Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
`• a COMMUNITY DEVELOPMENT Permit #: FPS2012 -00019
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/29/2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9612 SW WASHINGTON SQUARE RD GO2
Project: Claires Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Provide (13) new fire sprinkler drops for new tenant.
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 02/16/2012 $102.20
12% State Surcharge - Building 02/16/2012 $12.26
Type of Use: COM Plan Review - Fire Life Safety - COM 02/16/2012 $40.88
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 02/16/2012 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 02/16/2012 $8.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
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 $165.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,616.00
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
Utili . I cation er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain - •.py the rules
or rect questions to OU - • -lling 503.232.1987 or 1.800.332.2344.
ssued By: Permittee Signature: /
l I .I-r �r .,1
'`i
Call 503.639.4175 by 7:00 a.m. for the next available in pectio date.
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 Application
Fire Protection System FOR OFFICE USE ONLY
� 1
City of Tigard ���Eg '�' Date/B ��QI�' �
liii PermitNo.:'
- ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 1 6 2012 Date/B : dinAlgr l ether Permit: 6 ui eg eH 0O 2�
TIGARD Inspection Line: 503.639.4175 FEB r C d Date Ready/By: Al am: 0 See Page 2 for
Internet: www.tigard - or.gov No:. d/Method: /5 I71/' Supplemental Information
' TYPE OF .',�c4I1l�i. REQUIRED DATA: 1= AND .2- FAMILY DWELLING:
❑ 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
-CATEGORY OF CONSTRUCTION • � work indicated on this application.
❑ 1- and 2- family dwelling gcpmercial/industrial Valuation: S
m
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
Ig JOB SITE INFORMATION AND- LOCATION . Total number of floors:
—
Job site address: � , 5. 1 �b , New dwelling area: square feet
City/ State/ZIP: 441 ® 1 '2-Z:3 Garage/carport area: square feet
Suite/bldg. /apt. no.: G7 —L Project name:C / /S WA f: 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: • I 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
nn / h�
DESCRIPTION OF WORK . work indicated on this application.
?RD �` Ai tom ) L / P w /' S ( 3) e pErt) Valuation: $ 7._p / , 4
� A) -r / PLD u�m,,T � P � G Existing building area: square feet
�[, New building area: square feet
❑ PROPERTY OWNER , ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/ State/ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
' ❑ CONTACT PERSON NOTICE
Business name: 5 c�D -,-
2 11-L / 6 ,, p.... 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:
CONTRACTOR BUILDING. PERMIT FEES'
Business name: li 7 A-T T`�� p . r/ D r / Please re dr to ce sckednle ''
Address: 9 D 95 � V � k T3 U4 /ofl s- �+ Permit fee:
6 G �/1-/Z,.1 r/ q 72 Z" State surcharge (12% of permit fee):
City/State/ZIP: "
5D 6 54 - Z9 2 3) [ G Q 4 - 57 FLS p la n re view (Due u% of permit fee):
Phone: ( � Fax (�� rJ (Due upon application)
CCB lic.: & 40 77 Total permit fees: / //
Amount received: �jw- 3
*
Authorized signature: L�. -c��
This permit application expires if a permit is not obtained
Print name: jUC -A/ / Th Date: DZ - i (, - )2_ within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
1:\ Building \Permits\FPS- PermitApp.doc 03/23/06 440-4613T( I 1/02/COM/WEB)
City of Tigard: Fire Protection Pert Checklist
Page 2 - Supplemental Information
Dds&il5 work to be done • .2.1 Y-;;-„,`!".Yr:,.;;/:-,"..
1.) E New 2.) Modification to sprinkler heads only:
1=1 Addition 0 1-10 heads: No plan review required.
0 Alteration Ig.41+ heads: Plan review required.
DI Repair
•
Number of sprinkler heads: )
Additional description of work:
A:) Commercial Sprinkler
c • ' • t 1 4.1.e ' , '
[] Wet 0 Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
•
;
otict;Pi •
Hood Project Valuation:
..•;• •
C) , -
- Mae* - ; •••: r+1.
Submittal shall Battery Calculations p Yes
• include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $
J
`4:1.); '
Square Footage: Permit Fee:
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 .„
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://www.ci.tigard.or.usicity_hall/departments/cd/docs/FPS-PermitApp.doc 2