Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
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COMMUNITY DEVELOPMENT Permit #: FPS2011 00094
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/21/2011
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9627 SW WASHINGTON SQUARE RD FCO2
Project: Sonic Subdivision: WASHINGTON SQUARE MALL Lot:
Project Description: Modification of (5) sprinkler heads for new tenant.
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC
9095 SW BURNHAM BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
CARLSBAD, CA 92008
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 07/21/2011 $72.61
12% State Surcharge - Building 07/21/2011 $8.71
Type of Use: COM Plan Review - Fire Life Safety - COM 07/21/2011 $29.04
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
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 Calcs Provided: Cut Sheets Required:
Total $110.36
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,238.00
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
issua • - , or if work uspendee for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uti Notification Center. h•-e ru are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a co • the rules
of direct questions to OUNC b .ailing :13.232.1987 or 1.800.332.2344. /
i
I sued By: �C !� Permittee Signature: p /
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completi. of the project.
Approved plans are required on the job site at the time of each inspection.
Building.Permit Application
Fire Protection System RECEIVED ,
F OR OFFICE USE ONLY
/J n / / �/
City of Tigard Received DateBy: / 02� m vtNo.: `'�� �
v
13126 SW Hall Blvd., Tigard, OR 97223 JUL 21 2 0 1 1 Plan Review Permit
Permit: 4 , // d 1
- Phone: 603.639.4171 Fax: 603.698.1960 Date/By: :
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: IRI See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
mot; K `g? ii;ra �'V la . Ak aV x t LURED DATA 1 ,
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❑ 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
\ ' "' " ` ' ' a g 9 E ? work indicated on this application.
CATEGOAtY' OF CONSTRI ..IT � : pp
. .4mz s s�...� :� _. °r. . ..�. e�z't� ...... , a�� ... ..,�� _�: a . >,...� �.: x . .z..,.�; � �.*M.i.etgit &a...,.?M -s:
❑ 1- and 2- family dwelling Qonunercial/industrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Mastcr builder ❑ Other: Number of bathrooms:
fi ,a3 9 - w a 51 "' ITE�INFOR111ATION AND t A' +, & � `� c«a OCATION y V .' Total number Of floors:
t, . a JOB ` _+ �,F ,i l
Job site address: 7585 .511,q 1J j ,, Ja - , 5 , o , New dwelling area: square feet
City /State /ZIP: --fl Gi ) l // 97 z_-z_ `� Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: 6-0 L - 1,g_t..L L , kt Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
0 I Dr` C®MMERCrIAL LISE5CIinki 1014ii
_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
equipment, materials, labor, overhead, and the profit for the
K
;a�g x �_ l %V z DESCRIP=TION O U l'ORK��. F ��m work indicated on this application.
r aze ,r :. * s . ,_ it : , , ..0 n. .. e, 4, ,,,x. s x.. stma the .. k�. _ a n
Valuation: $
c � I IA- n 5` 5PntMl-c s .5 fl i Z 3
'p 1 >D ", S P ---, Existing building area: square feet
New building area: square feet
• b, e f �. uY'ty�u, ` ,� � m � -.. � a r � fi"S�` , 4f 1 as4* =. �1 1} t
1'ROPEI2TY 0� NER I „ - . ` TEN t _ { Number of stories:
<
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: - Existing:
Phone: ( ) Fax: ( )
New: .
mummakkat si PLICANT CONT CT 1'E:RSON s , a xu
Business name: • 5 c -b/o 74 - fc,_ 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:
f t „g 4 Y t 0 3 'CONTRACTOR{ "` V 3 1 • T
e= i '`.,, � a �.;. t a < . x x . sr:.ez�r.: .,w.:_.:.�. tr t � .....z ,,r.: ...hulk �v .°�. + iiii s � f 'BUILDING PERMIT FEL'S `1 R � t ��`,,�'
Business name: ty�-` Y"l�r, P//() i� C.7' /t.,,c/ p (Tease.rejar,to, jee,scf�ediile) .,
` Permit fee:
Address: ?DC). S Six/ , t),A) 5 ,
/State /ZIP: �e y� G� State surcharge (12% of permit fee):
Ci
ty , ! " � � / 6 / _ ' ` . 3 FLS plan (40% of permit fee):
Phone: (g�1 3) &F,1 2 _ Z c ) Z ed Fax: ( 3) to t 4- - 96, 7 an review
upon application.)
CCB lie.: 4 - 7 Total permit fees: tt
Amount received: # ( LO / 34
Authorized signature: - e:___--
This permit application expires if a permit is not obtained
Print name: (✓V�C /x,/1— Date: - al l within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\ Building \Permits \FPS- PermitApp.doc 03/23/06 440- 4613T(I1/02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Descrrbe work to be done _ r° , g " t ' 'm
1.) ❑ New 2.) Modification to sprinkler heads only:
El Addition 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
T me t£ e- stei `C lefe A B' C a z Fe Fern
tr '''u �s'r sv�
A AA) Commercial Sprinklkr" * x -
� T tMAMV S , ,
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
• K. Factor
Sprinkler Project Valuation: $
ka, XF 3 s - s 4 "" — , at
`B. ,41zypejI Hood Fire "Suppression ystera i, � ��'� i - � r x
- - oo - Project Valuation: $
. C / � �`1 z k ' a - e iv "" * � '4441-41:4*- 'eke
3 Eire�Alarm , R � : �. r ,
Submittal shall _ - - -_ - __Battery Calculations- - -- El Yes ---- -- - - -- - • - - -
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
' i "` ,e, , - F * S weggr `m o' a ` F' € s `, a ,�" ' �- "�� ' .r r `�. `mss ` -form
.., •*
a Residential Sprinkled(Sta�nd dlie'S � g ., rjt omvllP � .
Square Footage: Permit Fee: i, � .
$187.50 �s vt
0 to 2,000 ��
2,001 to 3,600 $232.50 �t��, a
3,601 to 7,200
7,201 and greater • $381.50 i k, :40 6,0 0 01�
Sprinkler Project Square Footage: sq. ft.
` '_ e Sa ra. , . x ,�� 3 v ,
x_ . e t, , : ..,th �� ..Fg. v O„ F ]CE Pr otection PegA114 ees> ::'A ..1„ , 4 ...go4a . ,, „rt o4;
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.
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http: / /www.ci.dgard.or.us/ city_ hall/ departments /cd /dots /PPS- PermitApp.doc 2