Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
. COMMUNITY DEVELOPMENT Permit #: FPS2011 -00110
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Date Issued: 09/14/2011
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9597 SW WASHINGTON SQUARE RD B13
Project: Lush Subdivision: Lot:
Project Description: Modification of (10) fire sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC Owner: PPR WASHINGTON SQUARE LLC
9095 SW BURNHAM BY THOMSON PROPERTY TAX SERVICES
TIGARD, OR 97223 ATTN HILARY RAYMOND
CARLSBAD, CA 92008
PHONE 503 - 684 -2928 PHONE.
FAX: 503 - 684 -9657
FEES r
Description Date Amount C
Specifics: Permit Fee - COM 09/14/2011 $102.20
12% State Surcharge - Building 09/14/2011 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 09/14/2011 $40 88
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 $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,075 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 No • anon Ce -r Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a spy of the rules
or direr questions to OU C b a r. 503.232 1987 or 1 800.332.2344
Issue By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection sate.
This permit card shall be kept in a conspicuous place on the job site until c. pletion of the project.
Approved plans are required on the job site at the time of each inspection.
. Building Permit Applicatioln,riEN
Fire Protection System 1, V ` FOR OFFICE UsE:orrLY -
City of Tigard SEP 14 2011 Date/Bed p /y // (M / /'� //
0 Pernut No
y �� /
11 13125 SW Hall Blvd., Tigard, OR 5,-Iii, n N. ,
' ' Phone: 503 639 4171 Fax 503 5MI1 TIGARD Da eBy: Review 4a/ o'l a77/
Other Permit.
,TIGARD Inspection Line 503 639 4175 BUILDING DIVISION Date Ready/By: Jana E See Page 2 for
Internet. www tigard - gov Nonfied/Method Supplemental Information
? t >? - TI PE It ', , ° RI .,;2 � >' -.',',,,15;,,:,W,: ',:...: �. - ,
1 F
O ,.)'O ;:r
�,:. RE� LlIItEDDATA: ` =1AIt'D;2- F NG
❑ 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
, a , work indicated on this application
; r * °k'= ',;, `: ` °`fl ,' ' - 4 : ,,' ,, g, `:w "x l Yi.
e ,'
a ', O3s > - ' " GA TEG O f : poO F; ,C O NS TRUCTIO,NIRt< • ° _
iii 1- and 2- family dwelling ommercial/iudustnal Valuation: $
II Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
_ J OL SIT 1NFOR114AI.ION':AND Total number of floors -
„k �'•. ;° 'tp. , " �" ; � F ° ;, ^ ;'_ ° F - ,. ...�, €s �.... .,;., .., ._. ,., � �t> .- ia��- ;ei::;.s; z:p °E.,: '.� '' ?: ` ,
Job site address: q Ai 4 1 ', . New dwelling area: square feet
City/State /ZIP: 7 'I ( � f p_ 9/ Z-2-3 Garage /carport area: square feet
Suite/bldg. /apt. no.: if.3 ) 3 Project name: L L),..5 N 7' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
e REQ'U' l D tiT AP:xG41V71VIERC kL)JS j =P 1 X: I TtE Ii\L V: Wg r i f' „ s= IS•T x
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•.-,:,.,:,:„ .P, ",i >.: ,:, :. _. and profit materials, labor, overhead, a e ofitforthe
r
" ` P'•- "k'- •DESCRIPTION:,oF iWO K, �; , ; 4'''' , mss'' work indicated on this a
6,x,3 �. ,� < � � �� y�, �sz,la application.
` %e_4--7--- /`� „ I 'PpkCi ID 5 p l` /!1•/ . - � L Valuation: $ 2
Existing building area: square feet
New building area: square feet
;:'�: M.•5�,� ;�'.'.�rk'�, >, ,. "�mr'�:a�" , =;�"i -',?,i � .� s.c r;a=..s�,i- t �;a� °r„ a..:_-
aOW ER: ® - TENAN „
T 7' n
'e - - _ Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP:
Existing:
Phone- ( ) Fax: ( ) New:
:•..Hi: 0," ,, <`• " ;; , ",; ; e > ; - ` z : ;. sue .a ri +,. r+ ".� A... . ;; zr•:`. '. s �='&?x�.;va` %:";�,'�; .-1
��. =:lZ: 3:"4 "w,".: „.:c- eJlfi^.!.: .'S. +:< <. . -'s,:: x„ 4 :e'Yi. ,
�, � ' C ON •' 'A T ° "PERS N s
s
::�.�.�'.i &:: ��, '3,:YSr ', =. ,,� "�C,�; , �.:'�a, :i x^.<:.' fh '",,:�:a;- '�ri';/.�I =L'.M1 - ,� =;
Business name: '�
�� t% /v�/�,�/ � /L 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 -
GO TR�
� �- 'i'n`s: N ACTOR' =
, ER1V11>T " E>; S
y'�,, ,,5'�,. >„ �� BUIL;DIN fE F -- �' < =�F`� °�:
�, «,x's, a, a, r ,&Y „ " - «�s'r�w. .. t„ .>,. ,, .._ 3,x . '.s ,, ,.. ,x .- „ �$� R=fes, �.b
' , name: ; ” .l )' 2 %pie 7120-7-----770A) T 0 � -�' ::s :, , , a .,
Business :
=� ,mss ° =, •ii��.�*�' <" ".' '(Plea'se;refir.io fe`e'seJiedu7P ` :�.a
� 'V 1 5 0�,U ,k2 ` / Permit fee.
Address: 909
City/State /ZIP: I/c4 2) o� q 7 �Z State an reie surcharge ( of permit fee):
/ FLS plan review (40% of permit fee):
Phone. (50 3) 8 ¢ _ 29 Z Fax: ( 3) g3 1- -9‘.... 5 (Due upon application )
CCB lie. - ( 4o '7 7 Total permit fees:
Authorized signature: . Amount received: 4/ S5 3
• e l
This permit application expires if a permit is not obtained
Print name: ,6UG36,V � i - -j ., Date: 9 — l4- if within 180 days after it has been accepted as complete.
* Fee methodology set by Tri County Building Industry
Service Board
I \Build og\Permrts \FPS- PerrmtApp doe 03/23/06 440- 4613T(1 1 /02 /COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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: 1 _
Additional description of work:
-„ �a ", °'• my.�%�.,„ s :V . '.`- _• : .3..s
z . , �•'`' -.�" - .•,3sm = .ice u�� ,z.:'?`, , � „ �s,rc� .,f 3E,'\ '�2"'S
:aR; •;• �;',:£,, ° v,= ,.> ^ ^ -yvA v ,i�., gY.m'�; ' -.:.; xa n r > ,. , : x t�,^ `
A : >r"; :Cotxiime �'' �,: �3:,;,� °�',. , - _� >.m�: ;.F,: , :�r ��;• >, ,.�:�.,
' %` ,,:�,.. p . �' -ten �—
. >�f � R„ _ „� x, ° • - x � ,�- ._ =r�• <�, �,����.. "e� = , „_ae „_R °�>�ti. p_ . �y, : _ ,.. n , '•���"�.t, �„ ".. ,�;i�•:
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B .T : <;e Hoo,cF'ire`S`u iressxoxa't = seria
Hood Project Valuation: —
#�i,'i.': .:','�v�, .,:t�•., v, =TS,. .',•Ha^ - i;<,5.,- ,_�v.,s.
.... � �> .SS{I.ate ,
,. .i'ta:+ ,r. ;i4�, .a, :>n'- i:.>��• < , - .a ;.'�:•�l .. ,r. .,'; `.:� -�v „- F'f_ „y/'e•:ne £i is #vt r "1. < °:• x 3xi
Submittal shall__ ___ __ Battery Calculations - -- -❑ —Yes - - - - -- --
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
w
,:A p 'F , . �� R, s �x ; v,y� • r- yy'?,, . � ',..: , -. .,3 'v� ".
-,,.. ..n.,✓Y`- • c'k" „;d'� °” ,.,`:< . ,.y,.
,,,, 'etr�^ w ^, >
Re ..r�•a • },,, x,. ; =y�'3 .r:� =;; ° y �,''^ + a• " �..t��aE- ,::. Y'.�.. '�?
D' s`rdeiitia�1 S rtrikl "r n = : t,s ° „t:: _ i e E...M ., ,... &3; t _, M, ,>w . :s ,
-
p e �(Sta d A1one,.S ,,stem ��;.� �, . �.��', . .;��:,. . #�ry #
J .. e,' : � �;. "' ` i .. %3 • ^ �7 #
''„hg's - •',�`,� ... ' .3,b:' 3e` a>n ,,. -,
Square Footage: Permit Fee: =' " "' -Eq -+
0 to 2,000
2,001 to 3,600 � " ,_�'"
0
$187.5
,� �� -,.s` �x,:,,, •
$232.50> °;, < "'•;':. '; F
3,601 to 7,200 $292.50 0 _:"'`'"'c.3
7,201 and
greater $381.50 140; > ' :41:34. _ ,, F hb., ;,
Sprinkler Project Square Footage: sq. ft. 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 / /wvww a ugard or.us /city_hall /departments /cd /dots /PPS - PermitApp doc 2