Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
$ COMMUNITY DEVELOPMENT Permit #: FPS2009 00012
,TI GARD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 Date Issued: 04/20/2009
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9665 SW WASHINGTON SQUARE DR CO2
Subdivision: Lot: 0
Project: Aritzia
Project Description: Add /relocate heads
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THOMPSON PROPERTY TAX SERVUCES, Permit Fee - COM 04/09/2009 $98.25
2235 FARADAY AVE STE #0 Tax - 12% State Surcharge 04/09/2009 $11.79
PHONE: Plan Review - Fire Life Safety - COM 04/09/2009 $39.30
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: FPS Type of Const: IIB
Occupancy Grp: M Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required Yes Sprinkler Type Wet
Standpipe Required: Yes 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 $149.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 6120
Residential Square Footage 0
Fire Alarm Valuation 0
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 Or .on
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -001 -0100. You may obtain a copy of e rule ,
I
Issued By: '.i. '• :J I ) 1 I I A Permittee Signature: J �,�
Call 503.639.4175 by 7:00 a.m. for an inspection that busine • day.
This permit card shall be kept in a conspicuous place on the job site until 7• mpletion of the project.
Approved plans are required on the job site at the time of each Inspection.
BtlT Permit Application i t. -i•
Fire Protection System FOR OFFICE USE ONLY
Cl of Ti ICEDI V Rceived \ PemritNo.: [ , C� ^ef/C/l/`1 �,^ n 1111 `J g and o ard, OR 223 — Dat : : �r �
_ ° 13125 SW Hall Blvd., Tigard, (� .013 ��
DO
Phone: 503.639.4171 Fax. 503.598.19 �R "" 8 Z Other Permit:
D Plan at eJB R evi' e � .
��
TIGARD Inspection Line: 503.639.4175 � (�� Date Rea:y : y l' q Imo gf See Page 2 for
Internet: www.tlgard- or.gov c'jN N. .ed/Method 7 pep) / 0 9 Supplemental Information
CO d[ nN1$10N • / /
�Yc-4 pct
TYPE 0 �/ 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
.AKidition/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 WommercialJindustrial Valuation: $
❑ Accessory building El Multi-family Number of bedrooms:
El Master builder ❑ Other: Number of bathrooms:
?(.Go, JOB SITE INFORMATION AND 'LOCATION /� Total number of floors:
Job site address: /1..�� S IA Pii , 4, n � ,`C� �jii . New dwelling area: square feet
City/State/ZIP: I' ` /�, V ,r�0 I 7 2 Garage/carport area: square feet
Suite/bldg. /apt. no.: / all Project name: Inc 1 A _ i A ' i.df Covered porch area: square feet
Cross street/directions to job site: I ,li ` - . 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
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ v�
' i A Existing building area: square feet
New building area: square feet
❑ PROPERTY =OWNER I 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
. t1 PPLJCANT ' ' ' ❑ CONTACT PERSON NOTICE
Business name: ` e , u y _ �r��` eI� All contractors and subcontractors are required to be '
Contact name: � "' 1 C' 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: ( ) I Fax:: ( )
E -mail:
CONTRACTOR'':.- _ - BUILDINGPERMITFEES *_ , .
- (Please rear to fee schedule) : `'
Business name: r - mil - Permit fee: le 2 5
Address: 9 S ) 3u.rn ,.� 7
` State surcharge (12% of permit fee): 1 i . /
City/State /ZIP: . /- ii FLS q Z FLS plan review (40% of permit fee):
(Due upon application) D9 - ri 3�
CCB lie.: 04,•111 g Total permit fees: 1 L{R . 31
-r
Authorized signature: i Amount received:
/� This permit application expires if a permit is not obtained
Print name: .. W M, f Date: 4 — iir ---6:il within 180 days after it has been accepted as complete.
*
Fee methodology set by Tri-County Building Industry
Service Board.
I \Buidmg\Permits\FPS- PertnitApp doc 03/23/06 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) El New 2.) Modification to sprinkler heads only:
Addition El 1-10 heads: No plan review required.
Li Alteration nif 1+ heads: Plan review required.
Repair
Number of sprinkler heads:
Additional description of work:
A) Commercial Sprinider /
- ,",1•••
Wet El Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K Factor
Sprinkler Project Valuation: $
Hood Project Valuation:
• -1- -„
Submittal shall Battery Calculations 0 Yes
include: Individual Component Yes
Cut Sheets
Fire Alarm Project Valuation: $
S quare Footage: Permit Fee:
0 to 2000 $187.50
2001 , to 3,600 $232.50
Atf":
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 culgard or us/city_hall/departments/cd/docs/FPS-PermitApp.doc 2