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Permit CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00006 I I I DEVELOPMENT SERVICES DATE ISSUED: 1/7/2005 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 SITE ADDRESS: 09714 SW WASHINGTON SQUARE RD F -4 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: M 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: # - 737. o0 Remarks: Replace (9) fire sprinkler heads. Owner: Contractor: WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC. BY THE MACERICH COMPANY 9095 SW BURNHAM 9585 SW WASHINGTON SQUARE RD TIGARD, OR 97223 TIARD, OR 97223 one. Phone: 684 -2928 Reg #: LIC 64077 FEES REQUIRED INSPECTIONS Description Date Amount Sprinkler Rough -In [BUILD] Permit Fee 1/7/2005 $62.50 Sprinkler Final [TAX] 8% State Surcharl 1/7/2005 $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 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling (5 3- )2 or 1- 800 -332- 344. Issued By: ,,_ :4 ' A _____. Permittee -- ` Signature: /�. �'�'� Call 639 -4175 by 7 p.m. for an inspection the next business day ( ' Fire Protection System Building Permit Application FOR OFFICE USE ONLY City of Tigard R j © � / �- Il 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 /id d j ' + � Date/B Other Permit. Inspection Line: 503.639.4175 _ 1 I Date ReadyBy: RI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Al Supplemental Information . _ , ` 3, . - - +,._;'. TYPE OF WORK.- :,I;' - -' ' REQUIRED DATA 1 AN]) 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 ,__Virrcldition/alteration/replacement ❑ Other: equipment, matenals, labor, overhead, and the profit for the ' ' CATE OF CONSTRUCTION:': . work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling mmercial/industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: ' JOB SITE INFORMATION AND LOCATIONS• • , , _ - V • Total number of floors: Job site address: - f \ V 1 UV (\ aDO �evItYe • New dwelling area: square feet City/State/ZIP: � 0 0 4 , ,0 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name RKAI 111.1.-R_ (113,1j?} Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet d! - REQUIRED DATA COMMERCIAL -USE C Subdivision: I 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 � '" �� 1 . � D n E � S � C � RI II P � TI p O 1 N � OF WORK work indicated on this application. 1 eklA1V T I `-Fir T �, V eAke Valuation: $ 7 3 / -7 . 00 Existing building area: square feet New building area: square feet ' -'P t�OPERTY OWNER . ' ' I • - ' - ❑ TENANT '' " Number of stories: Name: W -pm m-1 N 0 -rot S0,0e 1 ,� l Type of construction: Address: 1 PO v 121i2.-- V v" V Occupancy groups: City/State/ZIP: p oPJ \ - 2 e2ScD Existing Phone: O aI?.,?-, • (W J®� Fax: ( ) New :Et ❑ CONTACT PERSON, ''' " ` NOTI Business name: (see/ 0,, c ` e,� 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: junsdiction in which work is being performed If the City/State/ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) I Fax: : ( ) E -mail: ,. CONTRACTOR Business name: (� .c-Ni �� ] � , BUILDING PERMIT FEES` Address: \Y l "A I P� U► �/N u Pl ease refer to fee schedule. Ci ty /State/ZIP: �I 1 � •7/ � t r Fees due upon application Phone: ( 1 ) ,° Fax: rio->) kWYS • 61 � 7 � �� ^ ^^ �� Amount received CCB lic.: •`� +, Date received: Authorized signature: / -- This permit application expires if a permit is not obtained 1 'p within 180 days after it has been accepted as complete. D Print name: 1�., 1i` � �T� � 4114, L Date: 0 1 ' '1 1 O * Fee methodology set by Tri -County Building Industry `/ Service Board. I \Bmidmg\Pemits\FPS- PermttApp doe 12/03 440- 4613T(I I /02/COM/WEB) . 411 City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done : r .' ° : 1.) ❑ New 2.) Mo ation 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 a " ', : _ ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ ] - J' — 7, B.) Type I Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarin _ . 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): $ 157. 0t Permit fee based on valuation (see attached chart): $ (02. Permit fee based on square footage (D) (see fees above): $ State Surcharge 8% of Permit Fee: $ cj • C70 FLS Plan Review 40% of Permit Fee: $� TOTAL: $ 5/) 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. i•\Building\Forms\FPS Checklist.doc 12/29/03 CITY OF TIGARD 24 -Hour BUILDING t, Inspection Line: (503) 639 -4175 a6 _ cooD(p INSPEbTION'DIVISION Business Line: (503) 639 -4171 BUP 0206 y- 06,5"6.7 Received Date Requested ( c ( AM PM I BUP Location 9 7/% Ii) /T _ S Suite - MEC Contact Person Ph (31,2_.) (e 6 'i 7 9 V PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner LC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler • Fire Alarm Susp'd Ceiling -' �� Roof Other: Othe - - ' • WO •� PART FAIL : ING I 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 . Q Reinspection'fee of $ required be •re next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please cal ' or reinspec ' • n RE: nable to inspect — no access Fire Supply Line 4 ADA \ Approach/Sidewalk Date �» Inspector / Ext Other: Final DO NO REMOVE this inspection record from the job site. PASS PART FAIL