Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 11 ' • COMMUNITY DEVELOPMENT Permit #: FPS2009 -00085
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9659 SW WASHINGTON SQUARE RD M06
Subdivision: Lot: 0
Project: Spencer Gifts
Project Description: Add (8) sprinkler heads.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, Permit Fee - COM 09/15/2009 $83.95
2235 FARADAY AVE STE #0 12% State Surcharge - Building 09/15/2009 $10.07
PHONE: Plan Review - Fire Life Safety - COM 09/15/2009 $33.58
Contractor:
WYATT FIRE PROTECTION INC.
9095 SW BURNHAM
TIGARD, OR 97223
PHONE: 503 -684 -2928
FAX: 503 - 684 -9657
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: M Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: Design Area:
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required. Alarm Type.
Pull Station Required: Smoke Detectors Req
Battery Calcs Provided: Cut Sheets Required'
Total $127.60
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 4750
Residential Square Footage:
Fire Alarm Valuation:
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 Noti n Center. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of th- rul
or direc uestions to OUNC • calling 503.246.6699 or 1.800.332.2344.
Iss d By: "" , ,/ `I Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business .ay.
This permit card shall be kept in a conspicuous place on the job site until co pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application IN DP "1'12- itkm -Ez 9 ( 9 % co LocIri- c6cv)ct. n1.ejt
F-t. A-cps
Fire Protection System FOR OFFICE USE ONLY
CEVED Received 4 City of Tigard Dat : Q !/ Permit No.: • PS q/QQQ. 5
1 - a 13125 SW Hall Blvd., Tigard, OR
p 1 view �i lb �1 I Other Permit:
Phone: 503.639.4171 Fax 503 598.1 20 09 Date/By: Date/By:( (
TIGARD Inspection Line: 503.639.4175 Date Ready : I „,,..,..1. n� I . El See Page 2 for
Internet www.tigard - or.gov Notified/Method: lv • 1 i V efi0 t:-et Supplemental Information
� CITYOFFTIGA�RDs' ` L� I\,,LRw�er (•=1 U
- TYPE BU G DIVISION 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 XCommercial/industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
9 s.7 JOB SITE INFORMATION AND LOCATION • , Total number of floors:
Job site address: 9. - /k/ k • NiA—LL -RD New dwelling area: square feet
City/State/ZIP: -- riCj 6) 91 -z_2__ Garage /carport area. square feet
H d (p Suite/bldg. /apt. no.: . I Project name: SPi iCi'✓ IS 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 O WORK' T '' work indicated on this application.
ADD 'T y�
reux v l�-i 1 y t'L (2. - _ ,....2. , bv)ps Valuation: $ / 7 • -
e1.) ter. s / (0. Avo- r:22 b `® z5 Deck_ Existing building area: square feet
rn s 1 L i,u P -r r 1 1ST /l j, LIME - 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:
a$PPLICANT ❑ CONTACT PERSON NOTICE'
Business name: , /� ,.�
r j - t� � M" - � / �f'C Li97Z- 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: junsdiction in which work is being performed. If the
City/State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
J
1 J / /� �4- CONTRACTOR -, - '' ' BUILDING PERMIT FEES
l I T r-/R F ?��e�� (:),..1
(Please refer to jee scliedulk)
m
Business name: �`� ` �1 /� Permit fee:
Address: 90 9 5• a)fL �fJ -k.1 -sr
State surcharge (12% of permit fee):
City/ State/ZIP: --r7 Al2.6 04_ 9 7 22-3 FLS plan review (40% of permit fee):
Phone: (503) 6g 4 . 2 1 Z d, Fax: (03 lo� - % 57 ( Du e upon application.)
CCB lic.: (24x)7 7 Total permit fees:
Authonzed signature: Amount received: 1 1( 4 2 7. le 0
This permit application expires if a permit is not obtained
Print name:k /A f y....) Date. 9 — ) 5 -,n, 9 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building industry
Service Board.
I \Budding\Perm,ts■FPS- PemutApp doe 03 /23/06 440- 4613T(11 /02/COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describeworktobedone
1.) D New 2.) Modification to sprinkler heads only:
El Addition 0 1-10 heads: No plan review required.
Ej Alteration 0 11+ heads: Plan review required.
Repair
Number of sprinkler heads:
Additional description of work:
0 Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
Hood Project Valuation:
C) Fire larm1
= 1 ",
, - _ 1 ;^ •
Submittal shall Battery Calculations 0 Yes
include: Individual Component LI Yes
Cut Sheets
Fire Alarm Project Valuation: $
(Stan'clAl'orie_Sygleir4
Square Footage: Permit Fee:
0 to 2000 $187.50
2001 to 3600 $232.50
3601 to 7200 $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.o.tigard.onus/city_hallidepartments/cd/docs/FPS-PermitApp.doc 2