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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT s p Permit #: FPS2011 -00041 COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2011 Parcel: 151260000300 Jurisdiction: TIGARD Site address: 9534 SW WASHINGTON SQUARE RD H -12A Project: AT & T Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Modification of (24) sprinkler heads. Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC 9095 SW BURNHAM 2235 FARADAY AVE STE #0 TIGARD, OR 97223 CARLSBAD, CA 92008 PHONE: 503 - 684 -2928 PHONE: FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - COM 03/24/2011 $123.72 12% State Surcharge - Building 03/24/2011 $14.85 Type of Use: COM Plan Review - Fire Life Safety - COM 03/24/2011 $49.49 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg Sheet (over 03/24/2011 $2.00 Occupancy Grp: M Height: ft 11x17) Stories: 1 Info Process /Archiving - Sm Sheet (up to 03/24/2011 $2.50 11x17) 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: Total $192.56 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $4,010.00 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 or direct ions to ■UNC b calling 503.232.1987 or 1.800.332.2344. Issu d By: - f / Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspect • n 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 - E?c ` � E T , i a_ - e- Fire Protection System OFFICE USE ONLY Received 1 11111 City of Tigar Date/B : �� Permit No.: `� ��QC! : ° 13125 SW Hall Blvd Tigard, OR 9722 a\ Plan Review �� Phone: 503.639.4171 Fax: 503.59 "� �rlC\. Date/B %r�`L�r % �� Other Permit: TIGARD Inspection Line: 503.639 A Date Ready e' a ` Jury: a See Page 2 for Internet: www.tigard or.gov G `_ S� Notified/Method: 1 ✓ f/ Supplemental Information P 6„ s)N ., � � t / ,/ l i 7 t_'Y 6 6b// . , TYPE OF WO ± r .s Q[IIRED DATA 1 AND 2 FAMILY DWELLING ❑ New construction ❑ Dein Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the Y :'"CATEGORY OF CONSTRUCTION - ` ` work indicated on this application. El 1- and 2- family dwelling Commercial/industnal Valuation: $ ID Accessory building El Multi-family Number of bedrooms: El Master builder ❑ Other: Number of bathrooms: JOB SITE - INFORMATIONS AND LOCATION " t Total number of floors: Job site address: 9A3fit .(/t} 144 , 5Q, New dwelling area: square feet City/State /ZIP: 1l1=74# / ) . re._ f 7lZ3 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name:AT5 I 5 © p ..... z2 Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet g -tw A + R Q S.E � E I -m I . A 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 * 1 i. i:N ah m r equipment, materials, labor, overhead, and the profit for the t $ A , S ! �' work indicated on this application. A Alvo/(9I . � : c4- 7 ; Ai, x ' , 4 Valuation: $ 4 1 ) 1,n , 41:16 s pikile a=�Y� 5 /. -) -� elov Existing building area: C/ square feet f v / 4 116-44---7(>1—. New building area: square feet ` '' ittni " O - 64: t� ` r i Q » 't Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) /-a New: . I'I' LICAN ' s q � , _ ,..7- OONT, T P D X 4 ,M4 .� .711 e _ :: { 1 Al - 0 . 41 'w4.401iitrapIRWIRMYROMNAM Business name: S . 6 etM7 C Tn/2_ 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: O :....., " V..i CONTRACTOR ri x ... ` _i . l UIL G DIN PER FEES* } Business name: ,.: (Pteaserefar to fie sch edde, . , Address: 9v9 S sw kotemilltitm 5 Perot fee: /State /ZIP: 17 �./� State surcharge (12% of permit fee): ty Z J � � C Z � FLS plan rev (40% of permit fee): (5p Phone: Fax: S 3 (Due upon application.) CCB lic.: (046 77 Total permit fees: Authorized signature: C Amount received: iq . Thi perm applicat expires if a permit is not obtained Print name: eU,,.,„ �7 Date: 3 -24-- � + within 180 days after � it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I:\Building\Permits \FPS- PermitApp.dac 03/23/06 440- 4613T(11 /02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information D'escribe be " done: 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: z4 Additional description of work: Type of System (Complete A, B C or 'D as applicable): A.) Commercial Sprinkler ❑ Wet ❑ Diy Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System q _. . ; t. Hood Project Valuation: $ ir e'" ar ia s ? � � , �. , 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 $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 Fes 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- PermitApp.doc 2