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Permit g CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2011 -00042 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2011 Parcel: 1 S 1260000300 Jurisdiction: TIGARD Site address: 9640 SW WASHINGTON SQUARE RD G11 Project: Hanna Andersson Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Modification of approximately (19) fire 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 $112.96 12% State Surcharge - Building 03/24/2011 $13.56 Type of Use: COM Plan Review - Fire Life Safety - COM 03/24/2011 $45.18 Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 03/24/2011 $2.00 Occupancy Grp: M Height: ft 11x17) Stories: Info Process /Archiving - Sm Sheet (up to 03/24/2011 $7.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Gales Provided: Cut Sheets Required: Total $181.20 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $3,045.00 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 Notifi n Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain - •p of th- rules or direc uestions to U calling 503.232.1987 or 1.800.332.2344. / lssu By: Y Perm ittee Signature: �/ Call 503.639.4175 by 7:00 a.m. for the next available inspectio date. This permit card shall be kept in a conspicuous place on the job site until c *1 pletion of the project. Approved plans are required on the job site at the time of each inspection. Building Permit Application lei` F i .. Fire Protection System FOR OFFICE USE ONLY Received City of Tigard �� DateB : A i / PemutNo.: /� ���Qy/� _ .1 13125 SW Hal] Blvd., Tigard, OR 97223 sss��� ' Ph one: 503.639.4171 Fax: 50 3.598.1q� �! Plan Revie • ,Cj 1� Date/By: (� _ 5. /t Other Permit: TIGARD I Line: g 03.639.4175 �y P `L� Date edlMe y /� / Supplemental H pP ementalInforma See Page 2 for Internet: www.tigard or.gov Notified/Method: l6on \\\\ ,:c* ,�() I� w� 4 ' TYPE OF WOxRJ tJ1R D 1 A ND 2 F AMILY DWELLING ❑ New construction ❑ Denco tOO\:' Permit fees* are based on the value of the work performed. 1 _ Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Oth equipment, materials, labor, overhead, and the profit for the OF CONSTRUCTION work indicated on this application. .:� ... .:,CATEGORY ..: r3,. a El I- and 2- family dwelling Eommercial/industrial Valuation: El Accessory building ❑ Multi- family Number of bedrooms: ❑ Master bu CI Other: Number of bathrooms: l� der JOB S ITE ; INFOR11,4 ATION AN D OCATION ar Total number of floors: Job site address: / . J 5 IA/A_ IA/A_ SSC? New dwelling area: square feet City/State /ZIP: -f' n 0 / 02 9 7223 Garage/carport area: square feet Suite/bldg. /apt. no.: project name: -l4 bt - Ari.iiez. s' 0,c/ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet 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 ',aa equipment, materials, labor, overhead, and the profit for the ES ! a ip , �. " mom. �. wank indicated on this application. ADD k L °It R- , 1 Valuation: $ AI , 7)4_57 p/2-1 M K e iii e i .i) ../ -7— Existing building area: square feet 1 q * ( 1 -0 Y e New building area: square feet • � m x.�u ,�' � a+ s� ,�r��s t � x � - �` �:' 4o`�s 'at.•,t r w �i �. .., i e. £ O lA Number of stories: ,g ,Ap, .,,i, i . y, i:,. � 4 r s. 4 :w.,: , ;%,< : _ .. ,:ac mac. , F.,a,:i r, Name: Type of construction: Address: • Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: ., PPLIC � . t , r .❑ Q R # ''' . ' f ICAN n e, 0 1T4 T O 'i NOTICE W .f ,k .' Business name: 5 -t),(t (_1?) 4 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?' - r i * � ��x t, � ., �.` � $UILDING PERMIT • FEES •; � - �_- (Pl fee scl : "ed rele2 . Business name: I/c M / / / p�C-L� - 5 O /© ii,z ° Permit fee: Address: q C) 9) sW 13 L)gAi M1,?) 4..._ S / � Q State surcharge (12% of permit fee): City/State /ZIP: -7-7 j g /, / G' 17 Z - FLS plan review (40% of permit fee): Phone: (5 ) E ! Z g j i- 2 Fax: (50 3) e g¢ -9 (, 57 (Due upon application.) CCB lie.: 6 77 Total permit fees: Authorized signature: �� e. f //114/---------- Amount received: �/ 51. P O /T This permit application expires if a permit is it/ obtained Print name: t Pe E / /� "A Date: 3 -z4-- /I within 180 days after it has been accepted as complete. EA/ C * Fee methodology set by Tri- County Building Industry Service Board. I:\ Building\ Permits \FPS- PemutApp.doc 03/23/06 440- 4613T(11 /02/COM/WEB) A. ity of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information „.. „.., Describe v;ior1c'ie..be dOne':': 1.) 0 New 2.) Modification to sprinkler heads only 0 Addition 0 1-10 heads: No plan review required. 0 Alteration 11+ heads: Plan review required. 0 Repair Number of sprinkler heads: 19 Additional description of work: . q - r 345'6'1. S . kif e *X.C 6 :Iiiii. 1 :4. 6 4;'.0k0:14 ,11 04T41 311661 4igletrA 9 141%':: WrZ .!p:Nokiriorrraotyvvswoqtowowf4yt:v::,„: 4,4•40*„i, - :Arr : ..z‘."-r,, .0 Wet 0 Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor • Sprinkler Project Valuation: $ tw!..! 14 ,',1V-A,V,q:,::. : 1kc ."V=L.AtphgtritnS~t2:IV:VA.VESfftWNEegtt4ti24VW — , Hood Project Valuation: ' — Awe-r , ',64,iciaiii, foltv, It VAtit4MITI: :!t:.0kOr:4 , 4 - ave4 4 6.41 , k;Z:v4Z41.141 5 % , 2fIthiatplliVP; " ..tifiir4VMPAKVe q't 'Or 'rem ° Submittal shall Battery Calculations 0 Yes include: Individual Component D Yes Cut Sheets Fire Alarm Project Valuation: $ ",!" .,1,ZZ,VMWMT*0MgirniEVA.MMVA, V*11. %te. A4e$441.1;\ VkaniAfeiA.UOVP*=X*AttttViPaP'tk*.'Vrl:VAAfaVi.tkl";,n:'iia'agnie:Art%F:ViaO: : "44 IA! ',I*0■42444. 4'''9::7*.t.11;"S."14*?*°tOlIONP4AgtOtatigWVAIRaggi*Ada,,I:atOttiSeeetkOVM:rKie - -ii.Dpitiat'britiiikleitt(Saiial:v 1 S • uare Foota:e: Permit Fee: ,..zzerow,T3IMPTIMIEriMAIMIR . :4104430,w:twowt .';''-.31Aws;:ukti;v4l*tzlozito 0 to 2,000 $187.50 iiiittellengtaieVIMEWK. W:',101444.040 2,001 to 3,600 $232.50 4.4.$41100VtitilfeSV:'Vt. 3,601 to 7,200 $292.50 a. •:4;44•to 1 111. ::4M4. • *".•• 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. Fire Prote&io Permit Fees 4P 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.usicity_hall/departments/cd/docs/FPS-PermitApp.doc 2