Permit + . .w BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2005 -00492
A. DEVELOPMENT SERVICES DATE ISSUED: 10/5/2005
j l l l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09315 SW WASHINGTON SQUARE RD ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire 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: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 30 BASEMENT: sf AREA SEP. RATED:
STOR: 1 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: $ 1,200.00
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
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 360- 699 -4403
Reg #: LIC 70822
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/26/2005 $62.50
[TAX] 8% State Surcha 9/26/2005 $5.00
[FLS] FLS Pln Rv 9/26/2005 $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 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy
of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: _ j 7.0 .. f L � . j�
Permittee Signature: n p
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.
7 1adgA 1
Fire Protection System F1'1' EIV
B Permit Appl 2 1 e ::, I OR OFFICt: t sr: ()NIA.
City of Tigard SEP Received
13125 SW Hall Blvd., Tigard, OR 97223 CITY OF
1 Date/0 • ' • W /.� �l 1�' Permit No -0- A/A'
� �f h��
Phone: 503.639.4171 Fax: 503.598.1960 EGA Other Permit:
Inspection Line: 503.639.4175 �V � �. ®I ` 1 •f ly Date Ready : -3--0 / tuns la See Page 2 for
Internet: www.ci.tigard.or.us Noti -1 - Supplemental Information
3
:'4• , ' 1 --{+ `, TYPE, OF . O RK + ' s• . r O ,. ¢� ' W /•, REQUIRED, DATA.1- A
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
rAAddition/alterationheplacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
a -.. `'- ' •" CATEGORY OF'CONSTRUCTION . 1 -:t work indicated on this application.
❑ 1- and 2-family dwelling Commercial /industrial
Valuation: S
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
- : ;'4,.1' • JOB SITE. INFORMATIOI AND LOCATION . , . _,_. , . , , Total number of floors:
Job site address: 3 Sic/ \ K/ / A�I 1��ZTU� Sa ,, 1 . M b ` New dwelling area: square feet
City /State/ZIP: T t g,n ` 0 c G Garage /carport area: square feet
Suite/bldg. /apt. no.: b 3) Project name: TeAvA ki A 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
.. •
DESCRIPTI OF WORK "
, " "
' K . ' ' -• " work indicated on this application. ,*yam
A 17C
E1.��o f 1" 1i15 `[b Valuation: $ I
Ki \,,./...u. S ; cE t ` Existing building area: /0r3 square feet
T New building area: square feet
- . IROPERTY OWNER I . • - „ ❑- TENANT , .. • • • Number of stories:
Name: 1 Cep_ J2
Type of construction: //
Address: LlO I W `L s I,.,> i EE raw i / ST 1c0 Occupancy groups: ' ++�� 3o
City /State/ZIP: s 7v, JTp, M3 I Li ch , LA C ( a4D ( Existing: 1 G- P . :n
Phone: 5/ c 314 — 6000 Fax: ( ) New:
' - . APPLICANT • ❑ CONTACT PERSON •
' , , NOTICE 1 • -
Business name: P t o - r c c -c-E-itcya,' .) 113c , All contractors and subcontractors are required to be
Contact name: ..._ JCi•NS licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4-7 f iiy\I ,Li £4A t',,& <((` jurisdiction in which work is being performed. If the
City / State/ZIP: \j3, PV & /1g 678 1 1 applicant is exempt from licensing, the following reasons
1 apply:
Phone: ( ) ZZZ -6 cr, I Fax::(( ) 6qq— 14.63c—
E-mail:
. - • .. i CONTRACTOR • ,. • , • • ,
Business name: A- 1 ( ( t' l 2F O rl C.,,,,i . : BUILDING PERMIT FEES* —
Address:
Please refer to fee schedule.
City / State/ZIP:
Fees due upon application
Phone:( ) Fax:( )
CCB lic.: —7pg Amount received
�� 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: _ E Ca(....lk.) Date: elcZ 1 dS--- • Fee methodology set by Tri- County Building Industry
Service Board.
I \Buuding\Penmb\FPS- PermiAppdoe 12/03 • 440- 4613T(I1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
- DeseribeivorktO bet 2 1-:' • " •
1.) 0 New 2.) Modification to sprinkler heads only:
ja 0 1-10 heads: No plan review required.
Z Alteration / Er 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads: 1Z.
Additional description of work:
'Type of SYsteMICOMPlete-A,.B,-C
A.) Commercial Sprinider t't-• .
• r' 7 . 7' - , • -
Wet I 0 Dry
Additional Standpipes I • WA
Information: Hazard Group ocui. 4-1aDi IL
Density
Design Area
K. Factor G L. c
Sprinkler Project Valuation: _ $
t Type I Hood Fire Suppression System . ,•,'
Hood Project Valuation: I $
, ,t,- ; • • ‘: ••• - •
C) - Fire Alarni
. „ . . ,
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
•
ResidentialSprinIder,(StandAlOne5ystem)...,.
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.
\Buildineermits\FPS-PermitApp.doc 2
CITY.QF TIGARD P
BUILDING DIVISION PERMIT #: a � 06) 1�,CIZ
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 I ! Att
1 Inspection Requests (24 Hrs.): (503) 639 -4175 'I _ � ..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 6 / S 14 f SO. rap CLASS OF WORK:
SUBDIVISION: L #: TYPE OF USE:
PROJECT NAME: — J - ��Ala J
DESCRIPTION: I 1.
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: - 1 -7 - b S Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
�' S �- �'c�.'e I � LA .)-(_ c j /5 - �' TS
Corrections /Comments /Instructions:
1 to
pa . rrrikralwry
r
I A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FO,Fi INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - lk1
, r Date: I l (7 U Phone #: (503) 718-