Permit CITY OF TIGARD PERMIT
PERMIT #: BUP2004 -00320
� DEVELOPMENT SERVICES DATE ISSUED: 7/2/2004
�= -- 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10124 SW WASHINGTON SQUARE RD A -7,8 PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG 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: : sf N: S: E: W:
OCCUPANCY GRP: 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: $ 700.00
Remarks: Relocate (7) fire sprinkler heads for TI
Owner: Contractor:
PPR SQUARE TOO LLC WYATT FIRE PROTECTION INC.
BY MACERICH COMPANY 9095 SW BURNHAM
9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223
TIAone`.OR g 503=2639 -8865
Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Description Date Amount Sprinkler Rough -In
[BUILD] Permit Fee 7/2/2004 $62.50 Sprinkler Final
[TAX] 8% State Surchart 7/2/2004 $5.00
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 Utility Notification Center. Those rules are set forth in OAR
952 -00.1 -00 s a ough OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 13) 246-66'• or 1-800-332-2344.
Issu: d By: ��; ;
S it a
Signature:
re:
Call 639 -4175 by 7 p.m. for an inspection the next business day
Fire Protection System
Building Permit Application FOR OFFICE USE ONLY
Date/By: 7 4y Budding Q loo w�� i2� �
Planning Permit No.:
o Approval Other
City of Tigard Date/By Permit No :
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.
Phone: 503- 639 -4171 Fax: 503 - 598 -1960 00101 J'' � P ost - Review Land Use
- - �� i- i , - � Date /By: Case No.
Internet: www.Ci.tigard.or.us Contact Jurys.:— ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method• _ 7 tea Supplemental Information
TYPE OF WORK REQUIRED DATA:
❑ New construction ❑ Demolition 1 & 2 FAMILY DWELLING
gAddition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed Indicate
❑ 1 & 2- Family dwelling g Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, 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: l Total number of floors
' I Z k S W ' Zl1At$L� ' SQ 2-Q New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: KI 1 ,3%( . 6's 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: I 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.
((�� yy L qqe
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
❑ PROIKRTY OWN I ❑ TENANT , Type of construction
j� LO tb )3a ,1
Name: Y}� �`' Occupancy group(s): Existing: New:
Address: cis5S6 61.0 1.64. ,L2 2 7
City /State /Zip: 17e, .,2 , c Q7a? -3
NOTICE: All contractors and subcontractors are required to be
Phone: Fax: licensed with the Oregon Construction Contractors Board under
APPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: Wyk �E___ Pzysr. jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address: Saa Co./IT,
City /State /Zip:
Phone: Fax:
'BUILDING PERMIT FEES *, . .
E-mail: Please'refer to fee schedule. .
CONTRACTOR '
Business Name: 'fAT 19 mass r P'1 dw Fees due upon application $
Address: q09 S s. t,J - 61tie
City/State/Zip: mount received $
Y P � TI Co !� PcIQ!� D�
Phone: &S4- Z42v Fax: Mag 4 5657 Date received.
CCB Lic. #: &10
A uthorized Notice: This permit application expires if a permit is not obtained within
Signature ��� Date: 7/2 09- 180 days after it has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
P' .ise print name)
i \Ilia \Permit Forms' I1' .•• 'ri ^,.. iii u;
r
Fire Protection Permit Check List
Describe work to be done:
A.) ❑ New B.) Modification to sprinkler heads only:
❑ Addition NI, 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair Number of sprinkler heads: 7
Additional description of work: Tjcv,, --- ' occi\J �cN
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet ca. Dry ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ — 700 `
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.
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: $ S,
FLS Plan Review 40% of Permit Fee: $ —0—
TOTAL: $ 61.
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
!ic :-sad fire suppression engineer, or NICET level "3" technicians.
•-:•• 02/28/03 '
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUD 6° -
Received ( Date Requested —7 AM PM BUP
Location /6 1 g' 'C 1,v / S Suiite MEC
Contact Person o .t :a �s - �� Ph ( ) Co 79 °Z 9a4 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner A 4://1IL -4 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 c / p� b!) Insulation f z > IM� - v J c�j�-1 C
Drywall Nailing
Firewall
Fire Alarm
Susp'd Ceiling
Roof
Ot er:
r
.0ri ING ifL
PART FAIL _ Ilfk■
Post & Beam 'MrLlly1 ' ii'
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 _ _
Low Vo lt i►1P� i �rI�i�
Low Voltage A �ra� � 1 . / � ��
Fire Alarm a. ! V
Final ❑ Reinspection 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 Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL