Permit •
A j BUILDING PERMIT
CITY OF TIGARD
PERMIT #: BUP2005 -00454
j l� A, DEVELOPMENT SERVICES DATE ISSUED: 9/23/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09368 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: 31 BASEMENT: sf AREA SEP. RATED:
STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:Y
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 2,300.00
Owner: Contractor:
WASHINGTON SQUARE LLC PATRIOT FIRE PROTECTION INC
BY THE MACERICH COMPANY 4708 NE MINNEHAHA ST
9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 9 86 61 -1 843
PWone?''10g-7R-8865
Phone: 360- 699 -4403
FEES Reg #: LIC 70822
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 9/8/2005 $72.10
[TAX] 8% State Surcharl 9/8/2005 $5.77
[FLS] FLS Pln Rv 9/8/2005 $28.84
Total $106.71
• 1
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 -246-6 9 or 1-800- 332 -2344.
Issued By: / 4� (4..) Permittee Signature: e y'y j G Z l j • ( ..
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.
73t g' SW W t"Vit.r. s6
' ., Fire Protection System 7 /G
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'% Buil Permit Application �a' �' FOR OFFICE: USE ONLY
City of Tigard Hi lS C I - 0 7 1% [ RD e d Q .��
�-' /,► _d c -"AV 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Other Permit: p
Phone: 503.639.4171 Fax: 503.598.1960 j �' '; / 'b "; f'' Date/B . ��, ol Z: { / 'S dr 05
Inspection Line: 503.639.4175 �i 6 4 ^'_ Dale Ready : f ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method 0 Supplemental Information
RRCIITY11I1O�F TIGARD
TYPEw IVISION • REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ 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 work indicated on this application.
13 m
I- and 2- family dwellingmercial /industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
fE INFORMATION AND LOCATION Total number of floors:
Job si:_ _......a. g36Qg sw VA� � , eb, New dwelling area: square feet
City /State/ZIP: 77r4 . D 02 Garage /carport area: square feet
Suite/bldg. /apt. no.: F Project name d j e 4, , J . C,( Covered porch area: square feet
Cross street /directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL CHECKLIST
Subdivision: I 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 work indicated on this application.
/� � C Ic-
f pD . Pl)..ILL S - 1 - . - . We.,‘/ JALL,S Valuation $ 21 3,0c)
4 r. ti L I N6t-r Existing building area: square feet
New building area: square feet
PROPERTY OWNER ,S TENANT Number of stories:
Name 6\it FE c , Type of construction. 2
Address: 5� �(hV■ISn s 1 7 - E Occupancy groups: i n k 1
City /State/ZIP: < J rRA 1 S( / 6.4 ^ ( 31 1 d� � Existing: ( 6PP.
Phone: (41.5-) Z7 e, _ 71 S� (.41S Fax: Z 5 — ` S New: \ \ / /
X APPLICANT ❑ CONTACT PERSON NOTICE
Business name P�T2ldT F t 2' cs 1 Cp l (< All contractors and subcontractors are required to be
Contact name: r t �5 licensed with the Oregon Construction Contractors Board
A, under ORS 701 and may be required to be licensed in the
, 1\1 Address: Q7 F / v' 1 k i j J E -s - c . jurisdiction in which work is being performed If the
City / State/ZIP: 'f,,Qe , �d4 l e,cpco ( applicant is exempt from licensing, the following reasons PP I Y
apply: 6 2 , — (o°CS 1 Fax. .3(00) Co -` g -- 4 e 5 _ 6 74r, 7
E -mail: p p
CONTRACTOR a o � 0
Business name: Ppx'CEI-05 Pc. BUILDING PERMIT FEES*
Address:
Please refer to fee schedule.
City /State/ZIP:
Fees due upon application
Phone:( ) I Fax:( ) •
CCB lic.: O 6C-Z---- _ 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: l jE 5(' 6L` L j,_ ) I Date: Ct 5 Cot • Fee methodology set by Tri -County Building Industry
Service Board.
i. \Bwlding\Pemnts\FPS- PennuApp doc 12/03 440-4613T(11/02/COM/WFB)
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City of Tigard: Fire Protection Permit Checklist
*Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional • •Standpipes " • •
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
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.
I:\ Building \Permits\FPS- PermitApp.doc 2
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00454
j 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/23/2005
Phone: (503) 639- 4171, 1l h
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 2
SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANIE & JACK
DESCRIPTION: Fire sprinklers.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639-8865
CONTRACTOR: PATRIOT FIRE PROTECTION INC PHONE #: 360-699-4403
Inspection Request Scheduled For: Date: 10/27/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 3prinlder final 019559-01 503-519-9751 N
Corrections /Comments /Instructions:
1 ( 1 W . Woo= -_
.....,
A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR I PECTION ❑ ADDITI AL FE S ASSESSED •
Inspector: ®t Date: ‘. Z.. � F --- one #: (503) 718-