - ' j — 'a
Approach/Sidewalk Dat vO Inspec t or BgAN i3( O Eut ��3I
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL