Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001-00128 da
``vr'a DEVELOPMENT SERVICES DATE ISSUED: 4/19/01
— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09400 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: t06513141fiGTON 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: S2 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 : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE:
Remarks: Relocate 2 sprinkler heads at new emergency exit.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
P.O.BOX 21545 9095 SW BURNHAM
SEATTLE, WA 98111 TIGARD, OR 97233
Phone: Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT CTR 4/19/01 $62.50 27200100000 Sprinkler Final o� (�
5PCT CTR 4/19/01 $5.00 27200100000 EX :r �S
Total $67.50 s/7 /0 3
l)
‘00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes C
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is 76
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
t • I N
952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or dired questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Permit a �/
Signature:
/ ‘ /V
CIS Issued By: . •1�; . •, - ", L
Call 639 -4175 by 7 p.m. for an inspection the next business day `2
BU P - Building Permit ELC - Electrical Permit
Inspection Description Date Passed By J Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing •I Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing Inspection Description Date Passed I By
_ Post/beam mechanical
-
Suspended ceiling Gas line
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP — Fire Protection System Permit Plumbing underslab _
I[ Inspection Description Date Passed By Crawl drain
I Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in I Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm fmal Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SW R - Sewer Permit
Engineered soils J Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
e CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2001 -00128
, , w; � 4 DEVELOPMENT SERVICES DATE ISSUED: 4/19/01
A 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09400 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01107
SUBDIVISION: tOMBb9QNGTON 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: S2 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 : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: `/0
Remarks: Relocate 2 sprinkler heads at new emergency exit.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
P.O.BOX 21545 9095 SW BURNHAM
SEATTLE, WA 98111 TIGARD, OR 97233
Phone: Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT CTR 4/19/01 $62.50 27200100000 Sprinkler Final
5PCT CTR 4/19/01 $5.00 27200100000
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 or 1- 800 - 332 -2344.
Pe rm ittee /
Signature:
Issued By: -ti6,/ /' j4 I — �L .
Call 639 -4175 by 7 p.m. for an inspection the next business day
: , Cfs
4 , r ir.. A
( (II/191u
4
•
r
r ` Building Permit Application
Date received: y //0/ Permit noStoO / — DOS if
w; City of Tigard
Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By eceiptno.:
•
Fax: (503) 598 -1960 14,,,2.00, ; Op / / Case file no.: Payment Y type:
Land use approval: I &2 family: Simple Complex:
TYPE of PERMIT
❑ 1 & 2 family dwelling or accessory A Commercial/industrial 0 Multi-family 0 New construction ❑ Demolition
AAddition/alteration/replacement ®.Tenant improvement Dire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: e/ • Q 0 . UJ ks 6l , r a Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: _ V k
Description and location of work on premises/special conditions: _ 0 - : -A ■ ■
t _Y_ - T
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (Floodplain, septic capacity, solar, etc.)
Mailing address: l & 2 family dwelling:
City: State: ZIP: 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: 5 'IAA 0- Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $ 40o
Existing bldg. area (sq. ft.)
B r e • e: W Y /kTr lei E- N. it_ AMR= New bldg. area (sq. ft.)
Address: - ii
EMIR �'� ZIP: 1112.3 Number of stories
Type of construction
Phone: n` - , v LZEIMME E -mail:
CCB no.: Occupancy group(s): Existing:
O New:
City/metro lic. no.: 4 cll 3 Notice: All contractors and subcontractors are required to be
ARC11I7 ECIYOESIGNl 1 ( 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 provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied with w e er peel herein or not Credit card number Expires
Authorized signature: ��\ Date: i O Name of cardholder as shown on credit card
�it
Print name: 4 (-Clv - ] RC) 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 (doocoM)
Fire Protection Permit Check List
A.) Li New ❑ Addition j.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: Z
Additional description of work:
•
Type of System (Complete A or B as applicable):
A.) Sprinkler Wet Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ co—
• B.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $ 'kpp'
Permit fee based on valuation (see chart): $ (
8% State Surcharge: $
FLS Plan Review 40% of Permit: $
TOTAL: $ (91 :
i:\dsts\forms \FPSchecklist.doc 10/04/00