Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00228
AA � DEVELOPMENT SERVICES DATE ISSUED: 6/20/02
`-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -
SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD 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: 2N : sf N: 5: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0.00 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: Y PARKING:
VALUE: $ 2,147.00
Remarks: Modification of 24 sprinkler heads.
Owner: Contractor:
PPR WASHINGTON SQUARE, LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH CO 9095 SW BURNHAM
ATTN JANET FISCHER ASSET TIGARD, OR 97233
S"PYione ONICA, CA 90407 Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
5PCT CTR 6/12/02 $5.77 27200200000 Sprinkler Final
PRMT CTR 6/12/02 $72.10 27200200000
FIRE CTR 6/12/02 $28.84 27200200000
Total $106.71
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Pe rm ittee
Signature:
Issued By: C1itit- e.�Azt.., (
Call 639 -4175 by 7 p.m. for an inspection the next business day
lir
t 0
P i uildingVermit Application
� �'` . , ,- ,.., , Date received:6 Q � Permit no.:JP p-- ,2-a�
�y� City of Tilgurd-1 �--+
- -.. • 6c..., g , Project/appl.no.: Rx 're date:
Address: 13125 SW Hall Blvd, Ti ar O 23
City of Tigard Phone: (503) 639 - 4171 ,. 9o l � �' Date issued: B • Receipt no.: O
Fax: (503) 598 -1960 JUN 12 2002 20° a Case file no : Payment type: I
Land use appr (`•d�' x U 1!�-) 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory )ffi Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
.Addition/alteration/replacement A Tenant improvement Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION -
Job address: 1 1 (4- S, t*) , w , • gcz es) Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: A L Q O 5k o E_S
Description and location of work on premises/special conditions: RFA kSG 5)Ci' I 5Peo.11(L -lam LUGiski
e_ I pv-rT QQrjGt-1
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: P Pie W P61-‘11 _SG1 LLL (Floodplaiii, septic capacity, solar, etc.)
Mailing address: ?0, x Z3 6 3 `
Uo I & 2 family dwelling:
City: - fl 6 fl 'State: OR_ q ie. 0 Valuation of work $
Phone: IFax: I E-mail: No. of bedrooms/baths
Owner's representative: — Total numbeeof -floors – — t
Phone: Fax: E -mail: New dwelling area (sq. ft.)
• - . APPLICANT - - Garage/carport area (sq. ft.)
Name: S EA GOp,c Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
cze
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E- mail: Commercial /industrial/multi - family:
CONTRACTOR Valuation of work $ 7 k 41
L
bJ
Y�� Fi pecfmCfZO� Existing bldg. area (sq. ft.)
Business name:
Address: q 0 S 5 , )3lA2n1 New bldg. stories
(sq. ft.)
City: – r1 61k �j I State: Of& ZIP: 172,y 3 Number of stories
I
Type of construction
Phone: 6434 - ,Z I Fax: I E -mail: Occupancy group(s): Existing:
CCB no.: 6401 New:
City /metro lic. no.: 43-1 3 Notice: All contractors and subcontractors are required to be
";
ARCHITECT /llESIGINER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the -- --q
Address: jurisdiction where work is being performed. If the applicant is "(
City: State: I ZIP: exempt from licensing, the following reason applies: l�7`�'
Contact person: I Plan n o.:
Phone: Fax: E -mail:
. ENGINEER
Name: Contact person: Fees due upon application $ 10(0,11
Address: Date received:
City: (State: IZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this ❑ Visa Cl MasterCard
work will be complied with whether s fed herein or not. Credit card number: / /
Expires
� /i
Authorized signature: S Date: / j Name of cardholder as shown on credit card $
Print name: 12iC. I Ai2-fl Imo fi Cardholder signature Amount
I s' Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00 /COM)
Fire Protection Permit Check List
A.) ❑ New ❑ Addition Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
Number of sprinkler heads: 24
Additional description of work:
Wi a of System (Complete A, 3 C C -as applicable) \ ,° ; t ' r 1
A.) Sprinkler Wet ' Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor 5. (,
Sprinkler Project Valuation: $ 2-14i
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: $
Project Valuation Subtotal (A, B &'C): $ Z\ 4
Permit fee based on valuation (see chart): $ ii . 00
8% State Surcharge: $ 5,77
FLS Plan Review 40% of Permit: $ Z,n,,P,4
TOTAL: $ 1 0 : 11
i:\dsts \forms \FPScheddist.doc 06/07/01
.I
CITY OF TIGARD 24 -Hour •
BUILeiNGf. Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUW � d.- 22181
Received Date Requested —7/i AM PM BUP •
Location f iiti/T ° SO Suite MEG -
Contact Person Ph ( ) gY'c 7 Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner a71G& 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 G'/l,�Q_� 19' 7o A ,-
Insulation /�J [ �`(, ` ¢ Y )
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm °,l l a 2--
Susp'd f /
Roof
Other:
Fi /
i ;'
PART FAIL /
- ING
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 L 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 r -
ADA ( _ /I I V (
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILMJNGi Inspection Line: (503) 639 -4175
INSPECtION DIVISION Business Line: (503) 639 -4171 MST
-S=
BUP 0%02 -002Zo
Received Date Requested 7-11 `'G L AM PM BUP
•
Location 7)t' .5 6 t) tt, Ski, - 5/ Suite r MEC
Contact Person 14)41 I {i i PPP 'AI L / Ph ( ) ( / 24'1 S 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 de:
Drywall Nailing
ire Sprin
Fire arm
Susp'd Ceiling
Roof
Other: -
Fi -
fJl e") • • RT FAIL
- -am
• Under Slab
Rough -In •
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: for /,c</ eo ✓*�c_-
Final C,:c ks..
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 1 , � - Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
Received Date Requested l ' AM PM BUP
Location ( 7 7/ OA S re--P Suite MEC
Contact Person ---- YY\-2 Ph ( ) a-, 02 PLM
Contractor Ph /( ) SWR
BUILDING Tenant/Owner �� ��'J�1 A6-4- ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors •
Ext Sheath/Shear
Int Sheath/Shear Q e
Framing 9 o ® �'"t 7 (/ �C �� �S
• Insulation '—
Drywall Nailing G..
Fi rewall
e Sprinkle �� s S �)
- • arm
Susp'd Ceiling
Roof
Other:
b
lam-;,
1i L
PART FAIL
• ,� BING 1
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole X77',//7/".-1
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 c
ADA
Approach/Sidewalk Date J l Z Inspector v l� Ext Z L I
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL