Permit it
C ITY OF TIGARD
PERMIT #: BUP2005 -00154
jl�� DEVELOPMENT SERVICES DATE ISSUED: 4/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09463 SW WASHINGTON SQUARE RD Al2 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Sprinklers (10) heads.
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: 22 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: $ 1,969.00 •
Owner: • Contractor:
WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIGARD, OR 97223
one:
Phone: 684 -2928
FEES Reg #: LIC 64077
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUILD] Permit Fee 4/20/2005 $62.50
[FLS] FLS Pin Rv 4/20/2005 $25.00
[TAX] 8% State Surchari 4/20/2005 $5.00
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.
�_ i � Issued By: �j ,� � Permittee Signature: '
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.
Fire Protection System � ' R
\ � . _ _ � ' '
i ti 0 4.
' uil Permit Application ,az 200 FOR OFFICE USE ONLY
City of Tigard WeR _/� /�%i
g tr I Received Pl Ry `w,, (/ /l�l I Permit No -5 G� \02OOs ,76 �Sv
13125 SW Hail Blvd . Tigard. 503 9 19 c� ' . A i+ Plan By. y / A5 / 5 ` '��/ Other Permit
�
p _ ri, V 7/T
Phone 50 =- 639.41 it Fax 50� .93 1960 ® , ( , Da[eiBy.
Inspecnor. Lane. 503 639 4175 0 � � ti! it Date ReadyBy � ) iuns 8 See Page 2 for
Internet «uu.ci ngard or us BUIL et. e. NonfiedMethod 9' Q5"'ra- Tit Supplemental information
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ :' construction I ❑ Demolition Perrmt fees* are based on the value of the work performed
IY
1 Indicate the value (rounded to the nearest dollar) of all
Addition alteration replacement ❑Other: equipment, matenals, labor, overhead, and the profit for the
- . • CATEGORY OF CONS ION work indicated on this application
Valuation. $
❑ 1- and 2- family dv. elline Commercial /tndustnal
❑ Accessory building I ❑ Multi- family Number of bedrooms
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION - Total number of floors.
Job site address: 64403 S \v v -11wrpNs - !.•-V . New dwelling area square feet
City /State ZIP: - 1 P1 O 14- 6117.2-.5 Garage /carport area: square feet
Suite,blde apt. no.: Project name �(� ' � 55 1..w Q' Covered porch area. square feet
Cross street'directions to job site. � j \)o e 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, matenals, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
DI) Pe(k6(5 06 PR EN 1 re ko v NctNfi Valuation S ` gOCI
. ?Yt`V IS p er--
1 Existing building area square feet
1 , 1 , r Y� New building area. square feet
PROPERTY OWNER . . " ❑ TENANT • Number of stones.
Name ?p \ N 1 N \ ThT XV fAir . + L� Type of construction:
Address pb 1 Occupancy groups. (5ft ,21
City 'State ZIP PtOP,( l' V I 2_ 9 131 0 Existing
Phone ( ) Fax: ( ) New
— APPLICANT ❑ CONTACT PERSON NOTICE
Business name- ( \ %e OWi�1 �) All contractors and subcontractors are required to be
Contact name \ licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to he licensed in the
Address jurisdiction in which work is being performed If the
Cin',State ZIP applicant is exempt from licensing, the following reasons
apply
Phone. ( ) Fax: • ( )
E -mail
CONTRACTOR -
Business name r1 p� �Q,,,, .
BUILDING PERMIT FEES*
Address 5 &NI trnhoviA ,,,
to Please refer jNC schedule. City State ZIP '� P A O (0-2: (� Fees due upon application 1 a2_ . Phone 16 03 ) IMi I Fax: (� l `_\
Q Amount received
CCi3 lic 11
Date received
\uthonzca signature This permit application expires if a permit is not obtained
t ,� -� �, isithin 180 da) s after it has been accepted as complete.
Pr,nt name 1 G�1UrOt 1 I Date 0 4- • .0 O ` Irce methodolog set b T:i- Count} Building Inoustr
Sen ice Board
City of Tigard: Fire Protection Permit Checklist P • r
Page 2 - Supplemental Information
Describe work to be done: -
1.) ❑ New 2.) Mop.acation to sprinkler heads only:
❑ Addition 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 1 L)
Additional description of work:
- Type of System (Complete A, B, C or D as applicable):.
A.) Commercial Sprinkler • - :. :: .., ��'.. • -p : .
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ I t (pa —
B.) Type I - "Hood Fire Suppression' System .,,,:, _; l; =r . •
Hood Project Valuation: $
;; .. - . .' 4•. •jy stJj,wtv.lfr�. P• ++i jrV - - -
C.) Fire Alarm : ; " �'' xhr;s, -� . K, " ;: z
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand Alone Sysfe:in)" _ . .. ' .. -
Square Footage: Permit Fee:
0 to 2,000 $187.50 � /'; �` - L.
2,001 to 3,600 $232.50 f"-
3,601 to 7,200 $292.50 �'�� -' �• k.�a,:k; - <_; . .
7,201 and greater $381.50 -0`
Sprinkler Project Square Footage: sq. ft.
Project Valuation Subtotal (A, B & C): $ \ l q(Qq
Permit fee based on valuation (see attached chart): $ .Q2 • So
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ --
FLS Plan Review 40% of Permit Fee: $ 2.. S . (x.) --
TOTAL: $ 6 12 . SC7
Plan review requires a completed application and 3 sets of plans at submittal. Plan review
eview -
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.
Budding\Forns FPS Checkl :st doc 12'29/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: BUP2005 -00154
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/28/2005
Phone: (503) 639 -4171 mu/4iiiI,I
Inspection Requests (24 Hrs.): (503)'639 -4175 ,„14- s__..
INSPECTION WORKSHEET FOR DATE: 6/9/2005 TIME: 7:09AM PAGE: 100
SITE ADDRESS: 09463 SW WASHINGTON SQUARE RD Al2 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SUNGLASS HUT
DESCRIPTION: Sprinklers (10) heads.
OWNER: WASHINGTON SQUARE LLC, . PHONE #:
CONTRACTOR: WYATI FIRE PROTECTION INC. PHONE #: 684 -2928
Inspection Request Scheduled For: Date: 6/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
999 Sprinkler final • 008780 -01 603-684 -2928 N
Corrections /Comments /Instructions: •
< _Sp I A NC F 0,1C.
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • ALL FO' INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ir Dater 0 ?/f9 Phone #: (503) 718-
•