Permit (99) It CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
s COMMUNITY DEVELOPMENT Permit#: FPS2016-00075
Tt(,.;ARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/04/2016
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10154 SW WASHINGTON SQUARE RD
Project: Pier 1 Imports Subdivision: OAKBURG Lot: 9
Project Description: Adding and relocating a(30)sprinkler heads for TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR SQUARE TOO LLC
9095 SW BURNHAM PO BOX 847
TIGARD, OR 97223 CARLSBAD, CA 92018
PHONE: 503-684-2928 PHONE:
FAX: 503-684-9657
FEES
Description Date Amount
Specifics: Permit Fee-COM 05/04/2016 $123.72
12%State Surcharge-Building 05/04/2016 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 05/04/2016 $49.49
Class of Work: ALT Type of Const: IIB Info Process/Archiving-Lg$2.00(over 05/04/2016 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 05/04/2016 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
Density: .15 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $197.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $4,660.00
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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.:•S 2.2344.
Issued By: Permittee Signature: I/
--
C. 639.4175 by 7:00 a.m.for the next available inspectionhate.
This permit card shall be kept in a conspicuous place on the job site until completion of , •tect
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System Folz orF• I;I(' I SE O\i.\
Received r
City of Tigard Date/By. a't �� r / PermitNo.: ,�/fJ
13125 SW Hall Blvd,Tigard,OR 97223 Plan Revview 1I ( f a
Phone: 503.718.2439 Fax: 503.59,x. , Date/By: �1 l Other Permit: daO l ,13�r.a�
I I(i n R D Inspection Line: 503.639.4175 �CV1j`` ^Q`0 Date Ready/BY: / \ J vs: I ® See Page 2 for (,� / ,/
Internet: www.tigard-or.gov ", P !• Notified/Method:. .D/��o r� Supplemental Information
" `i, I ,TYPE OF WO [ REQUIRED DATA:1AND 2-FAMILY DWELLING
❑New construction Permit fees*are based on the value of the work performed.
Q ' Indicate the value(rounded to the nearest dollar)of all
®Addition/alteration/replacement Ly'Other: equipment,materials,labor,overhead,and the profit for the
TLGORY,OF CONSTRUCTION
work indicated on this application.
dwelling Valuation: $
❑ 1-and 2-family g ®CommerciaUindustrial
Number of bedrooms:
0 Accessory building 0 Multi-family
0 Master builder 0 Other: Number of bathrooms:
JOB SITEINFORMATION AND LOCATION Total number of floors:
Job site address:10144 I,(/e/Ift S 12b New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:B Project name:Pier 1 Wash Sq 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 OF WORK work indicated on this application.
Add and relocate fire sprinkler heads as required for TI Valuation: $$4,660.00
Existing building area: square feet
New building area: 0 square feet
0 PROPERTY OWNER 0 TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Ordinary 1
Phone:( ) Fax:( ) New:
® APPLICANT ® CONTACT PERSON NOTICE
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Max Colley licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham Rd jurisdiction in which work is being performed.If the
City/State/ZIP:Tigard,OR 97223 applicant is exempt from licensing,the following reasons
apply:
Phone:(503)684-2928 Fax::(
E-mail:m.colley@wyattfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name:Wyatt Fire Protection (Please refer tofee schedule)
Permit fee:
Address:
City/State/Z1P: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lie.:64077 Total permit fees:
Amount received:
Authorized signature ,:"f
This permit application expires if a permit is not obtained
Print name:Max Colle Date:4/10/16 within 180 days after it has been accepted as complete.
y' * Fee methodology set by Tri-County Building Industry
Service Board.
\R..ildino\Peemiec\FPS-Perm ItAnn tine Rev111/052012 d411�Fl/7711/02/C lM/WFR1
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to lie done: '
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: 3__Q.
Additional description of work:
Type of System (Coinplefe'A,B C oz I?,as: pplicable)•
.. ty„ Le. •,a x 0 tx t`°.r 4 I 8 y, .,- �,,'� }i
x % :3 .ef Aye r E 't lj._Cotrimercial Sprinkler,
A.)
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 4660
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm.
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler(Stand Alone System)
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft.
Fire Protectign_Permit Fees
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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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