Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 '` COMMUNITY DEVELOPMENT Permit#: FPS2022-00114
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/20/2022
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9677 SW WASHINGTON SQUARE RD C05
Project: Levi's TI Subdivision: None Lot: None
Project Description: Installing sprinkler heads
Contractor: \WATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC
9095 SW BURNHAM BY MACERICH RET
TIGARD, OR 97223 PO BOX 4085
SANTA MONICA, CA 90411
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/20/2022 $177.52
12%State Surcharge-Building 09/20/2022 $21.30
Type of Use: COM Plan Review-Fire Life Safety-COM 09/20/2022 $71.01
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/20/2022 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 09/20/2022 $6.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: No Hazard: LT
Density: 0.2 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calm Provided: Cut Sheets Required:
Total $277.83
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $9,325.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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 the 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 952-001-0090. You may obtain a copy of the rules
,
Issued By: 4. Permittee Signature: `� is i
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Building Permit Application oECCIi V r
Fire Protection System f�t G FOR OFFICE USE ONLY
n
City of Tigard AUG 1 it.) Received
eis a yin/dam PenttitNo_: 1 13 j
y L'
1114/ • 13125 SW Hall Blvd.,Tigard,OR 97223 la Review
I Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGA tniny: 4_ is...-1-2_ Other Permit:
rlt.A.P.I1 Inspection Line: 503.639.4175 BUILDING DIVIS Ready/By: C., kris: HSee Page 2 for
Internet: www.tigard-or.gov Notified/Method: 1 qAi ) Supplemental Information
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ I-and 2-family dwelling 0 Commercial/industrial
❑Accessory building El Multi-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:910139W Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard Garage/carport area: square feet
Suitebldg./apt.no.: Project name:Levi's Wash Sq Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
•
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: 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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $9325
Adding heads for tenant improvement
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
IN APPLICANT 0 CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ronin Campbell licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard, OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:( )503.684.2928 Fax: :( )503.684.9657
E-mail:r.campbell@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer to fee schedule,
Permit fee:
Address:9095 SW Burnham State surcharge(12%of permit fee):
City/State/ZIP:Tigard, OR 97223
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077
Total permit fees:
/J rf f R. Amount received:
Authorized signature:fV1(
�W/ I\ This permit application expires if a permit is not obtained
Date:8/18/22 within 180 days after it has been accepted as complete.
Print name:Ronin Campbell * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Buadmg'Permits'FPS-PmnitApp_031016.doc 440-4613T(11/02/COM/WEB)
RECEIVED
AUG 18 207
City of Tigard: Fire Protection Permit Checklist CITY OF TIGARD
Page 2- Supplemental Information BUILDING DIVISION
Describe work to be done:
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 40 Number of alarm devices:
❑� Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3)copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑■ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type SSP-QR ❑■ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑■ Yes ❑ No
Hazard Group Ordinary
Density 0.2
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $9325
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 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
W:\Permits\Pemut Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2