Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2005 -00535
DEVELOPMENT SERVICES DATE ISSUED: 10/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S126BC-01506
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 480 ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Fire sprinkler TI, add (3) sprinkler heads and relocate (2) sprinkler heads.
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: 2FR : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: • FIRE RET?
OCCUPANCY LOAD: 43 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: $ 775.00
Owner: Contractor:
WYSE INVESTMENTS T & L COMMUNICATIONS INC
111 SW 5TH AVE SUITE 1100 PO BOX 87387
PORTLAND, OR 97204 2800 NE 65TH AVE SUITE A
Phone: 503 - 294 -0400 VANCOUVER, WA 98661
Phone: 360- 737 -9725
FEES Reg #: LIC 67787
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 10/6/2005 $62.50
[TAX] 8% State Surcharl 10/6/2005 $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 -00 4rough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to 1 5 UNC by
calli 503 - 246 -6:99 • r 1 - ' 00- 332 -2344.
Issue By: '1 / J Permittee Signature: k kr-'"f
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 PYotection SA,:. I V v®
Building Permit xa i ><catign Q5 F OR OF ICE USE O,NL\
City of Tigard 00 U v � Re i v y „VII Qg imp I Permit No. p t z 5
13125 SW Hall Blvd., Tigard, OR 97223 GW Plan Review �� ,4... w
Phone: 503.639.4171 Fax: 503.598. OF p 1v \S \GN ii ,, ', f `�' pate/B Other Permit:
Inspection Line: 503.639.4175 ,\\�\ .7.4..t.* �3'! I Daze Ready/By. See Page 2 for
Internet: www.ct.tigard.or.us B \\-
Not Supplementallnformation
TYPE OF WORK REQUIRED 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
1 ,21Ntddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling tiXommercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE. INFORMATION AND LOCATION Total number of floors:
Job site address: 70020 SW W 4.5 -�, In y /" 4 _ Sit_ New dwelling area: square feet
/�� City /State /ZIP• PO cY D re o / Garage /carport area: square feet
Suite/bldg. /apt. no.:l- f Project name: a oc9 /lea A 6( Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: I Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
� dci ^ 3 Valuation: $
2 _ IoC cF�1 '-f ^� _ 2 - Existing building area: square feet
1 l New building area: square feet
b' PROPERTY OWNER _. . ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing.
Phone: ( ) Fax: ( )
New:
❑ APPLICANT ❑ CONTACT PERSON . NOTICE '
Business name: % 6.0144 in an t C a,t2c, tS All contractors and subcontractors are required to be
Contact name: SS , 11q t. licensed with the Oregon Construction Contractors Board
p under ORS 701 and may be required to be licensed in the
Address: / 0 0,1c 0739 '1 jurisdiction in which work is being performed. If the
City /State /ZIP: C/l.��u ve t ( ... j 1.4 948 03/77 applicant is exempt from licensing, the following reasons
apply:
Phone: (DEo) 73 7 7725 Fax: :(3o) 237 n YJ
E -mail:
CONTRACTOR
Business name: 71 Co,?/1<- C2/z;.-„s
BUILDING PERMIT FEES* -
Address: . /12, ao JG ?j,P--7 ,A Please refer to fee schedule.
City /State /ZIP: � G pCl�� Wi
Fees due upon application
Phone: (3 `) 3 7 q72 $ Fax: (3 7 7 ?k
7 7 r) 6 p7/ ��� Amount received
CCB lic.:
��/ Date received
Authorized signature: ..j `�� This permit application expires if a permit is not obtained
✓ within 180 days after it has been accepted as complete.
Print name: / f - f c.1, Date: /0 05 • Fee methodology set by Tri- County Building Industry
Service Board.
I \Building\Permits\FPS- PemritApp doc 12/03 4404613T(I I /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page2' - Supplemental Information
Describe work to be done:
1.) ❑ New 2:) 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: $
B.) Type I" = Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fir a 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): $
Permit fee based on valuation (see attached chart): $
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $
FLS Plan Review 40% of Permit Fee: $
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.
I:\Building\Permits\FPS- PermitApp doc 2
, •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005"00535
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2005
Phone: (503) 639- 4171 +�
Inspection Requests (24 Hrs.): (503) 639 -4175 1I..
INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:04AM PAGE: 31
SITE ADDRESS: 09020 SW WASHINGTON SQUARE RD 480 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: UNITED At_TH
DESCRIPTION• ire sprinkler TI, dd (3) sprinkler heads and relocate (2) sprinkler heads.
OWNER: WYSE INVESTMENTS, PHONE #: 503- 2940400
CONTRACTOR: T & L COMMUNICATIONS INC PHONE #: 360-737-9725
Inspection Request Scheduled For: Date: 10/13/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 018254 -01 503-888 -0235 N
Corrections/Comments/Instructions:
CALL j 4,) (5414(10G- I% 9 C.9 /2J6 -- ( j`
Tr o
EVT/ir W bw-r. wv4
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FO' INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' Date: ( a ( #: (503) 718 -
CITY -OF TIGARD
BUILDING DIVISION PERMIT #: gUP2.1005 C0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �amw
Inspection Requests (24 Hrs.): (503) 639 -4175 41 IL.
INSPECTION WORKSHEET FOR DATE: i is 1 TIME: PAGE:
•
SITE ADDRESS: gozC c(10 Uak SCR - fee-) CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: t_E_
OWNER: PHONE #:
CONTRACTOR: L. G+-W..Ilcl icrod PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
F
Corrections/Comments/Instructions:
•
Awk
_
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
Inspector: 4101 Date: ` 3 ` hone #: (503) 7.18 -