Permit O _
CITY OF TIGARD
:a Av i ,A., DEVELOPMENT SERVICES BUILDING PERMIT
PERMIT #: BUP2004 -00175
SSUED: 4/21/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09718 SW WASHINGTON SQUARE RD F -5 PARCEL: 1S12600-00300
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: B 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: $ 3,828.00
Remarks: Fire sprinkler TI, 30 sprinkler heads.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
BY THE MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQ. RD. TIGARD, OR 97223
PORTLAND, OR 97223
Phone:
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 4/19/04 $81.70 Sprinkler Final
[TAX] 8% State Surcharl 4/19/04 $6.54
[FLS] FLS Pln Rv 4/19/04 $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 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: V / :: ,6)
Pe rm ittee
Signature: "_
Call 639 -4175 by 7 p.m. for an inspection the next business day
re Protection System
iilding Permit Application _ FOR OFFICE USE ONLY
Received Building i
• Date/B : /! a 0 Permit No.: 1 . d / - 00
Planning Approval Other
City of Tigard Date/By: Permit No..
13125 SW Hall Blvd. � r Plan Revie Other
Tigard, Oregon 97223 �)1 � ( -p Date /By "Q Permit No.
Phone: 503- 639 -4171 IF 6e.- - 5 ■ e!I I 98 -1960 6 " 1 '9 4 ' ,U1!' 4, Post - Review,}/ / Land Use
Date/By Case No.
Internet: www.ci.tigard.or.us '70 I � --------140 Contact ��O0IF4. k El See Page 2 for
24 -hour Inspection Request: 503 -639 -4'175 Name /Met od. ,a/kick, L '"� J J Supplemental Information
CITY O� t IG; N
t nINS'` O IVIStO'
TYP�EWIr REQUIRED DATA:
❑ 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
❑ 1 & 2- Family dwelling ❑ 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 ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: {1 ic2 S V`► V\1(6>N . SliZ - W--1:)• Total number of floors .
New dwelling area (sq. ft.)
Suite #: Bid' . /Apt. #: Garage /carport area (sq. ft.)
Project Name: WI V p Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA: .
COMMERCIAL - USE CHECKLIST
Subdivision: Lot #:
Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
Valuation $ Cl s
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROPERTY OWNER ( TENANT ,, Type of construction
Name: iNv � 2.f.k . Occupancy group(s): Existing:
New:
Address:
City /State /Zip:
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
❑ APPLICANT 0 CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: (ee1 Co N (i 11 R) jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone: Fax: .
PERMIT FEES* .
E -mail: - Please refer to fee schedule. .
CONTRACTOR •
Business Name: 'Yatk F‘re. `I'oleCJ\ ON[ Fees due upon application $
Address: 4o4S PA
1� }t NI
NO M1& L O - 122,3 Amount received $
Phone: 943 034` Fax: , - 4IQS7 Date received:
CCB Lic. #: (Q (� -k�
Authorized V Notice: This permit application expires if a permit is not obtained within
Signature: Date: -1 180 days after it has been accepted as complete.
g re,' pip 12 04-4F.. *Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
i \Dsts \Permit Forms \BldgPcmitApp due 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.
+ i
11 heads: Plan review required.
Li Alteration � q red.
❑ Repair
Number of sprinkler heads: �(7
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: $ 3 i ' l 2 . °°
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: J $
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): $ 3, Q,7 —
Permit fee based on valuation (see attached chart): $ g - i °
Permit fee based on square footage (D) (see fees above): $
State Surcharge 8% of Permit Fee: $ l -
FLS Plan Review 40% of Permit Fee: $ 32_ . Ip?
TOTAL: $ 12.0 . q Z
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
Case Activity Listing :48A8PM
y Liti g 12:48:48PM
TIDEMARK Case #: BUP2004 -00175
COMPUTER SYSTEMS. INC.
; Assigned: . ;�, ,. one. 9 t ;,
, :» at a te.3 ;Hold = o 4 B ��', T otesr
r �+�.... " .v-. k• ". <� . , � . - � .,, t ,� ,3" ��, P : ,. t ,%,� -.. s � � tx.,
BUPC005 Application received 4/19/2004 None DONE DEB 4/19/2004
RCP
BUPC008 Permit created 4/19/2004 None DONE DEB 4/19/2004
RCP
BUPC012 Plans routed to Plans 4/19/2004 None DONE DEB 4/19/2004
Examiner RCP
BUPCO24 Plans 4/20/2004 None DONE BSB 4/20/2004
checked /approved by BSB
PE
BUPCO26 Approved plans 4/20/2004 None DONE BSB 4/20/2004
routed to PT BSB
BUPC783 Sprinkler Rough -In 4/26/2004 None PART RB 4/27/2004 Hard lid area
RB
BUPC784 Sprinkler Final 4/29/2004 None PASS RB 4/30/2004
RB
BUPCO29 Post - review 4/21/2004 None DONE DEB 4/21/2004
completed DEB
BUPC090 Ready to issue 4/21/2004 None DONE DEB 4/21/2004 All fees have been paid
DEB
BUPC100 (F) Issue permit 4/21/2004 None DONE BB 4/21/2004
RCP
BUPC960 Case Finaled 4/30/2004 None DONE RB 4/30/2004
RB
Page 1 of 1 CaseActivity..rpt
CITY OF TIGARD 24 -Hour
BUIL'DING' Inspection Line:_ (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
UP! 7'S
P
l
Received:. ''-lY� Date Requested /� -0 9s AM ``�� M BUP
Location / r 4 , ) 4 c - /2vl Suite MEC
Contact Person Ph ( ) co k& Z ' Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner L r7) J2 h ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Ina Sheath /Shear
Framing ! S P
Insulation
Drywall Nailing se_v‘3,
Fire Sprinkler
/ Susp'd Ceiling
Roof
410 PART FAIL
P ut BING
Post & Beam
Under Slab 4
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower 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 fl Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA Approach/Sidewalk Date � � / a Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL