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Permit
u CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT F '` COMMUNITY DEVELOPMENT Permit #: FPS2013 00027 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2013 Parcel: 1S 1260000300 Jurisdiction: Tigard Site address: 9618 SW WASHINGTON SQUARE RD G -5 Project: Helzberg Diamonds Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S Project Description: Add & relocate approximately 26 fire sprinklers for TI Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC 9095 SW BURNHAM PO BOX 847 TIGARD, OR 97223 CARLSBAD, CA 92018 PHONE: 503 - 684 -2928 PHONE: FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - COM 02/28/2013 $123.72 12% State Surcharge - Building 02/28/2013 $14.85 Type of Use: COM Plan Review - Fire Life Safety - COM 02/28/2013 $49.49 Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 02/28/2013 $2.00 Occupancy Grp: M Height: ft 11x17) Stories: Info Process /Archiving - Sm $0.50 (up to 02/28/2013 $3.00 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 $193.06 • Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $4,395.00 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 No -- • Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a • •y .f the rules or dire questions to . NC • ling 503.232.1987 or 1.800.332.2344. • Issue. By: , ( '' Permittee Signature: • Call 503.639.4175 by 7:00 a.m. for the next available inspectio • ate. This permit card shall be kept in a conspicuous place on the job site until c• pletion 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 ;j FEB 2 0 2013 . City of Tigard Received Permit No.: / P5��3 — a?yDa'7 1111 �yt ,. Date/By: t I.3 0 13125 SW W Hall Blvd., Tigard, O 97223 C0 1 1 O T G ' ' 1 ' Plan Review ' Phone: 503.639.4171 Fax: 503.598.1961 U O N G Dvisoiki Date/By: "Di Z( Other Permit:&49 /3- I) •.rmAR.D N ° . Inspection Line: 503.639.4175 Date Ready/By: . ]ur /_ " El See Page 2 for . • Internet: www.tigard- or.gov Notified/me 7 p c" : • 00 Supplemental Information �5 2 / TYPE OF WORK REQUIRED DATA: I -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 0—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 .1- ommercial/industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder / ! ❑ Other Number of bathrooms: 116G SITE INFORMATION AND LOCATION Total number of floors: Job site address: 144- sq, �` ) , New dwelling area: square feet City/State/ZIP: l , 7) / ©12_ 9 7 Z-Z3 Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: H 5E,rl 2)/ ONDlS 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK'; ^ _ work indicated on this application. p� 5c6 b ��G /� l- / 6 F Valuation: $ / , - �7 `-C p / -jr4 , /` j/ - � -5 �� - - S P 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: • - ,g—APPLICANT , ❑ CONTACT P . - ., a ,. 'r <, , ,,`;N - Business name: • 6 et)/(11-1b2 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: ./ y �7 2 y p� 1 2D, ` J (Please referlo fee schedule) 9D9 S Sk 6V/L4) /-ti Permit fee: Address: �p � City/State/ZIP: „ne, /v9 &R_ 9 `7 z2_-. -3 State surcharge (12% of permit fee): FLS plan review (40% of permit fee): Phone: (5'03) 6 z el i e a Fax: (593) &O. - b 57 (Due upon application.) CCB lic.: &'4 t77 7 7 Total permit fees: Amount received: / Authorized signature: 2� This permit application expires if a permit is not obtained Print name: .1 / !„-4 --- `m ,.) Date: DZ — l q _ ) - , within 180 days after it has been accepted as complete. * Fee methodology set by Tri -County Building Industry Service Board. 1:\ Building \PermitsWPS- PemtitApp.doc 03/23 /06 440 -4613T(II /02/COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information D -work = to - done,•' . " _ _ 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition ❑ 1 -10 heads: No plan review required. '0- Alteration g. 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: VP Additional description of work: Type of System (Complete A, B, C -or D as applicable): Al) Commercial Sprinkler ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System • • Hood Project Valuation: $ • C.) Fire Alarm Submittal shall Battery Calculations El Yes include: Individual Component El Yes Cut Sheets " - Fire Alarm Project Valuation: $ D.) Residential Sprinkler (Stand Alone System) . . _ • Square Footage: Permit Fee: 0 to 2,000 $187.50 L. 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 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. http: / /www.ci.tigard"or.us /city_ hall/ departments /cd /docstFPS- PermitApp.doc 2