Permit •
RP CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00001
- Date Issued: 03/05/2009
3 GARi) 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9665 SW WASHINGTON SQUARE PfrCO2
Subdivision: Lot: 0
Project. Aritzia
Project Description: Demo (3) uprights at removed wall, and add (1) SSP at new restroom
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES,
Permit Fee - COM 03/05/2009 $62 50
2235 FARADAY AVE STE #0
Tax - 12% State Surcharge 03/05/2009 $7 50
PHONE
Contractor
WYATT FIRE PROTECTION INC
9095 SW BURNHAM
TIGARD, OR 97223
PHONE 503 - 684 -2928
FAX 503- 684 -9657
Type of Use:
Class of Work: 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 $70 00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation 0
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 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 -0100 You may obtain a copy of the ules
or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344
Issued By 1. \.ctzs c lallfg s Permittee Signature: /./�/
• Call 503.639 4175 by 7:00 a.m for an inspection that busi •ss day
This permit card shall be kept in a conspicuous place on the job site until 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 OFFICE USE ONLY
- Cl of Tigard Received r 5 PernntNo.: 1
V 131 Hall Blvd., Tigard, OR 97223 Plan Review Other Permit: • Phone: 503.639.4171 Fax: 503 598.1960 Date/By:
TIGARD Inspection Line: 503.639 4175 Date Ready/By. Juns. El See Page 2 for
Internet. www.tigard-or gov Notified/Method: - T((. 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
Addition/alteration/replacement ❑ Other: equipment, matenals, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1 - and 2- family dwellingommercial/industrial
Valuation: $
C1 Accessory building CI Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 96,6 5 .5 w 144. , . . t RD i New dwelling area: square feet
City/State /ZIP: fl( f f o Di e_ 9 72,23 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: AKA. 1 ) 4 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.
•
.Dean 0 3 vPAG --F S �- •R-e/YIDI/1-D w/t-1 -1— Valuation: s /& , `
A- 0 0 9 .5 P CJ /t-A) R -rRooki• Existing building area square feet
New building area: square feet
' ❑ PROPERTY -OWNER _._' TENANT - Number of stories:
Name: 12_I f 4 Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ' - "® CONTACT PERSON _ NOTICE
Business name: S e- 70/Z-- 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 • _
Business name: BUILDI111G,P.ER�111T'FEES* -
1,.../),(4_,----,- 7 (Ekjdr, to.feelscheduT2 ' '
y� F �� 1 ���V . dse- re Permit fee: ( y
Address: 9V 95 S ki /-J L�/eA)/./;� '/
City/State/ZIP: ' D/z 9 7 22-3 State surcharge (12% of permit fee): 7_ So
FLS plan review (40% of permit fee):
Phone: (t3) & 54 — 27� Ea Fax: (503) 6,E, — 96G-7 (Due upon application.)
CCB lic.: 6, ID 7 7 Total permit fees: 70.
Authorized signature: aoll' 1 Amount received:
This permit application expires if a permit is not obtained
Print name: t06 A c i ar ' //.. N Date. O3 -05-09' within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
L\Budding\Permits\FPS- PermitApp doc 03/23/06 440- 4613T(i 1 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
xi
1.) U New 2.) Modification to sprinkler heads only:
Addition ig-4-10 heads: No plan review required.
eg_Alteration U 11+ heads: Plan review required.
Repair
Number of sprinkler heads:
Additional description of work:
BCprD , as ,applicable):, 4
L 3 •
•<;i9
ht; ; Commercial Sprinkler
'
Wet U Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
y s _e ,
Hood Project Valuation:
F ire • 0,•• °„.°' : - :-; .
r • t'i, Y., - 7
Submittal shall Battery Calculations U Yes
include: Individual Component U Yes
Cut Sheets
Fire Alarm Project Valuation: $
'1
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50 r
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 tigard or.usicity_hallidepartrnents/cd/docs/FPS-PermitApp.doc 2