Permit •
•
BUILDING PERMIT
CITY T I G �► R ® PERMIT #: BUP2003 -00609
� 1 � DEVELOPMENT SERVICES DATE ISSUED: 10/21/03
�- -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 01107
SITE ADDRESS: 09651 SW WASHINGTON SQUARE RD FC -10
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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: 5N : sf N: S: E: W:
OCCUPANCY GRP: A3 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: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 1,600.00
Remarks: Fire suppression for Type I hood.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC FIRE EXTINGUISHER SERVICE CTR
BY THE MACERICH COMPANY PO BOX 1391
9585 SW WASHINGTON SQ. RD. BEAVERTON, OR 97075
PORTLAND, OR 97223
Phone:
Phone: F- 626 -9993
Reg #: 60-3309 00069384
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Final
[BUILD] Permit Fee 10/9/03 $62.50
[TAX] 8% State Tax 10/9/03 $5.00
[FLS] FLS Pln Rv 10/9/03 $25.00
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.
Issued By:
Peg at e re:
Si �
nu 5 by 7 p.m. for an inspection the next business day
g6SI sw (0)4Jl 14 7ewerop
Fire Protection stem
Building Permit Application FOR OFFICE USE ONLY
Received t � / B udding / Q
Date/By / ' 0 9 o b - Permit No.: - ,.1'
A Other 0
City of Tigard 7 r. C, , 12 J Date/By: Plam royal Permit ` PP No •
13125 SW Hall Blvd. Plan Review I I Date/By. Case No. Other
Tigard, Oregon 97223 , , r Date/By /01 -,„ / J
fl s� Permit No H QQ,3'6°J5 7 co
Phone: 503- 639 -4171 Fax: 503 - 598 -196 V '' 'rl 1. I ? ' I '? Post- Review Land Use
.' U
Internet: www.ci.tigard.or.us - Contact
24 -hour Inspection Request: 503- 639- 4175CITY OF TIGARD Su See l for
P 4 Name/Method: � Supplementa
BUILDING DIVISION
TYPE OF WORK REQUIRED DATA:
I I New construction ❑ Demolition 1 & 2 FAMILY DWELLING
❑ Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed Indicate It
❑ 1 & 2- Family dwelling 0 Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, matenals, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building 0 Multi- Family
t -..-.
❑ Master Builder ❑ Other: Valuation.. $
JOB SITE INFORMAT ON d LOCATION No. of bedrooms: No. of baths:
Job site address:' 96 / 4, j �P ; , ; r i , Ming, Total number of floors
+ , = New dw area (sq. ft.)
Suite #: B I g. /Apt. #: Garage /carport area (sq. ft.)
Project Name: le JE AlOS Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
tk
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST .
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
4 D, CRI.PTI. DI OF WORK 0 the value (rounded to the nearest dollar) of all equipment, materials, labor,
� /``� �i overhead and profit for the work indicated on this application.
`itriZtlit / :ef 111. L 1 , ... A / A • r' /I,MP/ —V1Wi /
�i Valuation $ (QO0
/ Existing building area (sq. ft.)
/ New building area (sq. ft.)
Number of stones
❑ PROPERTY OWNER I ❑ TENANT Type of construction .
Name: Occupancy group(s): Existing:
New:
Address:
City/State /Zip:
Fax: NOTICE: All contractors and subcontractors are required to be
Phone:
(,APPLICANT IN CONTACT PERSON licensed with the Oregon Construction Contractors Board under
c' n provisions of ORS 701 and may be required to be licensed in the
Business Name: f6S & h€ exrodb4r5# f,C, duty ' jurisdiction where work is being performed. If the applicant is exempt
i
li
from licensing, the following reason a
Contact Name: �(Q(05 f g h lli g applies:
Address: aa) ale
City /State /Zip: / /,elyt,/j N 2-7-3
Phone: 61..q 330/9 I Fax: . 10 /73(0
BUILDING PERMIT FEES*, .
E -mail: Please refer to fee schedule. •
CONTRACTOR
Business Na72 JE ye, � Fees due upon application $
Address :1 0 ) f k
City/State /Zlp` jy ✓A� d
-7�-/ 97007. Amount received $
Phone: 5 3309 Fax: Sr /786 Date received:
CCB Lic. #: G ?3y41
Authorized ' Date: / 7 ) C 05 Notice: This permit application expires if a permit is not obtained within
Signature: e: �.�. ' e : r. 180 days after it has been accepted as complete.
ri , J *Fee methodology set by Tri -County Building Industry Service Board.
(Please pnnt name)
is \Dsts\Permtt Fonts \BldgPermitApp.doc 01/03
•
Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) 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: $ ( (p ® 0
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.
is \dsts \forms \FPSchecklist.doc 02/28/03
CITY OF TIGARD 24 -Hour " - •n
BUILDING Inspection Line: (503) 9 -4175 MST
INSPECTION "DIVISION Business Line: • (503 1539 -4171
, � BUP c3 - 00609
Received Date Requested 1/-3 AM PM BUP
Location 6/6,s-( 4) /4" - S(1. 'RS) . Suite '' MEC '----- O 0 S
Contact Person 9i.ri - Ph ( ) ( (1 330 9 PLM
Contractor Ph ( ) SWR
Blila Tenant/Owner T Tc. ),/ ELC •
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain .
Slab 14wpection N SIT
Post & Beam 1 Q r -
Shear Anchors I l rl- C>V6,-() Ext Sheath/Shear '[
Int Sheath/Shear
Framing •
Insulation vi C�M ,c t r ,k � \ S . -& 9
Drywall Nailing Uw
Firewall
Fire Sprinkler
Fire Alarm / L_ Lc la�� / t.-4..Z Thi..„ �� e........_ Susp'd , - g I . ` - •
Roof
# i
PART FAIL
1 MBING
Post & Beam
. Under Slab
Rough -In q
ater Service
Sanitary Sewer /
Rain Drains
Catch Basin / Manhole
Storm Drain .
Other: Pan
//,./ .
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line -
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA t c
Approach/Sidewalk Date I nspectorA V Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL