Permit 'CITY BUILDING PERMIT
OF TIGARD
PERMIT #: BUP2005 -00412
IMP DEVELOPMENT SERVICES DATE ISSUED: 8/25/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Add /relocate sprinklers.
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: 5: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 23 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: $ 5,000.00
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
I ARD, O 03 8 865
one: Phone: 360- 699 -4403
FEES Reg #: LIC 70822
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 8/18/2005 $91.30
[TAX] 8% State Surcharl 8/18/2005 $7.30
[FLS] FLS Pln Rv 8/18/2005 $36.52
Total $135.12
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 hrough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling . -246-6. , 1 -810 -332 -2 , 4.
i
Issue • By: - � Permittee Signatu t ' `,%/j�jLAT�
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.
, =vita
tasshia. so Fire Protccti m System '�1�
aY
Building' Permit Application _ '�J/ .1:61L O 01.1( i' l: O \.f.l '
City of Tigard rr r - (( 2 ' \ � �� Received . K.-kite . - A Perron No k a_ � di���i
13125 SW Hall Blvd., Tigard, OR 9 1223 Plan Revue twAs, Diner Pemut:
Phone: 503.639.4 171 Fax: 503.598.1960 I Date/B
Inspection Line: 503.639.4175 Li y 1 il�� . ,� '� L . Date Ready tun ® See Page 2 for
Internet: w.ww.ci.ttgard.or.us �" I Nonfied/lalet6od _ I �k Supplemental Information
Qt b )/ Vic a IGAHI
I ' . • _ „rt , , , ,' -� ' . 7: p r ' f` . RE DATA: 1, AND 2 -F*MILY D WELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
"' - •.` CATEGORY OF' CONSTRUCTION '• , " r - work indicated on this application.
❑ I -and 2- family dwelling Commercial /industrial
Valuation: $
�!I
❑ Accessory building ❑ Multi -family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE - INFURMATION -AND :LOCATION ‘. :. .. Total number of floors:
Job site address: 9 .S Ste/ wAst_t 1 1 Sa etie-oE_= New dwelling area: square feet
City /State/ZIP: - j �,Q�b p 2 63112-7..--S Garage /carport area: square feet
- / f
,
r Suite/bldg. /apt. no.: W� L Project name: L.. ,,, r 'gi j 2S 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.
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 - a - work indicated on this application. _
Qir eEC. p et 1, L,+�Q.S -- Valuation: __ ��
1 Existing building area: S �J square feet
Kim./ Y� �C_.0 c 6,-. ILA k_i cx
New building area: square feet
❑ PROPERTY OWNER 1 ^ -. TENANT . .: Number of stories: I
T Name: r g r I NI A- , I . j (_, Type of construction: 11 g
Address: 3"7c 6 t EST e_ ,,, 5 Occupancy groups: yyl 23
City /State /ZIP: A CR rV , 01 Ll9 "- Existing: )5,) . 6 eP ii__
Phone: ( ''O) .23 se I Fax: (3W) 66 , 5 -S 7d' New: • T—
APPLICANT • ❑ CONTACT PERSON NOTICE ' ' •
Baseness name: pA l 2 1 C� (j ��G t C 11. I C C. All contractors and subcontractors are required to be
Contact name: J� c: w t S licensed with the Oregon Construction Contractors Board
f under ORS 701 and may be required to be licensed in the
Address: Q'7v8 iJ M I,jki EU� t..4.e ( [ v jurisdiction in which work is being performed. If the
City /State /ZIP: U/ . V./A 906 a 1 a PPt� exempt from licensing, the following reasons
/�_\ Q PPlY:
Phone: W -t — Z -- ('O I Far:: ( O) Aa - 44 SS
E -mail:
CONTRACTOR •
Business name: S4MF. BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City /State/ZIP: Fees due upon application
Phone: ( ) Fax:( )
�708
Amount received
CCB lie..
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 ....1 Cock, i /� Date: ES 17 O * Fee methodology set by Tn- County Building Industry
Service Board.
t \Buddtng'Permits \FPS- PamitApp doe 12/03 440- 4613T(11 /02/COM/WEB)
CITY:_OF „TIGARD
BUILDING DIVISION PERMIT #: BUP2005-00412
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s' . "'I ��
INSPECTION WORKSHEET FOR DATE: 10/26/2005 TIME: 7:07AM PAGE: 5
SITE ADDRESS: 09312 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: KAY JEWELERS
DESCRIPTION: Add/relocate sprinklers
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503639 -8865
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360- 699 -4403
Inspection Request Scheduled For: Date: 10/26/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 019417 -01 503 - 619-9751 N
Corrections /Comments /Instructions: •
111 .♦
W4 -AIPIPpr
F ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
-I f\
Inspector: 'FA Date: 1U 2/0 #: (503) 718-