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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT ° =' COMMUNITY DEVELOPMENT Permit #: FPS2010 -00005 T I GAR D 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 02/04/2010 Parcel: 151260000300 Jurisdiction: TIGARD Site address: 9677 SW WASHINGTON SQUARE DR CO5 Subdivision: Lot: 0 Project: Aeropostale Project Description: Add and /or relocate approx (59) fire sprinkler heads Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount 2235 FARADAY AVE STE #0 Permit Fee - COM 01/21/2010 $166 76 CARLSBAD, CA 92008 12% State Surcharge - Building 01/21/2010 $20.01 PHONE: Plan Review - Fire Life Safety - COM 01/21/2010 $66.70 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: IIB Occupancy Grp: M Height: ft Stories: 1 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type" Wet Standpipe Required Hazard: ORD1 Density Design Area: K Factor: 5 6 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type. Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required. Total $253.47 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation" 8612 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 r -s or direct questions to OUNC by calling 5 3.246.6699 or 1.800.332.2344. Issued By: Signature: frANOW Call 503.639.4175 by 7:00 a.m. for an inspection that bu- ne- day. This permit card shall be kept in a conspicuous place on the job site until •mpletion of the project. Approved plans are required on the job site at the time of each inspection. 1 � Building Permit Application l j�� " `. - ` ` / Fire Protection System '' p �p FOR OFFICE USE ONLY AN City of Tigard , Received / �i Per II mit No. '06C46 .200 13125 SW Hall Blvd , Tigard, OR 97223 Oe .50GmA ® Date/B Plan Review / / Phone 503.639.4171 Fax. 503 598 1960 GM A D1V1S'` ® Date /B �i ,i Other Permit. 1 ,/ �R7 TIGARD Inspection Line. 503 4175 a`D1 1`1s+ Date Ready/By luns 0 See Page 2 for Internet: www tlgard -or gov �� Ng9fied/Method. .2/5 to. I • Supplemental Information Z442,41_ Al _,9 _ TYPE OF WORK R QU RED 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, matenals, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling 0 Cpmmercial /industnal El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 96,7T / s � 1 w z IA - 59 ,'�, New dwelling area: square feet City/State /ZIP: 1 16�1. 1/U ✓% © a 9 ` ZZ Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: 467:20p03 T71'(/ 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. I Lot no.: Permit fees* arc 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. ADO /I to /©k 6 octr 4-10#2,_ - 5 9 Valuation: $(,,, SPD / ,l /L / le G� - ti c(� - re s P A- -' Existing building area: square feet /� N I C- �- /'� wv 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: -4 L°Vj(f - rZ i C17 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: is exempt from licensing, the following reasons apply: 1 Phone: ( ) Fax:: ( ) E -mail: CONTRACTOR BUILDING PERMIT FEES* Business name: W y p //�{/ �/L0 r�C7 0 A (Please refer to fee schedule) 917 95 _5w ,3 0/zAh - Permit fee. (�K Address: City/State /ZIP: 12671/21) � 9 7 a'i State surcharge (12% of perm f ee) : �� 1 Q FLS plan review (40% of permit fee): Phone: (5D3) 6764_ - 03 Z Fax: CD 6,54_ 965-7 (Due upon application) o4. 7o CCB lic : f940 7 7 Total permit fees: 4a 5 5 .`f7 Amount received: O ,R5 3.q7 q7 Authorized signature: } 1- �iC This permit application expires if a permit is not obtained Print name: v , /t/E kA--i If 2 Date: 0/ — W — within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board i \Budding \Permns \FPS- PemutApp doc 03/23/06 440- 4613T(I 1 /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition El 1 -10 heads: No plan review required. - Alteration1+ heads: Plan review required. El Repair Number of sprinkler heads: Additional description of work: 5e st 1 Type ofSystem (Complete A, B, C or D as applicable): A.) Commercial Sprinkler El Wet El Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B:) > Type - Ia == =Hood Fire Suppression System �w Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations El Yes include: Individual Component El 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. 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: $ 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 /dots /FPS- PemvtApp.doc 2 CITY OF TIGARD S s C FPs o ZO 10 00a5 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 1 un n tri . 104Ii Inspection Requests (24 Hrs.): (503) 639 -4175 ...,,._,W INSPECTION WORKSHEET FOR DATE: 5 //ib TIME: PAGE: SITE ADDRESS: ' ,77 L €6511 CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: Gv j DESCRIPTION: OWNER: PHONE #: 5 - 7,t- 356 7 CONTRACTOR: PHONE #: caet l_ (9/626, Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message C � 9 SPr 114/kkr --6 1 Cn — U Corrections /Comments /Instructions: • • PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ‘� � r Date: 3 N Phone #: (503) 718- � P [Page Too Large for OCR Processing]