Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
Ill • COMMUNITY DEVELOPMENT Permit#: FPS2014-00132
T t C;A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2014
Parcel: 1S 135BA00102
Jurisdiction: Tigard
Site address: 10206 SW WASHINGTON SQUARE RD
Project: Destination XL Subdivision: OAKBURG Lot: 9
Project Description: Fire sprinkler modification of approximately(86)heads for new tenant.
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR SQUARE TOO LLC
9095 SW BURNHAM 401 S.WILSHIRE BLVD.
TIGARD, OR 97223 SANTA MONICA,CA 90401
PHONE: 503-684-2928 PHONE: 310-899-6437
FAX: 503-684-9657
FEES
Description Date Amount
Specifics:, Permit Fee-COM 08/20/2014 $166.76
12%State Surcharge-Building 08/20/2014 $20.01
Type of Use: COM Plan Review-Fire Life Safety-COM 08/20/2014 $66.70
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 08/20/2014 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 08/20/2014 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .15 Design Area: 1500
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 $262.97
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $8,981.00
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•- • • • NC by calling 503.232.1987 or 1.800.332.2344.
Is ued By:
4 Cif i Permittee Signature:
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 Annlicati Fire Protection System 1EGEIVED FOR OFFICE USE ONLI
City of Tigard ) 2L'14 �e/Bd �, // 1
AI IG y, g l/ Permit /4: 9.0lCI —(.�r!',j�
:. .- • 13125 SW Hall Blvd.,Tigard,OR 97223 V Plan Rev1�EP 7 Q /
Phone: 503.718.2439 Fax: 503.598af OF D Data/By. � Other Permit: u��0� —�U�cev
Inspection Line: 503.639.4175 V s r` Date Re ® See Page 2 for
lIGA121) �_
Internet: www.tigard-or.gov BI MI( � 11S No et �Q/�y �� Supplemental Information
vvtLvn�v� / 577��
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,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation:-and 2-family dwellin g Commercial/industrial
Uindustral S
❑ 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:10206 SW WASHINGTON SQUARE RD New dwelling area: square feet
City/State/ZIP:PORLTAND,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:DXL 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.
FIRE SPRINKLER DROPS IN NEW DROP CEILING FOR T.I. Valuation: S$8,981.00
Existing building area: square feet
New building area: 0 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: ORDINARY 1
Phone:( ) Fax:( ) New: ORDINARY 1
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Payne licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::( )
E-mail:a.payne @wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name:Wyatt Fire Protection
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:64077 Total permit fees:
Amount received:
Authorized signature:
This permit application expires if a permit is not obtained
Print name:Ashley Payne Date:8/5/14 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
I.Building g Permits\FPS-PermitApp.doc Rev 01/05/2012 440.46131(11/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
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: $.6
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group ORDINARY 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 8981
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: - $
D.) Residential Sprinkler (Stand Alone System)
Square Footage: Permit Fec:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
C:\Users\Ashley\Desktop\Permit Applications\Tigard App.doc Rev 01/05/2012 2