Permit A CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2005 -00541
� 1� � DEVELOPMENT SERVICES DATE ISSUED: 10/14/2005
'=-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09306 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Add & relocate (14) 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: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 25 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: $ 1,500.00
Owner: Contractor:
WASHINGTON SQUARE LLC PATRIOT FIRE PROTECTION INC
BY THE MACERICH COMPANY 4708 NE MINNEHAHA ST
9585 SW WASHINGTON SQUARE RD • VANCOUVER, WA 98661 -1843
T ARD, OR 97223
one: Phone: 360- 699 -4403
FEES Reg #: LIC 70822
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee . 10/7/2005 $62.50
[TAX] 8% State Surcharl 10/7/2005 $5.00
[FLS] FLS PIn Rv 10/7/2005 $25.00
Total $92.50
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
95 01-0011 - 'ugh OAR 9 - 001 -0100. You may obtain a copy of thes: •les or direct questions to OUNC by
c ling 503-246-66• or 1-81;k - 4.
Is ed By: � !J 1 ' � ' I�a� I Permitt Si is ices ,P ae .
Yl� 7
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 Protectio:i Syste
B
- 5)114 uildine Permit Application FoR (Irrlc't: t 1•: ()\l.)
City of Tigard Ct e/B . / _ _ . ).4.-/2-- ,ll W
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax 503.598.1960 Ot�� ll Dig . s, / ,A J' Wit:
Inspection Line: 503.639.4175 - . - '1 J� Date Re:. rc
Y. See Page for
Internet: www.ci.tigard.or.us ` ,l " Notified/Method. Supplemental Information
j ai - .- �aJ 1 ., {
'E ...`. tl - TYPE; rW T Y' : , f t ` - {; si ,4 ', ,•. �? REQiiIRED,DATA °31 A w 7CD WELL1 N G :
❑ New construction ❑apetion Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
'Addition/alterationheplacement 1 equipment, materials, labor, overhead, and the profit for the
vril, ,- ; s' • _ - J'" E �` - " t. . ' ` • ' .k . — '' - ? • work indicated on this application
*-. •, `__ ,C ATE G ORY O F , • ' UC N TI =t..: r ^
_ 9� • Valuation: S •
❑ 1- and 2 -family dwelling i Commercial /industrial
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder z ❑ Other: Number of bathrooms:
�f� ' ` :y ' ` ' Total number of floors:
;:' . -: °,,Y /�"� -- � OB {,S7'1!'E,_11vFORMATION}AND. LOCATION ' _ > '
_ - - a _. :,.'•-- :�:
Job site address: 934, -5v,,/ \ ( '[ < ' ,. New dwelling area: square feet
City /State/ZIP: �'G ok. -rj-3 1 de '9 7Z3 Garage /carport area: square feet
Suite/bldg. /apt. no.: V ( Project name: KQkSS4aCiLic le 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: 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
,: DESCRIPTION: OF WORK •- - , work indicated on this application.
• / _i .7- - - _ _ ' ,.rr� :.w. :. CYO
�aDl�/ LJo�CA- c t N i'.L.E �S / + 'TC Q, DA/
Valuation: S / Sc---
` ptt-l.-S 4 F 1 L1 k.1CT5 Existing building area: square feet
New building area: square feet
.
- PROPERTY OWNER - - . - I ,' ' TENANT »'. t . ' ,, Number of stories:
Name: Type of construction: g Q
Address: Occupancy groups: // / U
City /State/ZIP: Existing: ('M > f..1) j
Phone: ( ) ( ) New: V' Fax: ' n
_ 1
' APPLICANT : ~ , '.'' . - ❑ CONTACT PERSON -
Business name: P (d 1 IQ E P C I I c &,j I kr . All contractors and subcontractors are required to be
Contact name: - �' �w I �� licensed with the Oregon Construction Contractors Board
Address: L�''� 14E- /� I �� under ORS 701 and may be required to be licensed in the
� F4 S ( , jurisdiction in which work is being performed. If the
Y /41Qc�uv�� WA 19C�o� I
1 applicant is exempt from licensing, the following reasons
City/State/ZIP: t _ apply:
Phone: (7X) 2ZZ 6C C) I Fax:: adj 619 CI _ 44B
E -mail:
u CONTRACTOR ,.. ., -- - yti r ,r,.i
Business name: 1-'a (� t CST geE P G � I IL( c__ BUILDING PERMIT FEES' ' -
Address: {
Please refer to fee schedule.
City /State/ZIP:
Phone: ( ) Fax: Fees due upon application
( )
CCB lic.: 7o 9� Amount received
�G Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: , J F 0( c i IvS Date: IC 7/ QS • Fee methodology set by Tri -County Building Industry
Service Board.
1 \Buddmg\Pennits\FPS- Pcm,Wpp doe 12/03 440- 4613T(I1 /02/COM/WEB)
0 ,
- City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) 0 New 2.) Modification to sprinkler heads only:
J2rAddition 0 1-10 heads: No plan review required.
12r Alteration z Er 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: ill
Additional description of work:
.Thielif. Skiteig.teciiii` iililek11,ACH61Drii.ca 1.77- 7.....7. -7':-.F.P.F
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. - : , . . ... - • , - :-. - ,;..b_. , ..21... - , - r "t =,-9 . - 3. -, '; `' _. -.. ,. ‘i , '.: :L:::::: -1t:.:f. i';',..,:FW$,', ':. ,, w, `, !.i':' '.;:4
gi Wet
Additional Standpipes 1 1
Information: Hazard Group le) . /_-t?■,P. at
Density
Design Area IS
K. Factor 6.6,
Sprinkler Project Valuation: $ l 6 c —
13:).?..TYpel::::41:10;iict Fiie':Siiiiiii '`.,'":::,i?,k
Hood Project Valuation: I $
C.) 24
, ;!..' - .`4..i....t:I.M.,' ,- ..-tr.- - ,7:. - ,... -4,;:'="-if :il•‘:-;; 4i:- ,..,:i'd';',-;:!:-'4.--
1
, ''k ;•-• %, . • %.: t ?, .r.?" r 117(t7W111 - . 1. 4.. - :i: ''":. "A ir:: .1,' --:- 7 : ‘.- .‘ -.' .,..', ■::. - 2.. - ::. -
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
.1 ,N y, ',1+,7: •
'... .Z , .;_i..... :No': -r•■•• 1. - -:,,, , , :. - w.., ,,r.- t) -,...,,,,. ,.,->.-;4,2, :-.).
Square Footage: Permit Fee: '8;44' ' --' ,,i- F.1.4,,,,":...,3,=.
0 to 2,000 $187.50
2,001 to 3,600 $232.50 , ...-;:_.x:. , :'...::-.'.f::: - ::..J,-.;•_ 4 . -- ;."Li: ; :r...,;:.'
, i--, , -.;.r. -
3,601 to 7,200 $292.50 .1f,:,.,: :,.,-.- • '
..----i-4,,
7,201 and greater $381.50 . :. ,.‘ .• : - , ,:.;:;,..,,,, ;-.,.,- ,-.. '.,i . i '.....,.
.. . „ .
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:\suilding\PermitsWPS-PermitApp.doc 2
\r I r �
CITY OF TIGARD CS
BUILDING DIVISION PERMIT #: ays 00 S(0
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: b
Phone: (503) 639 - 4171 'e
Inspection Requests (24 Hrs.): (503) 639 -4175 < - -. .
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 936‘2 Wig 3& . p� CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For:. Date: f ( — 17 — c L Pour Time:
Code # Inspection Description Confirm # Contact # Message
� 9 6 1 -9 7
Corrections /Comments /Instructions:
-.guy' 3 g -41111F r OP - L
41
•
•
p ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t
Inspector: !V Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP200S.- 005,41
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR - DATE: 11/9/2005 TIME: 7:09AM PAGE: 84
•
SITE ADDRESS: 09306 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: KASSAB JEWELERS
DESCRIPTION: Add & relocate (14) sprinkler heads.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360- 699 -4403
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 020631 -01 503. 519.9761 N
Corrections /Comments /Instructions:
ras.
11 1 / A I LIII■
/1
•
-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 1
Inspector: dr, Date: ( [ Phone #: (503) 718-
30(p Oa_s , Scot '0( oP4220 - 40
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
7Disiiiibi * koikt i e V eireik e t Xt - VM4 31 ,VASMSO47K.:4r'; - .4, 4 51".. - -i-Tfe:i?:?i'A
1.) 0 New 2.) Modification to sprinkler heads only:
12rAddition 0 1-10 heads: No plan review required.
Er Alteration / 471 1 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: t
Additional description of work:
1* TOf SiiteigTealiiiiletel
-.-
'T . XrCPm n l' !. irc j a l§. ' g,..K 1,n :Net:4Z4ta.;,V;gtfrf,rtA.KtNtrfts,WA.VM,I..VW;c'u'rg
O Wet
Additional Standpipes J) 6R 64
Information: Hazard Group 6-QP.
Density
Design Area I S
K. Factor Co
Sprinkler Project Valuation: $ 11
Hood Project Valuation: I $
-..-',...,•:"...7! :1, fb,;._ 7, 7- • ' • -
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
,
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.
1:\BuildingTermits\FPS-perrnitApp.doc 2