Permit ph ° ' CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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a COMMUNITY DEVELOPMENT Permit ft: FPS2010 00014
T t G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/11/2010
,....c.;:,: Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9702 SW WASHINGTON SQUARE DR F10
Subdivision: Lot: 0
Project: Sprint
Project Description: Relocate approximately (7) heads at TI.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 Permit Fee - COM 02/11/2010 $51.09
Permit Fee - COM 02/11/2010 $13.45
PHONE: 12% State Surcharge - Building 02/11/2010 $7.74
Contractor:
WYATT FIRE PROTECTION INC.
9095 SW BURNHAM
TIGARD, OR 97223
PHONE: 503 - 684 -2928
FAX: 503 - 684 -9657
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $72.28
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 920
Residential Square Footage:
Fire Alarm Valuation:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued By: I 1 Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that busin• s day.
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
Fire Protection System FOR OFFICE USE ONLY •
" 1 f i :I Received
City of Tigard � � I . , 4 F 1 I Date/By: No.: �10 ,
v 13125 SW Hall Blvd., Tigard, OR 97221 ` '' ''':a • Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: N , Q Oc
FEB 11 2010 Juris: ® S ee Page 2 for
TIGARD Inspection Line: 503.639.4175 D ate Ready /By: �--{- g
Internet: www.tigard- or.gov Notified/Method: 1 I� Supplemental Information
CITY OF TIGARD .
TYPE OF v>DING DIVISION REQUIRED DATA: 1- AND 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
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
❑ 1- and 2- family dwelling );4- (commercial /industrial
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder Q O2 ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / �e,e--_, 614 JA�, -cC + /_!� Y'``.D , New dwelling area: square feet
City /State /ZIP: I/ (7 / /1-12_i) ) 0 2 9 711'3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 6pgi I Q / j , 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.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
� n �" DESCRIPTION OF WORK work indicated on this application.
Ret, y� C am" Tc/ APP, F �/ r `-- 7 5P4 fi / 10 / S . Valuation: $ 9 20, °C
1 0911 /- ,7)C L r : Existing building area: square feet
CC ��ll /J 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:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: e9 i ij -- 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: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) ' Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: )/J r4 1' f /�� 7 - .7 CA/
(Please refer to fee schedule)
j/,{ / 2AJ/ -/4 /�� fl Permit fee:
Address: 9095 S a),
� D � State surcharge (12% of permit fee):
City/State /ZIP: 97 Z Z 3
FLS plan review (40% of perniit fee):
Phone: (503) /- Fax: 5D3) 664 9b-7 (Due upon application.)
CCB lic.: 7 4077 Total permit fees:
Amount received:
Authorized signature: ,<Ze- /
This permit application expires if a permit is not obtained
Print name: �� YY
r 1t//t/ �—/ 2 1. f
/ 6 � Date: oz _/1 — /C:0 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry d
Service Board. �'7 2 -2 v �1
1:\ Building 1 Permits \FPS- PernsitApp.doc 03/23/06 440- 4613T(1I /02 /COM /WEB) /
City of Tigard: Fire Protection Permit Checklist _ C ��\\
Page 2 - Supplemental Information ris G6 i
• Describe work to bedone:`,.. '
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition - -10 heads: No plan review required.
°alteration ❑ 11+ heads: Plan review required.
❑ Repair 7 Number of sprinkler heads:
Additional description of work:
,Type of System Com .lete;`A, B C or D as „a ircable
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B:)” Type I„ Hood -Eire .Suppressibi System; ._._ W
Hood Project Valuation: $
C ); Fire Alarm �'
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D. Residential S rinkler Stand Alone stern
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $29250
7,201 and greater $381.50
Sprinkler Project Square Footage: sq. ft.
° Fire 'Protecttont 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: $
Plan review requires a completed application and 2 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.
http: / /www.ci.tigard.or.us/ city_ hall / departments /cd /docs /FPS- PerrnitApp.doc 2