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Permit ,, CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2011 -00062 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2011 Parcel: 151260000300 Jurisdiction: TIGARD Site address: 9502 SW WASHINGTON SQUARE RD J03 Project: Wetzels Pretzels Subdivision: WASHINGTON SQUARE MALL Lot: 0 Project Description: Relocating (8) sprinklers. Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE LLC 9095 SW BURNHAM 2235 FARADAY AVE STE #0 TIGARD, OR 97223 CARLSBAD, CA 92008 PHONE: 503 - 684 -2928 PHONE: FAX: 503 - 684 -9657 FEES Description Date Amount Specifics: Permit Fee - COM 05/20/2011 $51.09 12% State Surcharge - Building 05/20/2011 $6.13 Type of Use: COM Plan Review - Fire Life Safety - COM 05/20/2011 $20.44 Class of Work: ALT Type of Const: Info Process /Archiving - Lg Sheet (over 05/20/2011 $2.00 Occupancy Grp: Height: ft 11x17) Stories: Info Process /Archiving - Sm Sheet (up to 05/20/2011 $5.00 11x17) 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 $84.66 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $1,605.00 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 obi.. copy of the rules or direct questions t• • - NC by calling 503.232.1987 or 1.800 - 44. Issued Byz.---- Permittee Signature: Cal 5 by 7:00 a.m. for the next available insp-r tion 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 . r • F i r Protection System � i s - FOR OFFICE USE ONLY C' N1 Received v trp� • ' City of Tigard - „ p ° ✓- Pernvt No,: �" " WV G , 1_, • 13125 SW Hall Blvd., Tigard, OR 9722 Phone: 503.639.4171 Fax: 503.598.1960 v � 0 �1 Pan Rev Review / �� MP 7 . y , Other Permit: i �i11)10i-Gion33 Date/By: ,�I� Wl TIGARD Inspection Line: 503.639.4175 P e►'il Date Ready/By: Juris: See Page 2 for • Internet: www.tigard- or.gov �� O�'�� `f � i c ��O� Notified/Method: Supplemental Information „ V J -,tom _� tr.x- �. � . -. . M- ^��.... ^...... _. ::.,: > -.-., ,., i`t�s� s`� ,:x - •- �_: : :: - :: s� M .z` - _ � ' jz " "_ °`i:2 ', TIEE:QF ^'.W ' y ,. =`s : ,v `: RE f/1' UIRED ;DAT :.5 = 2 F Y;D,,VEL;I:ING,, , ,,, ' `i ' �'fi' ::fir �'-� >< <.r -. ,s . ,.., a �_`.�..,� ., '"," -. . ,�C .� .. � =u :,,,,; _ _,y, ; <1 �.w sW ''' :.� - .- _ 1 .. ,4 " , g aa = +. _ ,>, "' -_. Vii.. - ,.,. _ , , , ... . ... ...... . .. .. .n .... .., . • ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. ���� Indicate the value (rounded to the nearest dollar) of all j �ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the Fz't ,, ? . z.: -,,n xi, r„ Mz t_ux Nn>aekza :az :: :sty ,. ; :z ;:,�, 4 -�, , � *� �:�. �- ; � ` i ; � ,,�_,:, -�r,> , wor i on thi app , = 0x , ° ';CATEGORI ` OF' , C'O N STRI1GT10N,3'Wv;<*e'.:. ; ' ° „ ,s,;-,-; . �� �3?i�=����,a <r;a�?;�:,�:�:- s'��:,�w;r,��^-,`��.a:t,__ . -; a��-= � = r =: s- �: a , �_: �; ��rz��;::�`���'."��a�t= -�` ...,..,.- - -- Valuation: $ ❑ 1- and 2- family dwelling -6ommercial/industrial [11 Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: Total number of floors: 3'JOB` SIT : >I v I311 1 TI , ND" , 1. :_: ,' ", =, ,°, _- � s. t :' ,. . s "'� ' �� �:., E< A 1V` ,:. A I.O < C; A7'1UN;.,, <: : >.f:�::,�� �.�;�:� �:� � ;:L:` =:1..� .., ...,'...� :'< .. ,.,,.<=a F ��`�rn.,�r , :��a _, fir: =x �;.k �, �' . Job site address: 2 SUi f (� e` �� 5: t D .. New dwelling area: square feet City/State /ZIP: 17 & 0) / 7 9 7 z_?.._ 3 Garage/carport area: square feet Suite/bldg. /apt. no.: 3 Project name: �5 ' r R'r/ [ S Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet ,. EQC ; TA, COi11 '`` 7p�,, lY : HI;I f .,, r <�, �lfi:k , , •�' i .::�,'u><`*%' ".'ea:., :'�•:,.� „t >, ,- Aaaa�<o-a•:: <*,':w, ,a - _,�., s. } =� ..,. ,..,. +,a 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 `„ <r^ - ^- and the profit for the ,. , • 3i` .:.,; ` .3' °- is ".,.,,r �5;1c \:::'Fp�ifi,. ^?^ i'�2s -M`8, < . x ^°;: _ equipment, K'=” w,�� ,�: ,, , V- <a,,, -�:�. equtpment, materials, labor, overhead, a e r �, .tt'. %a l x'� t .,� F ., as,: V '='. ", F „:DESCRIPTION OF 'WC1 C,, .�'<=::'��f' =< ” ' 9 a: work indicated on this application. Valuation: $ I F 17 Aa •:(_-- /ei r te _ Existing building area: square feet New building area: square feet ° T�al°':� :: <� "� >: rb nt�xn �,;�:�, si < h: ,� c., ' '' rt£ ° �,"�"f'�;:'. C:'.:H: ayx Number of stories: ; PRO PERTYn ., `, ' b)V1VLE2 ', N > _-` ries: . , ;,.E. - " ,., .. .,, ..< .:r,t.,y;?t�:. ,.r : -, r e§,�t .N' :< �" i ". � +i * :lri�.l;; yi . � t;+fv' t: i �t Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: :3�,L .,a'.x :=�;ig : *� � . , s: � mE; ;¢, ;.�.�. <:�';,, - s>�: --�«r. ' =r� •>:'` &ii,'•:attt.�b,,,w,z ;, a ..s- < ;a� .o-`3' �.,.xx >, . ,...: .x ,3 Diu „ y> y ',x'�. 1T o';,u,. .^ €; -5 °'' �a'`:.` ld ?v ` i` 3' t.: �';s<+�t: 3i8`,s' „ -' Z <P PPLIGA a �- G O N T �: C �:�a > ;��� .�,. , >� "�`<'�i .,,,��t :�i ,, a,.,> "�' >�" > x.. ..��^ . . . -. • . ,... • . �. � „ ,�s`x, ,.. >:. - . , .. � _ „,..);,,,j:,„ t;x, •��' < ... <. �,' *� .'.e;t °n °;� ,1 .� ,, . , �. ,F ' _.; >: a - ; ,''Sgi, < ;. ,�;d -; Via.,, ri a t ;w :A.L : to S t:. v ; z -;7". (? l .'` `E A;%* t Business name: G{'xi"r��� 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: ( ) • Fax:: ( ) E -mail: :': :>; <' to m`reev z>`, ' 7 . ;. !,tea: CONTR r> ACTOR:: � , Business name: Y `�,. �.= x;;;. , �" B ^' ILDIN u I'ER1V11'TtF'E Y 1— i / �,. / ,t.1 7 --- - ! g2r" >'s�'„ .,,. - .. .,; ( Pleas ,re f er. toJee'sellediile).,` < x`: '` _., Address: q © y, , )/Z4 ` ,L j .5 -r Permit fee: p � State surcharge (12% of permit fee): City/State /ZIP: T ,o > &Z c) 7 u3 FLS plan review (40% of permit fee): Phone: ( 503) (er - Z9) Zc , Fax: (5D3) ( 6 4– — 96 57 (Due upon application.) CCB lic.: )4() 77 Total permit fees: • pi K Authorized signature: X .". 7 Amount received: This permit application expires if a permit is not obtained Printname:,,&4'526/ ---- ..,6 y 74 -- ) Date: 5 -/ —11 within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. I Building \PermitstFPS- Permi1App.doc 03/23/06 440- 4613T(I I /02 /COMJWEB) ' City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information . = . k > . �. :.:" escr be,vork to:b don - -.- .r:..�. "�i > s .izxa �3�`E;� ```�"E @'.s3��E11^ 1.) ❑ New 2.) Modification to sprinkler heads only: m ❑ Addition ,- __-10 heads: No plan review required. 'Slteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: Additional description of work: >�. T ype pfSystem w (Complete G;oraDNasa ' livable , ., .,�.�,. ,.<.. ._.�:=n,.... �:- awe-.. .. M ,r�" ;- ".,.., >. >,-,- ..a.. e -.a>; :.-: �'@ ��'?�'� :>x�i:�'.']F,a�w� ,��,,, ere�a •��:'rr •�E�; :- ..�r:_ - <:, ;_..,,, , „`?,. - �3``. -: :.. „•2 er, - -s - �'�S -:� .,apt. �`'�:. =a>�4: "€�>.._... :�-, s ;t.. . , ey:d ,..d- "t 'Y:"� ,:- u^. .-, .+�,3�: = �:' + "- �'�``,':r��.E: "a "mi ."'F:,ds•:•.- ski =.< : \:,"i .>':';,;'�i','gy...:,',`: ,�rr,.' Co excxal�.S =rxnkler � a =�'9,w '...{, -t x ie` :k> ,i , £"�:x. �,•x::J :,..9" vs'a`.. 4,", �<l: -.zd. ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ ) ,Hood'.:Fite,�::�u'� Hood Project Valuation: $ a x '3,2 .',�'i �'s i• '�.5 " <�.=i :.e?:�w- y� S z; Kh x �, ;.: .. a" tom?`, , Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ fi r "�` ' ��'�,� ^" �.< "`. ,�- i- x � �?'� ,<,• � '� "° - �i�+; " �GS�_3.r T yr" ,Y,o >�5 � �,Ti m E ,. i "��:._ >r:� °.ra€:ay;r :; �; -, ,z`.;; a''�" i ✓�. f� .,5....,.. .�".'.'q ° +:.;�,"��?: °:off - " D, ` .�Reent�'a1�S' - �'� gin; � ..,� �:�'�ax�E� . : ��> , •H�:�` >�,' � ��`r ��:4x >�., e " R >� f � : ' �.`, ate»... Square F N h W` _ - *'. q Footage Permit Fee: ',�:' x: �.� � .�f',E���'�.��t > ",� "�; -�'" 0 to 2,000 $187.50' ° ^• 2 001' to 3,600 $232.50 3,601 to 7200 , $292.50 7 and eater a:r f " la > � $381.50 Sprinkler Project Square Footage: sq. ft. y . S -F „ite zotecti`o3iz:Pernxt�Fees�E� �_ 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: //w w.ci.tigard.or.us/ city_ hall /departments /cd /dots /FPS- PemvtApp.doc 2