Permit „... BUILDING PERMIT
'CITY P ERMIT #: BUP2002 -00360
_ DEVELOPMENT SERVICES DATE ISSUED: 9/9/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09755 SW WASHINGTON SQUARE RD
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: : sf N: S: E: W: ,
OCCUPANCY GRP: TOTAL AREA: 0.00 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: $ 1,200.00
Remarks: Fire sprinklers
Owner: Contractor:
PPR WASHINGTON SQUARE LLC WYATT FIRE PROTECTION INC.
P.O.BOX 21545 9095 SW BURNHAM
SEATTLE, WA 98111 TIGARD, OR 97233
Phone: Phone: 684 -2928
Reg #: LIC 64077
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Sprinkler inspection
PRMT CTR 8/22/02 $62.50 27200200000 Sprinkler Final
5PCT CTR 8/22/02 $5.00 27200200000
FIRE CTR 8/22/02 $25.00 27200200000 •
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 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -6699 or 1- 800 - 332 -2344.
Perm ittee ��
Signature• / /�✓ LL
■
Issued By: U) r .4 4 o OPeerl
t
Call 639 -4175 by 7 p.m. for an inspection the next business day
•
q - 3 -0 Z.
' B u i l di ng Permit Application
Date received: g 2 02.... Permit no.: A , , ,,4_003( p
2t iy City of Citf Tigar
'__- Project/appl.no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: l Receipt 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 ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler/alarm ❑ Other:
JOB SITE INFORMATION
Job address: q 155" $ . W s 6 1 i - t rS1,TD1. So # 0 , Bldg. no.: Suite no.:
Lot: I Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: — T"-. MOi 1 LF
Description and location of work on premises/special conditions: I Z. H TF NAt 4 T Stvl 91ZOVEtil EN ► r
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST lA ,
Name: PPR, uit.61- VINIGION 3Q QF ., L1.-C- ( Floodplain ,septiccapacity,solar,etc.) k
Mailing address: RO, (30X l3(03 C 1 & 2 family dwelling:
City: I 6 o State: OR ZIP: ct 8, Valuation of work $
Phone: Fax: E -mail: 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: ��t: COm 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: Commerciallindustrial/multi- family:
CONTRACTOR Valuation of work $ l 1-00
A)YA -Tr FIRE- PROTECTIt� Existing bldg. area (sq. ft.)
Business name: 1
N New bldg. area (sq. ft.)
Address: q( s 5,�} gu
City: ""� GP i ) State: p_ ZIP: e('(�3 Number of stories
Phone: 14 - 21/213 I Fax: 4 .c% 1 I E -mail: Type of construction
CCB no.: 12.4011 Occupancy group(s): Existing:
New:
City /metro lie, no.: .13 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: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: Fax: E -mail:
ENGINEER
• Name: Contact person: Fees due upon application $ 9l is-7)
Address: Date received:
City: (State: (ZIP: 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 0 MasterCard
work will be complied with, whe e • - .. ed herein or not. Credit card number: / /
"� /
Authorized signature; / _ Date: 8/2_/02 Name of cardholder as shown on credit card Expires
Print name: R i — FA (LQ RC 1 H & $
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 (6/00/COM)
Fire Protection Permit Check List
A.) ❑ New ❑ 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: 12--
Additional description of work:
Typf „SystemRCorn°pl "ete,:A; ;.674 ap`.pl a6l e)
A.) Sprinkler Wet - Dry ❑
Standpipes
Additional Hazard Group c)20 •
Information Density
Design Area
K. Factor 5
Sprinkler Project Valuation: $ I ZOO
B.) Type I - Hood Fire Suppression System
Hood Project Valuation I $
C.) Fire Alarm _
Submittal shall Battery Calculations Yes ❑
include: Individual Component Yes ❑
Cut Sheets
Fire Alarm Project Valuation: $
Project Valuation Subtotal (A, B & C): $
Permit fee based on valuation (see chart): $
8% State Surcharge: $
•
FLS Plan Review 40% of Permit: $
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 11/21/01
CITY, : T,IGARD 24 -Hour
LDING Inspection Line: (503) 639 -4175 M DIVISION Business Line: (503) 639 -4171 1 .. _ 00 3 (e O
Received Date Requested ` // Z- AM PM p
4 l
Location 17 g� 14) tf ` so, RD Suite MEC
Contact Person Ph ( ) cj - LL PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 71 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
Insulation Drywall Nailing fri\r Firewall
(Eire Sprinkl
Fire Alarm
Susp'd Ceiling
Roof
Ot• =r:
ina
PART FAIL
BING
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: El Unable to inspect — no access
Fire Supply Line
ADA / 11//6
Approach/Sidewalk Date 1 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
Inspection Line:
BUILDING 503 P ( ) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171 _ ass
Received Date Requested 76i AM PM a d2 — CO 3C 0
Location 9 14J K17, Suite MEC
jCUL Ph ( ) F D I SS8 - PLM � !� ' 1 '
Contact Person _
Contr. nr Ph ( ) S 3 7 7 SWR 0 / §/
-..il DI Tenant/Owner (Y\ ELC '
Dung ELC
Foundation ACCeSS:� 6 �
Ftg Drain ELR
Crawl Drain f� e�071,6a - oo 4"/ a � i7/10 6 MEC-.2,0.0 -4 7a
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 711-711 - I 7-0.0 _ Qt _ " V R�
Framing
Drywall on
e � S� C1/ - � / o - Z _ (
Dwal Nailing
Firewall
Fire Sprinkler - p
Fire Alarm 4.
V c.i( w 0 Z — o v (f2, (ciAiNA) Susp'd Ceiling
Roof l
Othe es iciiiap
PART eflc
PL► BING ► ' U[ `-'z■ 7i b Z C� O 37
Post Beam 94 SS q /r/ � I (\9
Under r Slab
Rough In
Water Service - )
Sanitary Sewer
. �� 06 3 - C 1/n U_ s
Rain Drains
Catch Basin / Manhole Co b '/ 1 V 2 C ` IF)
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 9 1 I w'1� \ •
Approach/Sidewalk Date "( Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL