Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00423
4111‘ DEVELOPMENT SERVICES DATE ISSUED: 8/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09512 SW WASHINGTON SQUARE RD H -2 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire sprinkler.
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: 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: $ 1,959.00
Owner: Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
rnone?' O 503-63- 8865 •
Phone: 503 - 684 -2928
FEES Reg #: LIC 64077
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/25/2005 $62.50
[TAX] 8% State Surcharl 8/25/2005 $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 question 0 NC by
calling 503 - 2466 -6699 or 1- 800 - 332 -2344. V
Issued BY: Zl ,-/,) Permittee Signature "4--e----- / /
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that 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.
Fire Peottettion System .
B J lini g Permit A 1.1 lit_ • 'Ai / FOR OFFICE USE ONLY
City of Tigard ( ®
' Datew ' . 1. s i � _ #1.�� -- We i / 0 15
13125 SW Hall Blvd., Tigard, OR 9 7223 Plan Revie Oth r Aemiit:
Phone: 503.639.4171 Fax: 503.598.1960- 7 ' 2p0� �'' Date/B ,
Inspection Line: 503.639.4175 F I Date Ready/By: t un1 ® See Page 2 for
Internet: www.ci.tigard.or.us Notrfied/Method: �J S upplemental Information
CITY OF TIGARD
• - - BUILDING DWISION . •- _. _ .. -- . ,
- . - . •- TYPE OF WORK . , . - - ... _ : :' _ REQUI DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed. .
Indicate the value (rounded to the nearest dollar) of all
ddiuon/alteration %replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the i
•
- -- : -: -- -- CATEGORY OF - CONSTRU ION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling ommercial /industrial
❑ Accessory building ❑ Multi - family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
;';:-"..'.-."-.71...1,1... .. ' JOB SITE INFORMATION' AND LOCA TION -4 µ ' 4 ? 4, -' "� Total number of floors:
Job site address: Q` S I) V SN V � �t'j'D " 3' . I� > , New dwelling area: square feet
,,
City/State/ZIP: T i Ur 6,04A) 0 Garage/carport area square feet
Suite/bldg. /apt. no.: I Project name: Li DS -- Covered porch area: square feet
Cross street/directions to job site: \notits 1 7q -lv SQVa re. Deck area: square feet
A A ;-' Other structure area: square feet
RE UIl ED D.ATA:'COMMERCIAL- USE - CHECKLIST
Subdivision. I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
^ ' - - ' `'``.5 work indicated on this application.
f • _ DESCRIPTION `OF WORK 1 ' N • � ` - .. " C ;d )04
ADP � ' �,el n c, ate, Tl re SIvi NI K-101� �•eAd� Valuation: $
1 1
�� � w 1 t rn p fervwAr - Existing building area: square feet
AV f�/1 �/ New building area: square feet
�:' ROPERTY OWNER " : I • 7,:e.;.; TEN -14.11. , f".?� Number of stories:
Name: P PR- "' –. h{V TN v AAAR Type of construction:
Address: Occupancy groups:
City /State/ZIP: Existing: •
Phone: ( L� Fax: ( ) New:
• "- , • -• _ . -' •
` �- A PPLICANT _; _ ❑ CONTACT •PERSON . ' :r _ ` 7 : NOTICE
Business name: (tee (', cG1
ONTyR.OP. ) 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:
y:
Phone: ( ) I Fax::( )
E -mail:
CONTRACTOR.. -1 s :,a _ .. ,..: • •• - �'. xis
Business name: V 4 i� 1VN ."1.1%j ('� s . 'BUIL ER
DING PERMIT FEES*
Address: 4 O 4 5 S pub ' Y ► Please refer to fee schedule.
Ci '1 �
ry / State/ZIP. ► I � �/ " / I Z� Fees due upon application �' S �
Phone: (G 1j )41W ) • • . J Fax: (c 3 , 4 1/1 C_j - Amount received
CCB lie.: 0 i 1 'VV
Date received:
Authonzed signature �� J �� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Pnnt name. P\ ,(\I, i , /I3 Date: o2 . 23 , 0 5 • Fee methodology set by Tn -County Building Industry
` ', vV'
Service Board.
1 Budduig Perma.FPS "PerA pp aoc 1 :=03 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information •
Describe work to be done: -
1.) ❑ New 2.) Modi ion to sprinkler heads only:
❑)dition 1 -10 heads: No plan review required.
Et Alteration ❑ 11± heads: Plan review required.
❑ Repair
Number of sprinkler heads: q
Additi nal description of work: , ��
A Q60cakT& - ire sin NJ
Type of System (Complete'A, B, or D as applicable):
A.) Commercial Sprinkler.' : ,. -4 ' . - . -
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ I ) Gi3g —
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 Sprinkle`r(Staiid Alone System)
Square Footage: Permit Fee: -
0 to 2,000 $187.50 _, . - _ - - .
2,001 to 3,600 $232.50 s ...•
-
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): $ 1 j 4G)Gi
Permit fee based on valuation (see attached chart): $ tp7 ,SO
Permit fee based on square footage (D) (see fees above): $ ,�
State Surcharge 8% of Permit Fee: $ 5 . (o
FLS Plan Review 40% of Permit Fee: $
TOTAL: $ 101 . SO
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.
: 3i.:',:. ne Fcrms FPS Checklist doe 12/29/03
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 13U1 00
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �w
Inspection Requests (24 Hrs.): (503) 639 -4175 ° 'I I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: /0 4
SITE ADDRESS: ' ADDRESS: /57e 1,j,94,44#46,70,4 s A zg Z CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: La) S
DESCRIPTION: Fitt -- splz ereS
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
f'ejei S PR-iAl /41.072. I= vj,q -c_. 6176S3 -0 / 6iZ - 36 g — D/ Sn
Corrections /Comments/ Instructions:
pot
_ avr,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADD TIONA FEES ASSESSED
kfl
Inspector: A AV Date: Phone #: (503) 718-
1 l