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Permit
,.. r. CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT a .-;, COMMUNITY DEVELOPMENT Permit #: FPS2009 -00102 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 10/27/2009 Parcel: 1 S 1260000300 Jurisdiction: TIGARD Site address: 9538 SW WASHINGTON SQUARE RD H14 Subdivision: Lot: 0 Project: Orange Tree Yogurt Project Description: Add /relocate (9) fire sprinkler heads for TI Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount BY THOMPSON PROPERTY TAX SERVUCES, 2235 FARADAY AVE STE #0 Permit Fee - COM 10/27/2009 $102 20 12% State Surcharge - Building 10/27/2009 $12 26 PHONE Contractor: WYATT FIRE PROTECTION INC 9095 SW BURNHAM TIGARD, OR 97223 PHONE 503 - 684 -2928 FAX 503 - 684 -9657 Type of Use: COM Class of Work: FPS Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required. Sprinkler Type. Standpipe Required Hazard: Density Design Area: K Factor: Commercial Fire Alarm System: Fire Alarm Required: Alarm Type Pull Station Required Smoke Detectors Req: Battery Calcs Provided Cut Sheets Required: Total $114 46 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation 2525 Residential Square Footage: Fire Alarm Valuation 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 - : - _ -. er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of the ules " or dire questions to 0 • by calling 503 246 6699 or 1.800.332 2344 / Is ued By: / i I Perm ittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspection that business d . This permit card shall be kept in a conspicuous place on the job site until co • etion of the project Approved plans are required on the job site at the time of each i spection. Building Permit Application Fire Protection System FOR OFFICE USE ONLY City of Received permit No.: /6 � /� III 13125 SW Hall Tigard Blvd., Tigard, OR 97223 p xi R v i ew D • Phone: 503 639.4171 Fax. 503.598.1960 DateBy: Other Permit: TIGARD Inspection Line: 503.639 4175 Date Ready/By: I ' H See Page 2 for Internet: www.tigard- or.gov Notified/Method: //7 Supplemental Information TYPE OF WORK 'REQUIRED DATA:1 -- AND 2- FAMILY DWELLING ❑ 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 CATEGORY OF CONSTRUCTION . work indicated on this application. ❑ 1- and 2- family dwelling Xommercial/industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: 9532 JOB SITE INFORD'IATION AND LOCATION Total number of floors: Job site address: 91400901S. s 14 w IY l r $ ' D • New dwelling area: square feet City / State/ZIP: f 1(Al2- o / 0 / 9 7 Z .. Garage/carport area: square feet Suite/bldg. /apt. no.: 1+1 4. Project name: D 1 ( YotSDL-T Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST 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 DESCRIPTION OF WORK' work indicated on this application. A AA) Die- �i/l2 -I Ap -/ q Valuation: $ � 5 Z' , , Pi � 1� / / E /z- friCiot-D s Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER - ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone: ( ) Fax: ( ) New: APPLICANT .0 CONTACT PERSON . NOTICE - Business name: .5E6 eav lie - D,.... 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' . „- :. BUILDING. PERMIT FEES* Business name: VV y� ` / p`, pRO7 /i / / net/ (Pleaserefer, to fie-schedule) ' f �" `� / a Permit vt fee: � • AO 9� 57 Address: 9 , vV I/ City/State /ZIP: L 6 ( 4 7 ©/2 g 7 Z..- State surcharge (12% of permit fee): /A 6 p � FLS plan review (40% of permit fee): Phone: (50) 6e4 29�o Fax: (5D3) 6,,m - 96 57 (Due upon application.) CCB lie.: &40 7 7 Total permit fees: //19. y ( Authorized signature: ��.e Amount received: This permit application expires if a permit is not obtained Pnnt name: 6 /,_4 jJ Date: / — 2.6 D / � within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I \Budding\Permits\FPS- PeenutApp doe 03/23/06 440 -4613T(I1 /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information , Describe work to be d�ne: 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: 9 Additional description of work: i - Type of Sys�tern "( A, B, CC ,or ID as - applicable): • - • A.) Commercial S piinkler , ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Ty,pe = • I=Iood,Fire.'Suppression.System'- Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ ~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 Tees, ' ° : • , - 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.cn.ngard.or.us /city_ hall/ departments /cd /docs /FPS - PermitApp.doc 2