Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
•'�, - COMMUNITY DEVELOPMENT Permit #: FPS2012 -00004
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2012
Parcel: 1S 1260000300
Jurisdiction: Tigard
Site address: 9532 SW WASHINGTON SQUARE RD H11
Project: The Body Shop Subdivision:VASHINGTON SQUARE ESTATES NO Lot: 108
Project Description: Modification of approximately (10) fire spinkler 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
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/11/2012 $102 20
12% State Surcharge - Building 01/11/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 01/11/2012 $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: $2,143.00
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 ado ted by the Oregon
Utilit notification .-nter. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtai al c y o the rules
or . rect questions to O C by - 'ng 503.232.1987 or 1.800.332.2344. I
Is . ued By: / r Permittee Signature: /!
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 , ..ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System - FOR OFFICE USE ONLY
City of Tigard RE CEIVED Date/By: /" // 41 ,o, Permit No.: 4o /j ,.406 V
13125 SW Hall Blvd., Tigard, O R 9 7223 Plan Review
' 7 Phone: 503.639.4171 Fax: 503.5M61 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 J I'i 1 2012 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
� ,� i t - . 'TI \YFJ ;+' ?M�'rR 1 ri r RE UIRED`DATA 1 ANDZ F A14IIL D\VE1,LING4'�^`i
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❑ 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
,,.. 4 , ' '''': ..'' , .mss.: w
. , , work indicated on this application
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❑ 1- and 2- family dwelling Commercial/industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
x „ _"- u, ; O r M4 t \tr ;< , ..
ANp..L "OCATION°, ._ :: :...
,: - - .JOB =SITE.:.11VFOR114ATION � `' Total number of floors:
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Job site address: Q4 3Z 4 / �/f { , .� " r 4 D , New dwelling area: square feet
City/State /ZIP: • r ,, c J /! � ' c 7ZZ � j Garage carport area: square feet
Suite/bldg. /apt. no.: `' Project name: ® ,V /' Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
RE; - ;[ D TA: "GOMMER ,,, diEC K IS . T ?
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
" e
44'; 4 .44 ',yls ;,t',a'e ,,'!, I ;4 ; ,44.':i' ms $;' , . 4 .44r`PaA !:5 ° ". _ii . 5
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- "DE SCltu''` , rI0 , O WO . h o "" - » ' work indicated on this application.
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)4)4 ,b RR -t - O� i - i 0 ", 5P�ret)ke Valuation: $ I 1-3 cac "
67'�i� S 1i LJ !�. . Existing building area: `T square feet
New building area: square feet
i `;;1'1tOEEI2TY :: OV1'NER 't:' : '"' ° " s ,��, ' " •
,.m T ,0N N' ,': :' ° , , -3 stories:
"e., .l�' "5',��.- :€�•' <,� - ?ei,�ts0'FSi -. - �,, .: 5: '.h,,.2`;,� ,° ����', �- �:3°'w�,ot s�'.�r:4" " ±�•. ,,�.;, :;u,-- . .`�.�:;.`bs ` :ae'�a Number of sto
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Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP:
Existing:
Phone: ( ) Fax: ( . )
New: .
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Business name:
. C' --Ot f '��® - 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:
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Business name: W Y/1 F./ g_6- ?go 7 --___ 7 -, t)�
I .( e se, efe t fe ri leJa`Y,� _: : : " ;, =.:r
Address: qr) 95 .:.1A/ Bt /zAi G� 5 Permit fee: /�� '2° City/State /ZIP: C3 e7 ` 7 Z •�j State surcharge (12% of permit fee): 4q ••1 cp
FLS plan review (40% of pemvt fee): L/O •
Phone: (�-�D3) 6f3 4 - 2L, z_ 7
Fax: (r 53 6,, ( 5 1� - 9657 (Due upon application.) '/
CCB lie.: 6, 7 Total permit fees: / S, .3 7
Authorized signature: 01> •-•e Amount received: /_53
• T his permit application expires if a permit is not obtained
Print name: ‘../6 / — 71t,4t Date:` —y.-/Z_ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \Permits\FPS- PemutApp.doc 03/23/06 440- 4613Tti 1/02 /COM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition A_,1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: lb
Additional description of work:
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❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
•
K. Factor
Sprinkler Project Valuation: $
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Hood Project Valuation: $
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Submittal shall Battery Calculations ❑ Yes «
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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Square Footage: .. . , t . A1a f �;, =�. �.
.. ._ � �, � <,,' e .:cur- °',�,; �'L t�^a.�
e: Permit Fee: =�� °e'_ ' R! F :Ll`; F'p;
.0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200
$292.50
7,201 and greater • $381.50 � a; rgie4 3.; .
381.50 zF" ". � �r "' -�; .�,, , ,z =.:'�;,il�.�:`.;, ` 0 =a
Sprinkler Project Square Footage: sq. ft.
Project valuation subtotal (see A, B & C above): $
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: / /www.ci,tigard.or.us/ city_ hall / departments /cd /docs /FPS- PermitApp.doc 2