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Permit
M I! CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2009 -00002 Tigard OR 97223 503 639 4171 13125 SW Hall Blvd , Ti Date Issued: 03/05/2009 ?IGARD: 9 Parcel: 1S1260000300 Jurisdiction: TIGARD Site address 9563 SW WASHINGTON SQUARE DR BO2A Subdivision Lot: 0 Project: Gymboree Project Description: Add (3) heads at remodeled entry Owner: FEES PPR WASHINGTON SQUARE LLC Description Date Amount BY THOMPSON PROPERTY TAX SERVUCES, 2235 FARADAY AVE STE #0 Permit Fee - COM 03/05/2009 $62 50 Tax - 12% State Surcharge 03/05/2009 S7 50 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: ALT Type of Const: Occupancy Grp. Height. ft Stories. 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 Calcs Provided Cut Sheets Required Total $70 00 Valuations Required Items and Reports (Conditions) Sprinkler Valuation 625 Residential Square Footage 0 Fire Alarm Valuation 0 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 he 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 -0100 You may obtain a copy of rule or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344 1 Issued By. 30 t[I.U.P1> n Permittee Signature: A ge Call 503.639.4175 by 7 a.m. for an inspection that bu ess day. This permit card shall be kept in a conspicuous place on the job site un it completion of the project. } Approved plans are required on the job site at the time of each inspection Building Permit Application Fire Protection System FOR R OFFICE USE ONLY City of Tigard x NI Permit No: 2 Dat 2 7 `1 ,0000z v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review _ Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit: TIGARD Inspection Line: 503.639.4175 Date Ready/By. Juns H See Page 2 for Internet: www.tigard- or.gov Notified/Method 1 I Ckr Supplemental Information - TYPE OF WORK 'REQUIREDDATA:1= AND 2- FAMILY DWELLING El 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 . CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ ❑ 1- and 2- family dwelling ECommercial/industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder q 5 (, ,,. 3 ❑ Other: Number of bathrooms: .JOB' SITE INFORMATION AND' LOCATION r Total number of floors: Job site addres . 5K t4 i SQ t R D New dwelling area: square feet City /State/ZIP: -116 -1) © R___ 9 7-22. 3 Garage/carport area: square feet Suite/bldg. /apt. no.: 4 ' - / f Z Pr ject name: & y T M g o j j Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED`D'ATA:'COMMERCM- USE @HECKLIST 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. .• 4bD i !' i �� ft /2S tom' � Valuation: $ 6 27 ` -TO ✓� A. ` iR / � y /� Existing building area: square feet 1 New building area: square feet ❑ PROPERTY'- OWNER . ' -' ) ENANT - Number of stories: Name: y m e P Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: - PPLICANT '.❑' CONTACT'-PERSON. _ Business name: .- �9©� 7 --, me .„- ii --„, e __ 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: wi:- , r _-='4 l" - _ ' .:CONTRACTOR', r ' -_ -_ .. , ,- BUILDINGiPER MIT �FEES * ' - ' Business name: wY,4 f pl P/�- 7 C-TJO� - lP,kdse.`reje o(e.e'schedulel c;; - �- ^ ©7 6 5 b H--,472-7 Permit fee. /_r� Address: � / J' lU City/State/ZIP: - c34 t J 04 972 ZS State surcharge (12% of permit fee): 7 -SO `L /� / J / FLS plan review (40% of permit fee): Phone: (5 3) ‘..„F54 _ 2.9 Z 8 Fax: 3) (p,3 - 9057 (Due upon application.) CCB lic.: 624077 Total permit fees: 70. 00 Authorized signature: Amount received: �^'� -� This permit application expires if a permit is not obtained (/ 'E// Print name: Date: e) 3 -of- - ei 9 within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I \Budd,ng\Perm,s\FPS- PemutApp dot 03/23/06 440- 4613T(11 /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information - — iblV 1.) New 2.) Modification to sprinkler heads only: Addition 10 heads: No plan review required. El Alteration El ii+ heads: Plan review required. LI Repair Number of sprinkler heads: a Additional description of work: A.) Commercial Sprinkler ,:=T„ e:yr m lcte , Wet LI Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ Hood Project Valuation: C) FixetAlrm L.; Submittal shall Battery Calculations D Yes include: Individual Component I=1 Yes Cut Sheets Fire Alarm Project Valuation: $ ' YlkesitfelifiaLSpririkler Square Footage: Permit Fee: 0 to 2000 $187.50 2001 to 3600 $232.50 3,601 to 7,200 $292.50 -„; 7,201 and greater $381.50 Sprinkler Project Square Footage: sq. ft. 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 ugard.onus/city_hallidepartments/cd/docs/FPS-PermitApp.doc 2