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Permit ' , City of Tigard: Fire Protection Permit Checklist Page 2- Supplemental Information Describe work to be done: 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 El 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: T is e of S stem (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Sprinkler Type ❑ Wet ❑ Dry Additional Standpipes Information: Sprinkler Supply Line ❑ Yes ❑ No Hazard Group Density Design Area K.Factor Sprinkler Project Valuation: $ B.) Type I - Hood Fire Suppression System Hood Pro'ect Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Mann Project Valuation: $ /f1 (f(p 7. D ) Residential Sprinkler (Stand Alone System) Square Footage: Permit Fee: ';, 0 to 2,000 _ $198.75 3 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 Protection 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: $ I:\Building\Permits\FPS_Pennaapp_031016.doc 2