Permit CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2005 -00333
All i4, DEVELOPMENT SERVICES DATE ISSUED: 7/27/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09410 SW WASHINGTON SQUARE RD K -11 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Fire sprinkler TI, alteration of (25) heads.
REISSUE: �Q FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ,,A�fi 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: 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: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,902.00
Owner: Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
Ti ARD, 5036". O 9 8865
one: Phone: 503 - 684 -2928.
FEES .Reg #: LIC 64077
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 7/13/2005 $81.70
[TAX] 8% State Surchari 7/13/2005 $6.54
[FLS] FLS Pln Rv 7/13/2005 $32.68
Total $120.92
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 y w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 -0010 throug OAR 952 i:1 -0100. You may obtain a copy of these rules or direct questions to OUNC by
call' g 503 - 246 -6699 • r 1 -800- . 4 _
Is ed B 9 1 • 1 �� ../ % ' Permittee Sign e: 0 � I Ji /
.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.
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k, A; i ie) SW I(X.41‘ IV P 47-4: 60
Fire Protection Sy ,--)
Building Permit Application I FOR OFFICE USE ONLY ll
City of Tigard
Re "' /'j / / 05 PemntNo et/ 7 � U "�
g D4
11 3125 , W Hall Blvd., Tigard, OR 9 Plan Revie /
• hone' 503.639.4171 Fax: 503.598.1960 • c v Date/By: Oth Permit:
1 .T 7 ttion Line: 503.639.4175 . I J 1 Date Ready/By: ' /)„ 1G ® See Page 2 for
w•
_W /LS�t/
Internet: ww.ci.tigard.or.us Notified/Method: 7 4' Supplemental Information
TYPE OF WORK -. REQUIRED DATA 1- AND 2- FAMILY DWELLL \G
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed. •
Indicate the value (rounded to the nearest dollar) of all
[. �ddition'alteration/replacement I ❑ Other: equipment, materials, labor, overhead, and the profit for the
• • • CATEGORY OF CONSTRUCTION work indicated on this application.
• Valuation: S
❑ 1- and 2- family dwelling Commercial /industrial
El Accessory building ❑ Multi- family
Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms: ,
• ' JOB SITE L\FORMATION AND LOCATION 4 :� y Total number of floors: 1
Job site address: pA `o Svc 'J&s .i w 1 to New dwelling area: square feet
City/ State/ZIP: T1■(,tn'lrl O9/ Garage/carport area: square feet
•
Suite/bldg. /apt. no.: 1 I Project name: V.600 Covered porch area: square feet
Cross street/directions to job site: t tJly 1 -WW1 rej Deck area: square feet
•
Other structure area: square feet
I%E DD&TA "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 • r'- fi * Y,, work indicated on this application.
TeNaN r - 1.p n pw.rP.r .nr r Valuation: $ 3, 4 �Z
Existing building area: square feet
New building area: square feet
• ' • - - C PROPERTY OWNER . ❑ TENANT : iii Number of stories: •
?PR- v �r� t, N c 1 S Q v �
Name: Type of construction:
�e �l x
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
• ' APPLICANT . - ❑ CONTACT PERSON -:"±. NOTICE
Business name: wy Ft re , Np-4eunow J - 1.NC/ ' All contractors and subcontractors are required to be
Contact name: /n� licensed with the Oregon Construction Contractors Board
V{� � 'J 1.4 �m under ORS 701 and may be required to be licensed in the
Address: Tv 012-- q' Z jurisdiction in which work is being performed. If the
i ,. applicant is exempt from licensing, the following reasons
City/State/ZIP: W \ �'4 apply:
Phone: ( CA5) VpA, .211212 Fax:: ( ) Wcg4 . 4 to c
E - mail:
• CONTRACTOR { 4 •: 1, ' ;.. +"
Business name: (e (40 tcPr 1 ' PERMIT FEES* •
Address: i'� v J
Please refer to fee schedule.
City/ State/ZIP: �
Fees due upon application 4 12.0 . Cl U L.
Phone: ( ) Fax: ( )
Amount received
CCB lic.: <i
Date received:
Authorized signature: ��Q This permit application expires if a permit is not obtained
- within 180 days after it has been accepted as complete.
Print name: Sv` Date: 0, - t I �S 'Fee methodology set by Tri -County Building Industry
nnn��` �� Service Board.
1 Bu:Iding Perm= .FPS- PernutAppdoc ':3_C3 440- 4613T(1I /02/COM/WEB)
f
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work o _ I
l.) New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
-Alteration heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Tewunrr - 11)nprowyj N iV
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: $ .6 GIOZ
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone System)
I Square Footage: Permit Fee:
I 0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
1 7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $ A02
Permit fee based on valuation (see attached chart): $ gt10
Permit fee based on square footage (D) (see fees above): $ �
State Surcharge 8% of Permit Fee: $ .mil
FLS Plan Review 40% of Permit Fee: $ ' .
TOTAL: $ 12.0,g?
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.
3..::,:me Forms FPS Checklist.doc 12/29/03
•
CITY OF TIGARD
BUILDING DIVISION : PERMIT #: BUP2005-00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/27/2005
Phone: (503) 639- 4171 A ���i������ , 1 �
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/17/2005 TIME: 7:05AM PAGE: 89
SITE ADDRESS: 09410 SW WASHINGTON SQUARE RD K -11 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: LEGO
DESCRIPTION: Fire sprinkler TI, alteration of (25) heads.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639.$565
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503-684 -2928
Inspection Request Scheduled For: Date: 8/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final 013673 -01 503-684 -2928 N
•
Corrections /Comments / Instructions:
•
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CA FO" NSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I/ Date: o (7 -0 5 Phone #: (503) 718 -