Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
N I C , COMMUNITY DEVELOPMENT Permit #: FPS2013 -00086
Date issued: 06/26/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Modification of (34) fire spinkler heads for TI
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE, LLC
9095 SW BURNHAM BY J C PENNEY 0288 -1
TIGARD, OR 97223 TAX SERVICES
PO BOX 10001
DALLAS, TX 75301
PHONE: 503 -684 -2928 PHONE:
FAX: 503 -684 -9657
FEES
Description Date Amount
_Specifics: Permit Fee - COM 06/26/2013 $112.96
12% State Surcharge - Building 06/26/2013 $13.56
Type of Use: COM Plan Review - Fire Life Safety - COM 06/26/2013 $45.18
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 06/26/2013 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 06/26/2013 $2.00
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 $175.70
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $3,689.00
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 a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: Djj/ / / p / �s�
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
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
RECEIVED ved City of Tigard Date/By: if' aft i3 .� "1/54:16/19-27
Permit No: 6 4 1
r' Il 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review /�
Phone: 503.639 4171 Fax: 503 598.1 44 2 4 2013 Date/By . - f' ► •t Permit: /�ya,Av3'4,3 /
TIGARD Inspection Line: 503.639 4175 Date Ready/B : ]urn 0 See Page 2 for
Internet: www.ttgard- or.gov CITY OFTIGARD Nottfie ethod:40/09i4F / A, Supplemental Information
��11 GDNISION "' /SSQ,
TYPE �F WORTi 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
p i / 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 tgammercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
' JOB SITE INFORMATION AND LOCATION , Total number of floors:
Job site address: 950o $/,_,/ l/, 5q ( New dwelling area: square feet Tip
—
City/State /ZIP: 7 6 / /) / 1 (9� 17 zZ'5 Garage/carport area: square feet
Suite/bldg. /apt. no.: Projec t name: 7.2.f ' l��E- 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: I 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 applicatio n.
1C1_1� i 7 r ii-1 ) • sr P n �, %� > / 2d riA9 Valuation: $ 440A9, ea'
j A / -( 11*f-D5 c i�/ (il �l J., v s Existing building area: square feet
4 /0 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:
J PPLICANT ❑ CONTACT PERSON NOTICE
Business name: � T ea M��� 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: ( ) I Fax:: ( )
E -mail:
CONTRACTOR RACTOR BUILDING PERMIT FEES* '
Business name: - 49 It (7/L) (Please refer to fee schedule, '
Address: '# •r c � (/ ; i • -t Permit fee:
City/State /ZIP: /�1 ke / C)2 q7' 0 . 2 . : 3 State surcharge (12% of permit fee):
L A ! �/ FLS plan review (40% of permit fee):
d
Phone: (03) &g _2 _ Fax: (5&3) b.M - 96957 (Due upon application )
CCB lic.: ! (94 D77 Total permit fees: V / ?S 70
■ Amount received:
Authorized signature:
✓ ✓ //� Thi permit application expires if a permit is not obtained
Print name: 8 ' �' "t �/ 7 ,OC � /�U Date: (.r -24 -1 * within 180 days after it has been accepted as complete.
Fee methodology set by Tn -County Building Industry
Service Board
1 \Building\Permits\FPS- PemutApp doc 03/23/06 440- 4613T(I I /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done
1.) n New 2.) Modification to sprinkler heads only:
0 Addition 1-10 heads: No plan review required.
0 Alteration 0 11+ heads: Plan review required.
[11 Repair
Number of sprinkler heads:
Additional description of work:
-
A.) Commercial Sprink1er
Wet 111 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Project Valuation:
C) Fire AJarfn
4 •17 '
Submittal shall Battery Calculations D Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
-,,„
061011641 Si:414100 •
Square Footage: Permit Fee:
0 to 2,000 $187.50
2001 to 3600 $232.50 0,
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 tigard.onus/city_hall/departrnents/cd/docsrFPS-PermitApp.doc 2