Permit (43) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1111
COMMUNITY DEVELOPMENT Permit#: FPS2017-00058
T
[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/30/2017
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9591 SW WASHINGTON SQUARE RD B10
Project: Victoria's Secret Subdivision: None Lot: None
Project Description: Add and relocate fire sprinkler heads as required 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 05/30/2017 $242.08
12%State Surcharge-Building 05/30/2017 $29.05
Type of Use: COM Plan Review-Fire Life Safety-COM 05/30/2017 $96.83
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 05/30/2017 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 05/30/2017 $10.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: 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 $379.96
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $15,943.00
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 503.232.19: : .:::. 2.2344.
Issued By: Permittee Signature:
Ca 3.639.4175 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 unti completi•• roject.
Approved plans are required on the job site at the time of each ins ion.
/04,4A/ / V/ J
Building Permit Application
Fire Protection System RECEIVED FOR OFFICE USE ONLY
g Receivedt�
City of Tigard MAY 1 2017 Date/By: / . 7 �� Permit No.: p-105,16/7...�)`]/�ti X
111 13125 SW Hall Blvd.,Tigard,OR 97223 vvV V
p Plan R- tew
Phone: 503.718.2439 Fax: 503.598.19 Date/By Alf (7�t 7 Other Permit:Aii,,,,, 7_,0 0�,
Inspection Line: 503.639.4175 eITY OF TI GUARD l I gi See/�Page 2 forf
T I G A R D
Date Rea: ;,L.„, t� /� Juris:
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: ) /it/1 7 Supplemental Information
x , ,;. WORK, rs µ REQUIRED DATA 1- ND 2 FAMILYDWELLING,
0 New construction 0 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 0 Other: equipment,materials,labor,overhead,and the profit for the
rv,: CATEGORY OF'CO STRUCTION 2 work indicated on this application.
EI1-and 2-family dwelling ®Commercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION 44'''' _.
� ; Total number of floors:
Job site address:J585'SrW Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:B10 Project name:Victoria's Secret WaSq TI 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 '. ; ., fi; work indicated on this application.
Add and relocate fire sprinkler heads as required for TI Valuation: $$15,943.00
Existing building area: square feet
New building area: 0 square feet
4 '-*0 PROPERTY OWNER si+= 00 TENANT* ' ';" Number of stories: 1
}k.
Name: Type of construction:
Address:
Occupancy groups:
City/State/ZIP:
Existing: Ordinary 1
Phone:( ) Fax:( )
'ii CAN�r , i .
New: ',
F ,. �, APPLI ® CON'PACtPERSON* _*, w, � ,� �� �.
NOTICE �
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Max Colley 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:m.colley@wyattfire.com
_
t, �� TOR .4' ",
� �, ;.:-, �-' `�CONTRAC s< :� � x , �BIIILD�i(rPERMIT ES* i
\ (Please refer to jhe schedule) '; �
Business name:Wyatt Fire Protection ,..,,
Address: Permit fee:
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: 7 Amount received:
This permit application expires if a permit is not obtained
Print name:Max Colley Date:4/28/17 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613T(i1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
DestribecvOik to be tlori :`' t
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: 118
Additional description of work:
e of System-(Complete A,B,C;or D aapplic�ible) � i.
A, ) Co nmerrial.Sprinkler } , " 4
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 15,943
B)`.`Type Z- od Fire Suppressi System e.
Hood Project Valuation: $
C.) Fire Man � 41' , *
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
ape"
44 ,
)J( Md iat-Spunkier(Stand Alone, ys � " P_
Square Footage: Permit Fee: "
0 to 2,000 $198.75 * a
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.
4v4xFire PrQtecitjoPerini "Fees ;� � 41.4
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.
W:\Max\1112 PERMIT APPLICATIONS\Tigard App.doc Rev 01/05/2012 2