Permit GITY TIGARD BUILDING PERMIT
• COMMUNITY DEVELOPMENT DATE ISSUED: 9/13 2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: DAIRY QUEEN /ORANGE JULIUS
Project Description: Add /relocate (9) sprinkler heads for TI.
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: 28 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: $ 1,563.00
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
Phone: Contact #: PRI 503 - 684 - 2928
FAX 503 - 684 -9657
Reg #: LIC 64077
FEES
Description Date Amount REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcha 9/13/2007 $5.00
[BUILD] Permit Fee 9/13/2007 $62.50
Total $67.50
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 . ' • :''cation 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 dir -.t qu:. io s to OUNC by calling 503.246.6699 or 1.800.332.2344.
Iss d By: / i l/ Permittee Signature: / Zni
Call 503.639.4175 by 7:00 a.m. for an inspection that e usiness 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
Building Permit Application FOR OFFICE USE ONLY
IN City of Tigard DateBy. / g 4,7 , ! Permit No • / 6'5 '
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C ' Phone: 503.639.4171 Fax: 503.598 1960 Date /By Other Permit.
TI GARD l/ Inspection Line: 503 639.4175 Date Ready /By Ju�ne 0 See Page 2 for
Internet: www tigard -or gov Notified/Method. /eR Supplemental Information
TYPE OF WORK REQUIRED DATA: I- 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
,ddition/alteration/replacement ❑ Other: equipment, matenals, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
CI 1- and 2- family dwelling — Commercial /industrial
Valuation: $
El Accessory building I=1 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
Y SD JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: , 14,13 J /l�) 6 Q RD New dwelling area: square feet
City/State /ZIP: �g O . O2 9 � 7 z _ Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: t'C >�J g)ilC Covered porch area: square feet
Cross street/directions to job site: / _.J OLi US 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, materials, labor, overhead, and the profit for the
ADD �i
DESCRIPTION OF WORK work indicated on this application. 1
ADD { k G/ 1 9 6Pg /A) /c -Leg-- t
0 5 Valuation: $ I S tO5a
4 s � Fora .5-1,0 '" Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
- ,APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: 5125 eAIT, C 01e._ 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 be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: w yk ' r/ �� ��v � i �� � Q (Please refer In fee schedule)
�0 9s • p Ug • , 1, Permit fee: �a
Address: ( _
State surcharge (8% of permit fee): 5.00
City/State /ZIP: -77 D D i 9�7zZ.. F LS (40% 1 plan review (40 /o of permit fee):
Phone: (503 ) 6 84 - Z9 Z 6 Fax: (503) & e 4 - - 9& 57 (Due upon application.)
CCB lic.: &4077 Total permit fees: 67. Sb
Authorized signature: ���� pp Amount received: 407 .
...,,,e1....12____ This permit application expires if a permit is not obtained
Print name: 6(/ /.4-77-64../0 Date: 9 _ID - 7 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1• \ Building \ Permits \FPS- PermnAppdoe 03/23/06 440 -46t3T(II /O2JCOM/WEB)
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 0-1 -10 heads: No plan review required.
'Alteration ❑ 11+ heads: Plan review required.
❑ Repair n
Number of sprinkler heads:
Additional description of work:
Am) f DS ,¢-S ,li= cE 4_0c' FvYL - _ .
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: $
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.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (8% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 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.
http.//www.cLogard or us /city_hall /departments /cd /dots /PPS- Pcrm,tApp doc 2
CITY OF TIGARD
BUILDING DIVISION
A- sr PERMIT #: E JP2007- Ot3ttt35
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1312007
Phone: (503) 639 -4171 t`l
Inspection Requests (24 Hrs.): (503) 639 -4175 ' I I..
INSPECTION WORKSHEET FOR DATE: 10131/2007 TIME: 7 :00AM PAGE: 90
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEFN/ORANGE JULIUS
DESCRIPTION: Addlrelocate (9) sprinlder heads to TI.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYA1T FIRE PROTECTION INC. PHONE #: 503-684-2928
Inspection Request Scheduled For: Date: 10131!7007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
909 Sprinld« r final 083693 -01 503 684 -2928 N
Corrections /Comments /Instructions:
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x PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ ��t Date: �� �31 Phone #: (503) 718- �-(21
CITY OF ■ IGARD tf!
BUILDING DIVISION PERMIT #: B11P2007 -00485
13125 SW Hall Blvd., Tigard, OR 97223 �/ DATE ISSUED: 9/13/2007
Phone: (503) 639 -4171 i J
Inspection Requests (24 Hrs.): (503) 639 -4175 R'.-
INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7 :00Am PAGE: 56
SITE ADDRESS: 09504 SW WASHINGTON SQUARE RD J02 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DAIRY QUEEN/ORANGE JULIUS
DESCRIPTION: Add/relocate (9) sprinkler heads for TI .
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: WYATT FIRE PROTECTION INC. PHONE #: 503 -6B4 -2928
Inspection Request Scheduled For: Date: 10/2312007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
910 Sprinkler rough -in /test 058111 -01 503- 6842928 N
Corrections/Comments/Instructions:
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / Phone #: (503) 718- 1