Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 a COMMUNITY DEVELOPMENT Permit #: FPS2012 -00039
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/23/2012
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9573 SW WASHINGTON SQUARE RD B06
Project: The Limited Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: (51) 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 03/15/2012 $156.00
12% State Surcharge - Building 03/15/2012 $18.72
Type of Use: COM Plan Review - Fire Life Safety - COM 03/15/2012 $62.40
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 03/15/2012 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 03/15/2012 $5.00
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 $244.12
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $7,761.00
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 " • , the rules
or direct questions to OUNC by calling 503.232.1987 or 1.80x.332.23-:
Issued By: ermittee Signature:
Call 503.• •" 7:00 a.m. for the next available inspecti • date.
This permit card shall be kept in a conspicuous place on the job site until • . mpletion of the project.
Approved plans are required on the Job site at the time of eac Inspection.
i - Building Permit Application
Fire Protection System FOR OFFICE USE ONLY
IN City of Tigard gy�' �' DateBea ' Permit No.: �'� O _ . _i it
13125 SW Hall Blvd Tigard, OR 97223 �] J ^ 1� �� '
(� ` t Date/Beviewl ",- mi�� Other Permit: ( ' //. , /_. ,
Phone: 503.639.4171 Fax: 503.598.196 1 J
TIGARD Inspection Line: 503.639.4175 Mai 1 D ate Ready : ® See Page 2 for
Internet: www.tigard - or.gov \` � lU ` ' ,, 3 /Z d'a F Supplemental Information
-. - -
. - , A71ID
Tl < PE ;OF �• ... • ; `�REC1UII2EDD�iT:A:,1= 4ND.2 =F Y4.4EL'1;134G: '
❑ New construction ❑ Demolition Permit, fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
X Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
r = :• .,=.; ` ;•_ " •CATEGORY' OF CONSTRUCTION • _ _ work indicated on this application.
El 1- and 2-family dwelling
y elling Commercial/industrial
Valuation:
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Oth Number of bathrooms:
J.OB:- SITE INFORMATION AND:LOCATION , Total number of floors:
.. ... . mod' ,
Job site addres :: 095 1 it , SQ , , - New dwelling area: square feet
City/State/ZIP: --[78 rte g72z 3 Garage/carport area: square feet
Suite/bldg. /apt. no.: Project name: -171 `� z_l l — t Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED'1) TA: COMMERCIAL USE 11ECICLJST -
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
' . , I . DEESCRIPT OF •W OFK',,. , , -.., , , work indicated on this application. /_
v, 5PIZ A//z `- � Pi l i ' ) s
Valuation: $ / 4/ /i
.�L P/.%--c...., Existing building area: square feet
New building area: 5 5 square feet
" ❑,.PROP.ERTY. OWNER., '- . it TENANT ' , Number of stories: -
Name: Type of construction:
Address: Occupancy groups:
City/ State/ZIP: Existing: t RC- -- 7 - 4 C_
Phone: ( ) Fax: ( • ) New: Re j,g-y
�.f+L'I'P.ICANT ❑ :CONS ACS PERSON "
Business name: • i" C/ e..- 741Z)12... All contractors and subcontractors are required to be 1 '
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. 5 *::,_
„ .. ..- -.._ .. .,... .. �;'Bl]ILDINGP.ERMT1 �' _�� "� �
`
,, . ", '•L':. ' - V `� ` � . ,. (P%ase're�araojce,�sc /iedide r - ' :y• `
Business name: 14 14- r f' p� v et lr N ) _ .,• ., 1' .• .• . _ ..
Address: 9091 5 ii
- 6k/ 6utivi 5 -r Permit fee:
City/ State/ZIP: (� %�� 172 9'7 Z� 3 State surcharge (12% of permit fee):
/ FLS plan review (40% of permit fee):
Phone: (503) ‘54.. -'z_cyZg Fax: (9)3 B 4 — 9b57 (Due upon application.)
CCB lic.: , 4077 Total permit fees:
Authorized signature: . received:
This permit application expires if a permit is not obtained
Print name: �(/0 4)� � T Date:B -/5' Z within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1: tBuilding \Pertnits.FPS- PennitApp.doc 03/23/06 440-4613T(11/02/COM/WEB)
" •
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
e*0*t0 done
1.) New 2.) Modification to sprinkler heads only:
111 Addition fl 1-10 heads: No plan review required.
1:] Alteration a heads: Plan review required.
Repair
Number of sprinkler heads: 5/
Additional description of work:
Type of System ;
A.)1 Commercial Sprinkler
Wet D Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Fire Suppression System
Hood Project Valuation:
C) Fire Alarm
• . „ • r
• • - •
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
ResicktitiOl,:Sprinkler (Stand Alone Si,sterri); '
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.
Fird Fees ';. .
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.
hap://www.ci.tigard.or.usicity_hallidepartrnents/cd/docstFPS-PermitApp.doc 2