Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111 a COMMUNITY DEVELOPMENT Permit#: FPS2014-00183
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/19/2014
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9487 SW WASHINGTON SQUARE RD A05
Project: Auntie Anne's Pretzels Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Fire sprinklers,modification of(3)heads
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 11/19/2014 $56.47
12%State Surcharge-Building 11/19/2014 $6.78
Type of Use: COM Plan Review-Fire Life Safety-COM 11/19/2014 $22.59
Class of Work: ALT 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 $85.84
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $635.00
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
applicab All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
i ance, or if worci`�is, suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center.' .Those es are set forth in OAR 952-001-0010 through OAR 952-001-0090. You - o.tain a copy of the rules
or direct questions to OUNC by ling 5 . 2.1987 or 1.800.332.2344.
Issued By: r Permittee Signature: y I
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.
1
Building Permit Application CflVEP
Fire Protection System l., l 1+ G 1 ► FOR OFFICE USE ONLY
City of Tigard NOV 1 9 2 014 Dace�g� /�Ilk/ t Permit No.: '�j/ . /93
:. - •• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review !!
Phone: 503.718.2439 Fax: 59 11111) G(}•TI.Akll Date/By: Other Permit:'5� i-Av/;1343
I I \1,1, Inspection Line: 503.639.41751.11 I�Jl'TIGARD Date Ready/13y: _Tuns: ® See Page 2 for
Internet: www.tigard-or.govBUILDING DIVISION Notified/Method: 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 perfonned.
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.
dwelling Valuation: $
❑ I-and 2-famil y g ®Commercial/industrial
❑ 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:9487 WASHINGTON SQ RD New dwelling area: square feet
City/State/ZIP:TIGARD,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:A05 Project name:AUNTIE ANNE'S 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.
Add and Relocate Sprinklers for TI Valuation: $$635.00
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: ORDINARY 1
Phone:( ) Fax:( ) New: ORDINARY l
CO APPLICANT ® CONTACT PERSON NOTICE
of
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*
Business name:Wyatt Fire Protection (Please refer to fee schedule)
Permit fee: 56.4,
Address:
City/State/ZIP: State surcharge(12%of permit fee): eP:2V
FLS plan review(40%of permit fee): a
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:64077 Total permit fees: .,(
Amount received: ff gs�
Authorized signature: rie.____ This permit application expires if a permit is not obtained
Print name:Ashley Payne Date:11/19/2014 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\PermitsYPS-PertnitApp.doc Rev 01/052012 4404613T(t1/02/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:
El Addition ® 1-10 heads: No plan review required.
▪ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 3
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
® Wet El Dry
Additional Standpipes
Information: Hazard Group ORDINARY 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 635
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 Fee:
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
City of Tigard Permit No.: 41.5A9/1/-te l�J
III • 13125 SW Hall Blvd.,Tigard,OR 97223
• Phone: 503.718.2439 Fax: 503.598.1960 Date Received:
e9,, .,
I_ �\l) Inspection Line: 503.639.4175
Internet: www.tigard-or.gov By:
FIRE SPRINKLER AFFIDAVIT FOR ALTERATIONS
OR TENANT IMPROVEMENTS
(1 to 10 SPRINKLER HEADS WITHOUT PLANS)
Project Name: Auntie Anne's Occupancy: Food Prep
Job Address: 9487 SW Washington Square Rd Type of Construction:
Suite: A05
Contractor: Wyatt Fire Protection Phone: 503-684-2928
Number of Proposed or Altered Heads: 3
Type: SSP Hazard: Ordinary 1 Density: 0.15
I, Ashley Payne, Wyatt Fire Protection Oregon Construction Contractors Board No. 64077
certify the following is true and reasonably defines the scope of work for this project:
a) All work is limited to drops and armovers in a light-hazard occupancy.
b) Positions of sprinkler heads relative to architectural features such as soffits, beams, partitions, walls, etc.
complies with current adopted edition of NFPA 13.
c) The proposed work does not require hydraulic calculations.
d) Only one sprinkler head will be installed from one drop (exception: up to two heads from one drop may be
installed when each head is in a separate fire area).
e) The area covered per sprinkler head is limited to the spacing requirements of NFPA 13.
f) Tenant improvements in a new building shall be equipped with Quick Response heads (see 2002 NFPA 13,
Section 8.3.3.1 for exceptions).
g) The installation shall comply with the requirements of the current adopted edition of NPFA 13.
h) Piping shall not be concealed until hangers and bracing are inspected.
i) Final approval shall be subject to onsite tests and inspections.
In addition, I understand the following is required:
• Submit(3) copies of a sketch showing the area of work within the building's structure.
• Building fire protectio I stem permit.
• A copy of this docu' ent w i h a copy of the sketch attached shall be available for all inspections.
t► 19 IV
Signature: 1`�'� � � Date:
Print Name: Ashley Payne
I:\Building\Forms\FireSprinklerAffidavit_071514.docx Page 1 of 1
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9487 SW WASHINGTON SQUARE RD A05,
TIGARD, OR, 97223
Commercial - Fire Protection System
999 Sprinkler final
PASS - No C of O
FPS2014-00183
Jeff Grove
Violation Summary:
Inspector Contractor