Permit , �! CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
` -4 C OMMUNITY DEVELOPMENT Permit #: FPS2012 -00016
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2012
, Parcel: 1S 1260000300
Jurisdiction: Tigard
Site address: 9636 SW WASHINGTON SQUARE RD G10
Project: Buckle Subdivision: Lot:
Project Description: Modification of (62) fire sprinkler heads for TI
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC
9095 SW BURNHAM BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 02/01/2012 $220.56
12% State Surcharge - Building 02/01/2012 $26.47
Type of Use: COM Plan Review - Fire Life Safety - COM 02/01/2012 $88.22
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 02/01/2012 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 02/01/2012 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $344.75
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $13,900.00
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 .9 of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
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Issued By: ' Permittee Signature:
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Call 503.6' " 7:00 a.m. for the next available inspe . on date.
This permit card shall be kept in a conspicuous place on the job site un completion of the project.
Approved plans are required on the job site at the time of each inspection.
,, ,,Building Permit Application RECEIVED
Fire Protection System FOR OFFICE USE ONLY
Iii City of Tigard FEB - 1 2012 Received / Permit 2 i a ,
v - �� DateB l 4
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rev ew /
Phone: 503.639.4171 Fax: 503.598. CITY OF TIGARD DateB j` t� 2 '5 12_ Other Permit: a �
TIGAR
Inspection Line: 503.639.41 Date Read ]aria: 0 See Page 2 for
P BUILDING DIVISION :y: ? /., ki
Internet: www.tigard-or.gov Notified/Method: ` , Supplemental Intormafion
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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
$m6ddition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
"-,. : " =s s >s< °i: wor indicated ntlusapplication.
z:. ten. ,�P. .
~, , f; K? ^GA TE ORI' OF `C NSTR T101Y #< 3 F ,, ;,, ' on PP
III 1- and 2- family dwelling , Conunercial /industrial
Valuation: $
❑ Accessory building Ill Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
r �r�s:d E r, ,: -.,a ; :a. ,;;z `,;n f-N . ;fin Total number of floors:
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�_ �' WAJB;'' SITE` > INI+ - 'OR114ATiONAND LO.CA'T10N: ;- .
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Job site address: 9 5k/ Ail - , CO. New dwelling area: square feet
City/State /ZIP: /'h D / o 9 7'Z z? , Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: ' bUCH,_ 4__r- '- _, Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
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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
���3 ....Aa af�:' _ a�,':V: i!- N,- ;c' -'i3, v >i,:'� ":h -: y,NE.�,� >�5.. ,�. = =� equipment, materials, labor, overhead, and the profit for the
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- D`ESCRII' % %' :O ,,,itt . >-, work indicated on this application.
4 -h b Vo/c_- f�T t' �68 • z a Valuation: $ / / 9 ® - -.)
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__ t j - ) • Existing building area: ! square feet
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� New building area: square feet '
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®- . PR(?PEttTY' �W1 ' t T Number of stories:
Name: Type of construction:
Address: Occupancy groups: .
City/State /ZIP:
Existing:
Phone: ( ) Fax: ( - )
New:
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L,ICANT �'.00 s
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Business name: , ''� cN i - c72/e.._ All contractors and subcontractors are required to be '
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and maybe 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:
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Business name: '` i< iiii'r °:;,,.'- E " - r'` Please:re era; ce.'�scirediile �; "`;:;::< "1 "," "�;
IPA- /7--- , l/2. l � P,� r r > >'._ .a..
Address: 9 9 5- ' J / 'B V/02/014-71- 5'7 Permi
City 7 2 /State /ZIP: ,47 ` ta 0� 97 ZZ State surcharge (12% of permit fee):
FLS plan review (40% of pemvt fee):
Phone: (903) b -zi --e, Fax: (5 )) 6 - 96. 57 (Due upon application.)
CCB lie.: b. 407 7 Total permit fees:
Authorized signature: C% Amount received:
f �. .
This permit application expires if a permit is not obtained
Print name: v6 6 / 4 - 7 i Date: C)Z _D, — /7_ 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(11 /02 /COM/WEB)
.-
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1 D.esc llRVork to_be done_ ,._ Ea k ba 3
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration 1+ heads: Plan review required.
❑ Repair y
Number of sprinkler heads:
Additional description of work:
Co rn Te.te.�A ,�- =:;C ::orD�;as:a
.�- P', -.. __ �. . > >, �_ -�, �x......pI?
' ha '
❑ Wet ., [] Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Project Valuation: $
W a
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Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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Square Footage: Permit Fee: ;m.;?.: ,.. , ;,i- <<r;;Mirat
0 to2000 $187.50 ' . t aR
2,001 to 3,600 $232.50 °� y ' ':. :F� .;: Fv” ..
3,601 to 7 $92.50
200
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7,201 and greater $381.50 '' , N-t:., <4. ti 'i ~ 4 k , t ,:
Sprinkler Project Square Footage: sq. ft.
. - >d,
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.6 e ,rY ,.. ,..k to S `3$ -:s•: s'`S {v>!F « s�� , �; s�v n., °. �'E'i ',.n?: $e"'`
Fire--Pratectro f:PermltrF” 5... .� x::, .'
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- PermitApp.doc 2