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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT 114 ; COMMUNITY DEVELOPMENT Permit #: FPS2010 -00142 • I {CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2010 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address: 9524 SW WASHINGTON SQUARE RD H08 Project: H & M Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Fire sprinkler protection for new TI with water curtain at escalator. Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC 9095 SW BURNHAM 2235 FARADAY AVE STE #O TIGARD, OR 97223 CARLSBAD, CA 92008 PHONE: 503 - 684 -2928 PHONE: FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - COM 11/16/2010 $317.40 12% State Surcharge - Building 11/16/2010 $38.09 Type of Use: COM Plan Review - Fire Life Safety - COM 11/16/2010 $126.96 Class of Work: ALT Type of Const: IIB Occupancy Grp: M Height: 28 ft Stories: 2 Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Yes Hazard: LT Density: 0 Design Area: 0 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: Tota $482.45 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $22,665.00 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 obt copy of the rules or direct questions to 0 NC by calling 503.232.1987 or 1.800.332.2344. 41/1 Issued By: Permittee Signature: / / Call''= 9.- by 7:00 a.m. for the next available inspec on date. This permit card shall be kept in a conspicuous place on the job site until ompletion of the project. Approved plans are required on the job site at the time of each inspection. "Building Permit Application � 1 � ^� , Fire Protection System FOR'OFFICE.USE ONLY I City of Tigard CO Received DateB : /� O Permit No.: /�jOS Po/0 - /4/9- 13125 SW Hall Blvd., Tigard, OR ' It, =Y Plan Rev ew Phone: 503.639.4171 Fax: 503,59Z�'':I ) ��� Date, y: �� � Other Permit: i. � !/Q. —(0 /9 Inspection Lie : 503.639.4175 �1 6 Date Rea.'i' y: ' — Juris: El See Page 2 for TIGARD w\ V �A Internet: www.tigard- or.gov \v0 G O Notified/Method: .. ..0 t' Supplemental Information . Sl �"YIT w J s ', r s as. of ... e x Rifi,wPE OF W ® `.. i � i �. - .,.. SQUIRED DATA ,Ix ? 2 FA1VgLY DW,' $ r_,. < „�.,,..s ...4y ... -�a. ._ - �s:#,.'d3 ? „c� ,mz., .,,. re�Tsu� �r3Y€��sr_, .: ❑ New construction ■?10 < `olition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all d di ti on/al ter ati on/r ep 1 a c em ent ❑ Other: equipment, materials, labor, overhead, and the profit for the F - V P� work indicated on this application. .w f_ � 3. � �r ` , CATEGORY yOF CONSTRUCTION „ 3 ^ de r ❑ 1- and 2- family dwelling Commercial/industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: SV r'`, "t - - ” ' "' ” ' - - Total number of floors: ` s IO,B SITE : INFORMATIO N A Nll LOCAT Job site address: 9524 Sw 14461,0 /air)0 Sip r u) ; New dwelling area: square feet City/State /ZIP: -06 A a D / 0 9`72 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: I-I- t M 1: I , Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet L r REQ II2 D DATA COMAIERCIAL USE�CHECI{I IST` 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 ,DESCRI��j wq uC f -) r work indicated on this application. .s , Valuation: $ 2 2 4, (� 5, `�� • /i 5 � ,v � W I ' p, ► i -0+ .t- I .r.G/`YI -- )12--M-1 A 1 e- Existing building area: square feet . l -r , IAA New building area: square feet • ❑ PROPERTY OWNER , ltt ❑ TE15AN '� x R "' Number of stories: d . _ . - c *A ..A. Q4. , 3 ii m. , ; ,...,. -11.. ,.... �. m s . Fti >.... Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ✓ A PLICANT a ' � £k .. . r f.F - ... , z� ❑C A ,, w ka PEItSON l : ; ' � d.. -, .,,. NOTICE ; Business name: (� _ R . 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: ( ) • I Fax:: ( ) E -mail: e � 0 1 CONTRA , r y . �� s , w . , , BUI L ➢I NG P ERMIT FEES i o Tr Business ltillb R.- .., , o .,,. ,44.x. .a y� / 7l ����� ©_ n „,(E ase're/ei -to J ' , 'b name: �J,��i �� /�/ !.(" ',� / � ?., ' 1 � ,(J ,• f , Permit f ee: �� ?, Q Address: 91-)q5 ;j4 l s , � p 9 State surcharge (12% of permit fee): 3�- ,, ity C /State /ZIP: Z z J FLS plan review (40% of permit fee): // 9 Phone: (563 ) 684- — Z.9 Fax: (9)3) 6,,„2„4_ - q(,S 7 • (Due upon application.) / °t - CCB lic.: , 4 07 7 Total permit fees: 7 a , .v5 Authorized signature: • Amount received: i' _ This permit application expires if a permit is not obtained V � /tom — J Date: / 1 — //t, — D within 180 days after it has been accepted as complete. Print name: � * Fee methodology set by Tri- County Building Industry Service Board. I: \Building\Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(1 I /02 /COM/WEB) • 4 City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe #work to bedone'fi x �x�,s' 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. a lteration 11+ heads: Plan review required. ❑ Repair � Number of sprinkler heads: Additional description of work: ? ,� 4 . Type o£Systern (Corx�plete A B G�or�D _ appllc A , CotnrnerctalS rinkler��y�� x R ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B `) „ Tyj I Hovd F Sup p> es sxo $y s fi eaaa .., �' . , V ._ *Twf Hood Project Valuation: $ lift,Ant C )F Al arrn�3 3 3 q a Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ D Residen F tial S priiikler (St .Alone System y n ,.., - 44, Square Square Footage: Permit Fee: 0 to 2,000 $187.50 2,001 to 3,600 $232.50 • 3,601 to 7,200 $292.50 „i , "rt, r 4 k' 7,201 and greater $381.50 ' Sprinkler Project Square Footage: sq. ft. ' _ ��? - �Flre Protection Permit •Fees, k 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/ cit hall / departments /cd /docs /FPS- PermitApp.doc 2