Permit C ITY OF TIGARD
PERMIT #: BUP2005 -00323
� 6 ' DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Add /relocate sprinklers.
REISSUE: K � FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: )el" L'f r 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: 140 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: $ 9,800.00
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
- WAFT, OR 97223
e: Phone: 360- 699 -4403
FEES Reg #: LIC 70822
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/8/2005 $139.30
[TAX] 8% State Surcharl 7/8/2005 $11.14
[FLS] FLS Pin Rv 7/8/2005 $55.72
Total $206.16
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 -0 - 010 ugh OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calli g 503 - 246-66 9 - 1 . t • 332 -2 , 4. � ^
Iss ed By: a • , ,, s, ..."Ii, Pe rmittee Sign. ,, •
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.
tut It " � u`�`�m Permit Application -, t _ C a.
•p ate received- /or/: Permit no j t '� 3
t -.�' City of Tigard Q 73 E J Proj ect /appl. no.: J Exptrc date: Cim u% Tigard Address: 13125 SW Hall Blvd, Tiga
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 JUL O 3 2005 Case file no.: Payment type:
Land use approval: CITY nF TIGARD I &2 family: Simple Complex:
r t .t i IFiRI
' Tl PE OE PERMIT
J I & 2 family dwelling or accessory Commercial /industrial CI Multi- family ❑ New construction ❑ Demolition
Addition /alteration/replacement 'Tenant improvement Fire sprinkler /alarm ❑ Other:
• • - :IOB SITE INEOR11..IION •
Job address:qse.6 s A ([�I`[ c Bld no.: Suite no.: s-
Lot: I Bloclg367 (Subdivision: I Tax map /tax lot/account no.: C
Project name: ■ttl.t/sMS- ,,,,tuv/".A -'r
Descnption and location of work on premises /special conditions: ADh /eC1-43C..A.ZTE. cpc lkieL• -F 1 S 0 4t-i E1A/
OWNER: FOR SPECIAL INFORM1:1"f1O:N. USE CHECKLIST.._' (L
Name: j e. kAA.cF.Kjc,t•.l iN4—)y ( Fluudplain .septiccapacit■.sotar.etc.)
Mailing address: 410 J t LS4 t t fl — V �'C , " 7 1 & 2 family dwelling:
City: 9, i vi c ,
Li (cos. IStatc" (ZIP: °to4o( Valuation of work S _
Phone: 4ZS - 7 -Ced31 Fax: I E -mail: No. of bedrooms /baths i /
Owner's representative: Total number of floors G
Phone: Fax: E -mail: New dwelling area (sq. ft.) _ C
Garage /carport area (sq. ft.)
Name: Patriot Fire Protection, Inc. Covered porch area (sq. R.)
Mailing address: 4708 NE Minnehaha Street Deck area (sq. ft.)
City: Vancouver I State: WA I ZIP: 98661 Other structure area (sq. ft.)
Phone: (360) 699-440 Fax(360) 6 tail: Commercial /industrial /multi - family:
Valuation of work S _ t ) 9, OCR
Existing bldg. area (sq. ft.) s ae
Business name: Patriot Fire Protection, Inc.
New bldg. area (sq. ft.) .
Address: 4708 NE Minnehaha Street
Number of stories
City: Vancouver I StateWA I ZIP: 98661 Type of construction
Phone: (360) 699- 4403Fax(360)699 -44$- mail: P � �-
CCB no.: 708 Occupancy group(s): Existing: �__�
New �
City/metro lie. no.: 2503 MI contractors and subcontractors are required to he
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: t./( i,.4 Azc.� , r rS provisions of ORS 701 and may be required to be licensed in the
Address: ‘ii c" AZt' -tTIG Akee jurisdiction where work is being performed. If the applicant is
City: /j,c,,rl A State: AI ZIP: exempt from licensing, the following reason applies:
Contact person:1 4F'L tyfA Plan no.:
Phone:50._ .fr ,, ,,, , , Fax: E -mail:
ENGINEER ' . OFFICE USE ONLY . .-
Name: emo- S i2L7 , Contact person: b i C e, Fees due upon application S
Address: 103 L r 41•( p AAJ• Date received: 0
City -c 4 Sa rE SCC_, IState:C, IZIP: e14 pe Amount received S 54-
Phone: 6,.. '](,zzgZ Fax: I E -mail: Please refer to fee schedule. / 61.!
I hereby certify I have read and examined this application and the 'Not all jurisdictions accept credit cards, please call jurisdiction frrte information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied wit ther s ectfied herein or not. _ Credit card number I /
Expires
Authorized signature: Date: ?/S d� Name of cardholder as shown on credit card
Print name: _ I Err C ., /_, t I\IS Cardholder signature S Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6100 /COM)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00323
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 Ak
Inspection Requests (24 Hrs.): (503) 639 -4175 atilt
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 41
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WILLIAMS- SONOMA
DESCRIPTION: Add/relocate sprinklers.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360- 699 -4403
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 021147 -01 503 - 519 -9751 N
Corrections /Comments /Instructions:
iii
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.lam
iv _ wow
•
• PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL U CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: �� Date: Phone #: (503) 718-
CITY OF-TIGARD
BUILDING DIVISION PERMIT #: BUP2005.00323
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19 /2005
Phone: (503) 639- 4171Np�hIt
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/8/2005 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: WILLIAMS- SONOMA
DESCRIPTION: Add/relocate sprinklers.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360 - 699-4403
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 020625 -01 503 -519 -9751 Y
Corrections /Comments /Instructions:
i "i _
•
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL F•R INSPECTION ❑ ADDITIO AL FEES ASSESSED
41
Inspector: Date: " Phone #: (503) 718-
CITY OF-TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00323
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 jai
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I I..
INSPECTION WORKSHEET FOR DATE: 9/20/2005 TIME: 7:07AM PAGE: ` 70
SITE ADDRESS: 09367 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: W1LLIAMS-SONOMA
DESCRIPTION: Add/relocate sprinklers.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360 - 699-4403
Inspection Request Scheduled For: Date: 9/20 /2005 Pour Time:
i Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 016083 -01 503-222-6001 N
Corrections /Comments/ Instructions:
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mat. • i).___ -■Ar ... _ _ ,
_.... ._ ,._ r .
•
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL f, CALL ,OR INSPECTION [1] ADDITIO AL FE :. ASSESSED
- 'kl , ' 0 24 ir
Inspector: twilit Date: Phone #: (503) 718 -
•