Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
gel .' COMMUNITY DEVELOPMENT Permit#: FPS2019-00016
Date Issued: 02/26/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9339 SW WASHINGTON SQUARE RD T11
Project: Amerisleep Subdivision: None Lot: None
Project Description: Fire sprinklers. Altering(28)fire sprinkler heads for MFPA 13 TI.
Contractor: WYATT FIRE PROTECTION INC. Owner: PPR WASHINGTON SQUARE 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 02/26/2019 $123.72
12%State Surcharge-Building 02/26/2019 $14.85
Type of Use: COM Plan Review-Fire Life Safety-COM 02/26/2019 $49.49
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 02/26/2019 $2.00
Occupancy Grp: M Height: ft 11x17)
Stories: Info Process/Archiving-Sm$0.50(up to 02/26/2019 $7.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: ORD1
Density: 0.2 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 $197.56
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $4,173.00
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: . - Permittee Signature: 7),
C.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 of the project.
Approved plans are required on the job site at the time of each inspection.
%
Building Permit Applicatio ECE'VED
Fire Protection System FOR OFFICE USE ONLY
FEB 12 2019 Received n _ C , !' !�
City of Tigard Date/By: �( `K f i� Permit No.:-r{� h-0 Ut✓(�
IN II 13125 SW Hall Blvd.,Tigard,OR 9722 TIGARDv ' 1 , ''�y
# TY OF Plan Review � Othe
Phone: 503.718.2439 Fax: 503.5981 DING DIVISION Date/By: p1- i - J )a,- - cy.,"2 y
Inspection Line: 503.639.4175 t�iiluvJ Date Ready/By: / Jur See Page 2 for
T 1 G A ft D Internet: www.tigard-or.gov ,Notified/Metho . / Supplemental Information
,(e,1/ //JLe,,
xfi , OF3O11i ' fI" s + TAi1 1 aEi
❑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
#� §AT GORY CO STR oy,.,.If4 %f work indicated on this application.
Valuation: $
❑ 1-and 2-family dwelling ❑■ Commercial/industrial
❑Accessory building ElMulti-familyNumber of bedrooms:
El Master builder El Other:
Number of bathrooms:
'-',"1- � ` FOR.MATIO I InATi011 Total number of floors:
JOB SITE`IN-�..
Job site address:9584-SW Washington Square Rd New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.:1-11 Project name:Amerisleep Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED TA CO CI -U I IIECKLIST
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
i PTOO ARK work indicated on this application.
Fire sprinkler alterations for tenant improvement in mercantile space per Valuation: $ 1/ 7Y
N FPA 13 Existing building area: square feet
New building area: 0 square feet
� ?ROOPE Y ❑ TENT Number of stories:1
w .
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name:Wyatt Fire Protection All contractors and subcontractors are required to be
Contact name:Ashley Nishihara licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:9095 SW Burnham 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 I Fax::( )503.684.9657
E-mail:a.nishihara@wyattfire.com
Ci ,.,_ bfig . ..,., �RV'i" , ... ........ t .. �..' .. BUILDIt PST S
S
Business name:Wyatt Fire Protection Permit fee:
Address:9095 SW Burnham
State surcharge(12%of permit fee):
City/State/ZIP:Tigard, OR 97223
FLS plan review(40%of permit fee):
Phone:( )503.684.2928 Fax:( )503.684.9657 (Due upon application submittal.)
CCB lic.:64077 . Total permit fees:
Authorized signature: tzittj.2.e4it Amount received:
This permit application expires if a permit is not obtained
Print name:Ashley Nishihara Date:2.7.2019 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_031016.doc 440-4613T(11/02/COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2-Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
ElNew system Number of sprinkler heads: 28 Number of alarm devices:
❑■ Addition or ❑ 1-10 heads: Affidavit required and ❑ 1-5 devices: Affidavit required and
Alteration (3) copies of sketch showing area (3) copies of sketch showing area
to existing of work within building structure of work within building structure
system
❑■ 11+ heads: Plan review required and ❑ 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
'Type ref System(Compie eA B,± car)* ipi cable}
A Comtnercia rt kler
Sprinkler Type Wet El Dry
Additional Standpipes Nc
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group 0 K ,
Density 0. ., 0
Design Area ( SZ j
K. Factor
Sprinkler Project Valuation: $
Hood Project Valuation: I$
Submittal shall Battery Calculations El Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
k a $p' er �
� 0 *1:$y$te Adll "` a ,
Square Footage: Permit Fee: 1 1 ntl i ' e a
0 to 2,000 $198.75 W IptagttV,M
2,001 to 3,600 $246.45 _i,i
3,601 to 7,200 $310.05 Mitnelign stis
7,201 and greater $404.39 M= a
Sprinkler Project Square Footage: sq. ft.
I-IIIIIII4Z7gtg;agnllnetVlaIRRCPICS011NWW*INStnerMilltnaliatfltkallg
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
qabove):
State Surcharge (12%of permit fee): $
FLS Plan Review(40% of permit fee): $
TOTAL: $
w:\Permits\Permit Application Forms(Updated July 2017)\Tigard Fire Permit App.doc2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9339 SW WASHINGTON SQUARE RD T11 ,
TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Fire Protection System FPS2019-00016
Inspection Type: Inspector:
999 Sprinkler final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor