Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
-44
' = COMMUNITY DEVELOPMENT Permit#: FPS2020-00109
Date Issued: 10/20/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 1S136DC00300
Jurisdiction: Tigard
Site address: 11600 SW 72ND AVE
Project: 72nd&Baylor Apartments Subdivision: Lot: 19
Project Description: Fire supply line for a new six-story affordable housing apartment building.
Contractor: BREMIK CONSTRUCTION INC Owner: CDP DEVELOPERS LLC
1026 SE STARK ST ATTN PAINE, ERIC
PORTLAND, OR 97214 126 NE ALBERTA ST STE 202
PORTLAND, OR 97211
PHONE: 503-688-1000 PHONE: 347-218-0242
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-MF 10/20/2020 $263.60
12%State Surcharge-Building 10/20/2020 $31.63
Type of Use: COM Plan Review-Fire Life Safety-MF 10/20/2020 $105.44
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 10/20/2020 $42.00
Occupancy Grp: R-2 Height: 55 ft 11x17)
Stories: 5 Info Process/Archiving-Sm$0.50(up to 10/20/2020 $1.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $443.67
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $17,500.00
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: v 'die/' Permittee Signature: /
/ham (,k/ % L/ L''�/0^,
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 job site at the time of each inspection.
Building Permit Application
` Fire Protection System FOR OFFICE USE ONLY
City of Tigard :Ilk •ec atEived B :
• 13125 SW Hall Blvd.,Tigard,OR 97232371 F T- 'tane Review
Phone: 503.718.2439 Fax: 503.598.19�0 ' Date/B : • •• ) -I.
mi. Other Permit: i f _ •
i.11. R IT Inspection Line: 503.639.4175 r- 4 q Date Ready/By: El See Page 2 for
Internet: www.tigard-or.gov OL 20L� Notified/Method: /0 sr dotaNa Supplemental Information
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1J 1 I S, ',.1
TYPE OF i I"11 a 0S s e i tj IS( . — REQUIRED DATA:1-AND 2-FAMILY DWELLING
®New construction ❑Demolition Permit tees*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
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1-and 2-family dwellingValuation: $
El
❑Accessory building ®Multi-family Number of bedrooms:
ElMaster builder ❑Other: Number of bathrooms:
f OB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: !b8t1CSW 72nd Ave New dwelling area: square feet
City/State/ZIP: Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: N/A Project name: SW 72nd Ave& SW Baylor St Covered porch area: square feet
Cross street/directions to job site: SW 72nd Ave& SW/Baylor St Deck area: square feet
( )/C j T-e. , Other structure area: square feet
w (� REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: Tax No's. 1 S136DC00300, 1S136DC00301,and 1 S136DC00400
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New Fire Supply Line Valuation: $17,500 $
Existing building area: N/A square feet
New building area: 99,066 sf square feet
I.'1 PROPERTY OWNER ❑ TENANT Number of stories: 6
Name: Community Development Partners-Attu: Wendy Klein Type of construction:5 stories 1116 over 1 story 1A
Address: 126 NE Alberta St, Suite 202 Occupancy groups:
City/State/ZIP:Portland, OR 97211 Existing: N/A
Phone:( 407)929.8694 Fax:(N/A ) New: R-2, A-3, S-2
lif•tl El APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Scott Edwards Architecture All contractors and subcontractors are required to be
Contact name: Dave Mojica licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2709 SE Ankeny St. jurisdiction in which work is being performed.If the
City/State/ZIP: Portland, OR 97214 applicant is exempt from licensing,the following reasons
apply:
Phone:(503 ) 896-5378 Fax::( N/A)
E-mail: dmojica@seallp.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: Bremik Constuction-Attn:Paul Delsman
Permit fee: $263.60
Address: 1026 SE Stark St
State surcharge(12%of permit fee): $31.63
City/State/ZIP: Portland, OR 97214
FLS plan review(40%of permit fee): $105.44
Phone:( 503 )688.1000 Fax:( N/A ) (Due upon application submittal.)
CCB lie.: 160383 Total permit fees: $400.67
Authorized signature: Amount received: $400.67
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Dave Mojica Date: 10.14.2020 *
Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building1Permas\TPS-Pu mitApp_03 1016.doc 440-46I3T(I I/02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe work to be done: New Fire Supply Line Only
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
❑ 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 of System (Complete A,B, C or D as applicable):
A.) Commercial Sprinkler
Sprinkler Type ❑ Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line X❑ Yes El No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $$17,500
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El 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 Protection Permit Fees
Project valuation subtotal (see A,B & C above): $17,500
Permit fee based on project valuation (see fee schedule): $263.60
Permit fee based on square footage (see D above): $N/A
State Surcharge (12%of permit fee): $ 31.63
FLS Plan Review(40% of permit fee): $105.44
TOTAL: $400.67
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