Permit (83) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2016-00009
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/03/2016
Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9477 SW WASHINGTON SQUARE RD A07
Project: Yankee Candle Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Fire sprinklers-modification of(16)sprinkler 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 02/03/2016 $112.96
12%State Surcharge-Building 02/03/2016 $13.56
Type of Use: COM Plan Review-Fire Life Safety-COM 02/03/2016 $45.18
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 02/03/2016 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 02/03/2016 $17.50
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 $191.20
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $3,716.00
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 32.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti 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 961EA911
Cl of Ti and RECEIVED Received , I No.:
ty g
Date/Bv-. Permit 'CA�961&::am
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revi!aly� Other Permit:
Phone: 503.718.2439 Fax: 503.598.1%OjAN 2 1 2016 Date/By. 66&2
Inspection Line: 503.639.4175 Date Ready/bq: Juris: See Page 2 for
Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: pplemental Information
; Wv I R ' -
RE44�]R.Eb DATA;`I. 2FAMILY i'EL IN
A E
OW,
*New construction El 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 El Other: equipment,materials,labor,overhead,and the profit for the
work indicated on this application.
CATEGORY,
A CR S7RIJC71ON1 Valuation: $
El I-and 2-family dwelling 0 commercial/industrial
El Accessory building El Multi-family Number of bedrooms:
El Master builder ElOther: Number of bathrooms:
JOB SITE` Total number of floors:
,INFORMATIONAND LOCATION
Job site address:9477 SW Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:A07 TProject name:Yankee Candle Co Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REWIRED 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
Z!, DESCRIPTION OF WORK work indicated on this application.
RIPT
Fire sprinklers for complete retail TI in mail Valuation: $$3,716.00
Existing building area: square feet
New building area: 0 square feet
0 PROPERTY OWNER'�.. 0 TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Ordinary 1
Phone: Fax: New: it
Iff APPLICANT CONTACT PERSON
NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishihara 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@wyattrire.com
CONTRACTOR
BUILDING PERMIT FEES*
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:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Ashle .Ishihar V Date:1/21/2016 within 180 days after it has been accepted as complete.
Fee methodology set by Tri-County Building Industry
Service Board.
1:\Building'\Pcmits\FPS-PermitApp.doc Rev 01/05/2012 4404613T(I 1/02/COMAVEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe workto 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: 16
Additional description of work:
T" e of S stem Com' lete`A,B .0 or:D asa` licable •`` 'w ' ` ' `
A.) Commercial Sprnlder µ j
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 3716
B. _ Type I- Hood Fire Suppressioii System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Batte Calculations ❑ 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 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater 1 $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 onsquare 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