Permit (128) CITY OF TIGARDFIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2017-00102
T t c;A fg D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/12/2017
Parcel: 1 S 135BA00102
Jurisdiction: Tigard
Site address: 10104 SW WASHINGTON SQUARE RD
Project: Visionworks Subdivision: OAKBURG Lot: 9
Project Description: Fire sprinklers-Modification of(20)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 07/12/2017 $102.20
12%State Surcharge-Building 07/12/2017 $12.26
Type of Use: COM Plan Review-Fire Life Safety-COM 07/12/2017
Class of Work: ALT Type of Const: $40.88
Info Process/Archiving-Lg$2.00(over 07/12/2017 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 07/12/2017 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type: Wet
Standpipe Required: No Hazard: ORD1
Density: .15 Design Area: 1500
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 $164.84
Valuations:
Required Items and Reports(Conditions)
Sprinkler Valuation: $2,723.00
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
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 1.800.332.2344.
Issued By: Xr. Permittee Signature: ..— —'''J � �`
/7---- -`--
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 completion he 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
Of Tigard RECEIVED Receiveyd ci] /� //� ?a a
_ Permit No.: � co`
13125 SW Hall Blvd.,Tigard,OR 97223 Date/BPlan Review
= Phone: 503.718.2439 Fax: 503.598.1960 u L f 2017
Date/By: 7 10' j -] `� Other Permit:ilia AAA/7 1p
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: y Juris: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TP Notified/Method: 7/ yf I Supplemental Information
CITY /it� M
...i,,,!. ,.. , ' a".,, TYPE OF WORK „< p , ,< i .- r REQUIRED AM: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 0 Other: equipment,materials,labor,overhead,and the profit for the
. r4�' work indicated on this application.
1�'�C. EGOR�OF CONSTRUCTION E � PP
❑ 1-and 2-family dwelling ®Commercial/industrial Valuation: $
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
‘,'1-- JOB SITE INFORMATION AND LOCATION 41,,,<. ; Total number of floors:
Job site address:10104 SW Washington Sq Rd New dwelling area: square feet
City/State/ZIP:Tigard,OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Visionworks Wash Square 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
work indicated on this application.
' -,',),.3.4 DESCRIPTION,OF WORK Pp
Add and relocate fire sprinkler heads as required for TI Valuation: $$2,723.00
Existing building area: square feet
New building area: 0 square feet
0 PROPERTY , s� 0 TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing: Ordinary 1
Phone:( ) Fax:( ) New: II
x
l APPLICANT � ® CONTACT*PERSON x . f %. NOTICE ' ;`
xz
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
r CONTRACTOR ;V" BUILDING PERMIT FEES* ', ,,
Business name:Wyatt Fire Protection (Please refer tofee schedule)
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application.)
CCB lic.:64077 Total permit fees: t$744. ty
Authorized signature:. ----� Amount received: — '�/
This permit application expires if a permit is not obtained
Print name:Max Colle- - �� Date:7/5/17 within 180 days after it has been accepted as complete.
�;_ * Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp.doc Rev 01/05/2012 440-4613TO 1/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Desetibi,4btIc to be done: x ;
1.) ❑ New 2.) M.dification to sprinkler heads only:
® Addition r"; 1-10 heads: No plan review required.
® Alteration R' 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System(Complete A,B,C or D as applicable): M ; ;
A.) C f ercial Sprinkler 7 MP3,:
® Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Ordinary 1
Density 0.15
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 2723
B.) Type;I Hood°Fire Suppres *rt System' ; "' ��`
7r
Hood Project Valuation: $
C: ire Alrtll Ea `
:max `.01c,
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Spt mer(Stand Alo a!!System)
Square Footage: Permit Fee: r
0 to 2,000
$198.75
2,001 to 3,600 $246.45 'y`.
3,601 to 7,200 $310.05 4'44-
7,201
'7,201 and greater $404.39
Sprinkler Project Square Footage: sq.ft.
Fire'Frotection Permit Fees#s
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.
W:\Max\1112 PERMIT APPLICATIONS\Tigard App.doc Rev 01/05/2012 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10104 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2017-00102
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor