Permit CITY OF TIGARD BUILDING PERMIT
PERMIT #: BUP2002 -00527
� l � i DEVELOPMENT SERVICES DATE ISSUED: 12/9/02
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10100 SW WASHINGTON SQUARE RD PARCEL: 1S1356A -00102
SUBDIVISION: 4KBURG ZONING: C -G
BLOCK: LOT: 001 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: 278 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: $ 7,921.00
Remarks: Sprinkler modification for tenant improvement.
Owner: Contractor:
PPR SQUARE TOO LLC WYATT FIRE PROTECTION INC.
BY MACERICH COMPANY 9095 SW BURNHAM
ATTN: JANET FISHER, ASSET MGMT TIGARD, OR 97223
SANTA MONICA, CA 90407
Phone:
Phone: 684 -2928
Reg #: MET 8 00 0 0 0 04 4 593
FEES LIC REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 12/9/02 $120.10 Sprinkler Final
[TAX] 8% State Tax 12/9/02 $9.61
[FLS] FLS Pin Rv 12/9/02 $48.04
Total $177.75
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
952 091- 001 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
ca itig (503) 246 -6699 or 1 -800 -3 4 2344.
(
Issued By: k 1 10 p
;;; _,A -41/1 --" )
Perm ittee / /
Signature: . o
Call 639 -4175 by 7 p.m. for an inspection the next business day
II
A Bu Permit Application
, Date received: ' % .
O - Permit no.!1// a
'' fl k City of �.!
Citf Tigard
- -.. Project/appl. no.: Ai mee date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 -
Phone: (503) 639 -4171 Date issued: . Me ' eceipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory Commercial/industrial ❑ Multi- family 0 New construction ❑ Demolition
❑ Addition/alteration/replacement 111. Tenant improvement til Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: (WOO 5 .'v4. V-.1Ct.S\I'1 X61-1 ,uo.xy. 12r . Bldg. no.: Suite no.:
Lot: I Block: ISubdivision: I Tax map /tax lot/account no.:
Project name: l pi ._?
Description and location of work on premises /special conditions: 'TEN /AMT y-4 eQi3V 6 ENT
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: pp' _ V\(o h , , t LlL (Flood plain, septic capacity, solar, etc.)
Mailing address: ' P.0 . PDX 23(03S 1 & 2 family dwelling:
City: "1 !State: o f...... IZIP: qJ Z$ I Valuation of work $
Phone: � 'Fax: E-mail: I No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage /carport area (sq. ft.)
Name: S CO NI -c`O2.-_
Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family: —
CONTRACTOR Valuation of work $ - 75 z t
J & FIT Z, Prokec-j� WC-, Existing bldg. area (sq. ft.)
■
Business name: 'y ► New bldg. area (sq. ft.)
Address:
qocA5 5 ArNi Number of stories
City: j j. i , , State: Cre. I ZIP: °I 1 ?13 Type of ion
construction
Phone: ( • • 2 I Fax: 03 - 96511 E -mail: Occupancy construction
group(s): Existing:
CCB no.: (o 40 1 1 New:
City /metro tic. no.:
vow Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: I State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: 'State: IZIP: Amount received $
Phone: . I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa ❑ MasterCard
work will be complied with, whether specified herein or not. Credit card number: eX
Expires
Authorized signature: Date: Name of cardholder as shown on credit card
$
Print name: Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6)0/COM)
•
h
�
Fire Protection Permit Check List
•
A.) ❑ New t.Addition ❑ Alteration ❑ Repair
B.) Modification to sprinkler heads only:
Describe work to 1. 1 -10 heads: No plan review required.
be done: 2. 11+ heads: Plan review required.
• Number of sprinkler heads: 60
Additional description of work:
Type of System (Complete A or`B as applicable):
A.) Sprinkler Wet a Dry ❑
Standpipes
Additional Hazard Group
Information Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1 ,co ci
B.) Fire Alarm
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A & B): $ 1,
•
Permit fee based on valuation (see chart): $ 12-0.
8% State Surcharge: $ q.(pl
FLS Plan Review 40% of Permit: $ ¢S .o4-
TOTAL: $ 1 11 15
•
is \dsts \forms \FPSchecklist.doc 10/04/00
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 g ' -U�j 2 _ e.50 INSPECTION DIVISION Business Line: (503) 639 -4171
BUP 2 o 1 °t'7 s Z
Received 'bate Requested / _ 2 3 AM PM BUP cl
Location /0/0 O Li k S Q �. y Suite MEC ;- d O f I
Contact Person Ph ( 3 (c(Cp ` C - d 2 — (SOS
Contractor Ph ( SWR
BUILEMIC Tenant/Owner ELC
Taatirpa ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler e -
Fire Alarm
s 'd Ceilin
Roo
Other:
PA RT FAIL
• BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole /Z /6-e,e_ 7L2 „V C_
Storm Drain
I Shower Pan
Other:
Final -
PASS PART FAIL
MECHANICAL
Post& Beam Pa 6 r 14 , c7d4._
Gas Line
Smoke Dampers
F' a■
PART FAIL
CTRICAL
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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA �
Approach/Sidewalk / 3/03 Ins pector / O k 7 Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING • Inspectionte: (503) 639-4175 5 a �A
. INSPECTION DIVISION Business ' 503 639 -4171
161 A/249N-0e5
Received Date Re nested R 7'I0L�1 Bur AM PM a0o eVel *
Location l010 R.1 Suite MEC
Contact Person D AAA... Ph ( % 1 . ) 14' — � 9 /' PLM
Contractor Ph ( ) SWR
'® Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: i f SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation / I
Drywall Nailing / _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
inar 06,
PART FAIL
PLUMBING
Post & Beam
- Under Slab
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 El Please call for reinspection RE: I Unable to inspect — no access
Fire Supply Line
ADA e
Approach/Sidewalk Date �� Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job_site.
PASS PART FAIL
CITY OF TIGA 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP _® o.-5:=2 7_
Received 'Date Requested /oZ., a • AM PM BUP
Location I U G? 0 CO /4' S& D suite MEC
Contact Person Ph ( ) Co i 1 '�-- J �— PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing L
Insulation h 4 reee tj (� rfr'i1 f l�vl. 7 cc (I Drywall Nailing i 1
Firewall
(A P i t tj Q rr e C t , <
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PAS PART,--PAIL
PLUMBING
Post & Beam
Under Slab
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 ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat / 2 -Z Y O Z Inspector 6,7
Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL