Permit lb �
A i CITY OF TIGARD PERMIT #: BUP2002 -00258
1 BUILDING PERMIT
DEVELOPMENT SERVICES DATE ISSUED: 6/26/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10140 SW WASHINGTON SQUARE RD PARCEL: 1S135BA -00102
SUBDIVISION: @4KBURG ZONING: C -G
BLOCK: LOT: 001 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: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 18 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: i} BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: -51g ,SZD. CO
Remarks: Add 1 new sprinkler head.
Owner: Contractor:
PPR SQUARE TOO LLC WYATT FIRE PROTECTION INC.
BY MACERICH COMPANY 9095 SW BURNHAM
ATTN: JANET FISHER, ASSET MGMT TIGARD, OR 97233
S Phone ONICA, CA 90407 Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT CTR 6/26/02 $62.50 27200200000 Sprinkler Final
5PCT CTR 6/26/02 $5.00 27200200000
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 1- c( 2 -2344.
Permittee
Signature: \
Issued By: i Z.6 _ t_.�
7
Call 639 -4175 by 7 p.m. for an inspection the next business day
) --.e.:-•
Building Permit Application
�` I Cl of Ti aI'Il
Date received-4 -02- Permit no ?(�j g_
' 1 1 ( ty g
- Project/appl.no.: Expire date:
CityojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: Q \ AO 5 Al . ■ t ii2' cf. tea/ _„,. , APIIIIIIII Bldg. no.: Suite no.:
Lot: Block: Subdivision: / Tax map /tax lot/account no.:
Project name: j- • j. 4 9 v
Description and location of work • A premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: p ( • ■t a / a■a i 0 LLC " (Floodplain, septic capacity, solar, etc.)
Mailing address: 0 , s o , r„,„ 1 & 2 family dwelling:
REE State: O]_ ZIP: ) 2 Valuation of work $
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industriaUmulti- family:
CONTRACI.OR Valuation of work $ c`' r00
Existing bldg. area (sq. ft.)
Business name: Ft re. rotQc cfn L
'� New bldg. area (sq. ft.)
Address: - Aal '1SMA'
City: 6 (C. d ' ZIP: • '722 Number of stories
Z ; r 251 24, pe of construction
Phone:
Fax:��Q. E- mai l: Emai Occupancy group(s): Existing:
CCB no.: (4611 New:
City /metro lic. no.: 45 Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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 p is'ons s and ordin es governing this 0 Visa 0 MasterCard
work will be complied wh ther s ift h or not. Credit card number: Expires /
Authorized signature at f: Co f Z / O
6 1 Name of cardholder as shown on credit card
Print name: 1.{ P Y s LA-111rWa a ,1('l
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6 0/COM)
erjiirT 6am.5Z)
67. 50
•
Fire Protection Permit Check List
A.) ❑ New tif 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: APO / H( -
Additional description of work:
fs .� r c ..... tea- •yr fi � r »' C � -� ��k-'�"' ��+-.. a pn � - ;.g • � � ��
Type ;of Sy0601'Complete. A,¢BR,or C. a_s 41,l ca_'ble) t a
A.) Sprinkler Wet ❑ Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ &
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): $ C 50 , 00
Permit fee based on valuation (see chart): $
8% State Surcharge: $
FLS Plan Review 40% of Permit: $ •
TOTAL: $
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 11/21/01
CITY OF TIGARD 24 -Hour
BUILDING • • Inspection Line: (503) 639 -4175 M
INSPECTION DIVISION Business Line: (503) 639 -4171 7.3-e � BUP
Received Date Requested 1 d AM PM BUP 2 - 0 20c
Location /e / VO tz) - SO. F a Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) 6 Di - a`9ae' SWR
BUILDING Tenant/Owner L % _ I, ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain --
J
�
Slab Inspection Notes: ' 1 n SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing OrX—
Insulation ; /
Drywall Nailing
Firewal /
ire r Fire Alarm c_ % ,"%4:
Susp'd Ceiling
Roof
Other:
.400 ART FAIL
• I 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 : , ection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date bZ Inspect° / �--� Ext
Other:
Final DO NOT REMOVE this Ins cti record from the Job site.
PASS PART FAIL