Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2019-00066
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/13/2019
T"I( ;t I �� g Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9753 SW WASHINGTON SQUARE RD D02
Project: 85C Bakery Subdivision: None Lot: None
Project Description: Fire sprinkler.Adding(48)sprinkler heads for 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: Hourly Building Rate 06/11/2019 $180.00
Hourly Building 12%State Surcharge 06/11/2019 $21.60
Type of Use: COM Permit Fee-COM 06/11/2019 $166.76
Class of Work: ALT Type of Const: VB 12%State Surcharge-Building 06/11/2019 $20.01
Occupancy Grp: B Height: ft Plan Review-Fire Life Safety-COM 06/11/2019 $66.70
Stories: 1 Info Process/Archiving-Lg$2.00(over 06/11/2019 $2.00
11x17)
Info Process/Archiving-Sm$0.50(up to 06/11/2019 $7.50
Commercial Sprinkler System: 11x17)
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 5.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Caics Provided: Cut Sheets Required:
Total $464.57
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $8,355.00
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 ling 503.232.1;:7 or 1.800.332.2344.
Issued By: 7 •ermdtee Signature:
f /7, /J/ / . L
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 of the project.
Approved plans are required on the iob site at the time of each inspection.
Bu la`s Permit Application
Fire Protection System p ""' 1 t ^- FOR OFFICE USE ONLY
City of Tigard Received --
Date/By: kg T Permit No: \ ��.5
IN 11 „.
.f,,,,
13125 SW Hall Blvd.,Tigard,OR 9722��1_�; 2 9 `3�t,q Plan Review p
I1 Phone: 503.718.2439 Fax: 503.598.1960 t_ I” Date/By: 7 'j Other Permit-lit w lc,,./�{�('�j,� -
�'� \—^ `-
'CIGAR!)
Inspection Line: 503.639.4175 Date Ready/By: lir s: I lzl See Page 2 far
Internet www.tigard-or.gov o; t .ified/Method fi ` 0 Supplemental Information
H / n�
O Oso i i 9 1 .1 1 1 8 i "sem O ii' i
. ,`te .�. _.�. _�... . ,-. .>.. �- -.. . -.. ., . _ . ., ... , .
El New construction 0 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
+ C#T GORY OF:tO S't"RLICTtOI�I work indicated on this application.
1:11-and 2-family dwelling [Commercial/industrial Valuation: $
ElAccessory building El Multi-family Number of bedrooms:
ElMaster builder 0 Other: Number of bathrooms:
B, sni OF& FO A!4i0Total number of floors:
Job site address: C1V) ' \* ,,ptiCQ, R New dwelling area: square feet
City/State/ZIP: `; 2n4� V" Garage/carport area: square feet
Suite/bldg./apt.no.: `JProject name: (-6-bC 04fCovered porch area: square feet
Cross street/directions toob site:
j Deck area: square feet
Other structure area: square feet
1tI Q11 M T �R AL^U E G TST`
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
�� 41F';' .6.i . work indicated on this application.
�j ._.. , V� .,. CY‘v4-AI A)214 Valuation: 0 S $
\/ CitED Existing building area: ! l square feet
�( Cit
New building area: V square feet
Q PRt3PLTt'IY +tijt It I4I Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
Business name:W att Fire Protection
y ��� All contractors and subcontractors are required to be
Contact name: Q o{1'� C licensed with the Oregon Construction Contractors Board
Imo"' f 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: (,C,NYVbeAil
§Wiltfir _CON
?4 ,. teri*i
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:
/ Amount received:
Authorized signature:' �1 t "�(
/ This permit application expires if a permit is not obtained
Print name: r", �/��k Date: o1 3Ql a within 180 days after it has been accepted as complete.
V * Fee methnciningy cet by TrI Cnnnty Building Inrtnctry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doc 440-4613T(1 I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
De cei e. u'o , o be 4one _
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
❑ New system Number of sprinkler heads: 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
I=111+ heads: Plan review required and El 6+ devices: Plan review required and
(3) sets of plans. (3) sets of plans.
Additional description of work:
s
« Q tie Spl`iidd
Sprinkler Type [f Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line ❑ Yes ❑ No
Hazard Group
Density 0. I
Design Area W0
K. Factor 5'
Sprinkler Project Valuation: $ '155
�.. ,.. .....-. re... cry. ystet
Hood Project Valuation: I $
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: I $
Square Footage: Permit Fee:
0 to 2,000 $198.75
2,001 to 3,600 $246.45
3,601 to 7,200 $310.05 Mo
7,201 and greater $404.39 ,
Sprinkler Project Square Footage: sq. ft.
else � t a re
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: $
ix+. AFFE1,a6�.. (UFd.t.1 July 2017)\T:�a