Permit 1 ITY OF TIGARD
PERMIT #: BUP2002 -00262
�(4' DEVELOPMENT SERVICES DATE ISSUED: 7/22/02
+L. A- - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09300 SW WASHINGTON SQUARE RD PARCEL: 1S126C0 -01403
SUBDIVISION: 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: B 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: # /3 Ca
Remarks: Addition of (10) sprinkler heads for new mezzanine.
Owner: Contractor:
MAY DEPT STORES COMPANY, THE BASIC FIRE PROTECTION INC
ATTN: PROPERTY TAX DEPT 8135 NE MARTIN LUTHER KING BLV
611 OLIVE STREET PORTLAND, OR 97211
S PLio eIP 5 i 603 11 10 Phone: 503 - 285 -1855
Reg #: SIC 48641
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler Rough -In
PRMT CTR 7/2/02 $62.50 27200200000 Sprinkler Final
5PCT CTR 7/2/02 $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 or 1- 800 - 332 -2344.
Pe rm ittee
Signature: Al • J1I11 WI
Issued - : k ,,,).4. ti
Call 639 -4175 by 7 p.m. for an inspection the next business day
4 ,,,,
f .
`--- '3uilding Permit Application
,, Date received: 7 A/D� Permit no.:,ba -dia6
�, ,:;..,i__ City of Tigar `i
r
D
,
Project/appl. no.: • a date:
CiryofTigard Address: 13125 SW Hall Blvd, tga O 2 3
Phone: (503) 639 -4171 Date issued: Byk l Receipt no.:
JUL
Fax: (503) 598 -1960 9 2002 Case file no.: Payment type:
Land use approval: CL I i U1 I IU U � I &2 family: Simple Complex:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family ❑ New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
, JOB SITE INFORMATION
Job address: 1 W. ■ \-',f-,%J41.- SO - 12O_ Bldg. no.: Suite no.:
Lot: Block: (Subdivision: I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions: i )4 S TALL (=) paP 3f 2.J 1 17R.
-EV -2.
OWNER FOR SPECIAL INFOIZMATION,. CHECKLIST
Name: M I -I - FgAi4g (Flood plain, septic capacity, solar, etc.)
Mailing address: 1 & 2 family dwelling:
City: I State: I ZIP: Valuation of work $
Phone: 'Fax: IE-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: 13,4.1c. F'j - 1 9 gOT Tlarl Covered porch area (sq. ft.)
Mailing address: e, , r -a_44 3 g, .fj-wp Deck area (sq. ft.)
City: e0 -QQ I State:04_ I ZIP: '771 Other structure area (sq. ft.)
R i _ ,, _---; Commercial/industrial /multi - family: oo
P�h°° < : : _ o� �Fax:?.$S -0"113 E -ma
CONTRACTOR Valuation of work $ I SOO
Business name: 1342)C FL -e D' Grri?!-4 Nxw bldg. . area area (sq. . ft.)
New bldg. area (sq. ft.)
Address: ,ql+r(
City: I State: I ZIP: Number of stories
Phone: I Fax: I E -mail:
Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECh /1)ESIGN[R 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: I ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
• Name: Contact person: Fees due upon application $
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 ❑ MasterCard
work will be complied with, whether specified herein or not Credit card number: I /
, 'pp Expires
Authorized signature: f) - Date: 1 -2 -O7. Name of cardholder as shown on credit card
Print name: 12q-.4 0 $
Cardh older 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/OO/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: / 0
Additional description of work:
7{r.4.:i 7t - ;' - y.. v ;.;'S YMlii^j': " {: d 'y '1:1;t l:.y:' - "3 . •r
{Type�ofSystem4(:Compl_eteAor Casa licable� = ; 4 =3; -_ :1' ^ }
A.) Sprinkler Wet ,1I Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ / x`70 a0
B.). Type I - Hood Fire Suppression System
Hood Project Valuation $ ti
C.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
•
Project Valuation Subtotal (A, B & C): $ 1500
Permit fee based on valuation (see chart): $ 60A. 6° •
8% State Surcharge: $ 5 °
FLS Plan Review.40% of Permit: $ " . --6'
TOTAL: $ 6 7.5O
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.
• ':l
I: \dsts \forms \FPSchecklist.doc 11/21/01
CITY OFTIGARD 24 -Hour �:..
BU 'OINq/ Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MS •
BUP o 6t gla
Received Date Requested AM PM BUP
Location 730 C) (j) / S 2 Suite MEC
Contact Person A _) Ph ( ) c2g 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 r
Framing
/ /r › ../
Insulation
Drywall Nailing
FirewalL /
ire r'
ire Alarm
Susp'd Ceiling
Roof
Other:
'fit
PART FAIL
• 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 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 7N 6 - 7--- Inspector r� Ext
Other:
•
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL