Permit k CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
li'-! 2 COMMUNITY DEVELOPMENT Permit#: FPS2020-00126
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/15/2020
Tf ' 1R n g Parcel: 2S111ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: None Lot: None
Project Description: Kitchen exhaust hood suppression system.
Contractor: SANDERSON FIRE PROTECTION INC Owner: UNION HIGH SCHOOL DISTRICT
1101 SE 3RD AVE NO.3 JT
PORTLAND, OR 97214 00000
PHONE: 503-889-3110 PHONE:
FAX: 503-889-3192
FEES
Description Date Amount
Specifics: Permit Fee-COM 12/15/2020 $69.92
12%State Surcharge-Building 12/15/2020 $8.39
Type of Use: COM Plan Review-Fire Life Safety-COM 12/15/2020 $27.97
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 12/15/2020 $2.50
Occupancy Grp: E Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
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 $108.78
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $1,200.00
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: J],. ¢Mn n A,� Permittee Signature: en / pe rfic� y�}
V1/VI'` �.i:hSJt; JCJIJ� � l Gitj'�/f 1
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 R EC I V D . Received FOR OFFICE USE ONLY
City of Tigard Receive /A/ /,u — Permit No.: �P �+�Cb�y�
• 13125 SW Hall Blvd.,Tigard,OR 972p7j rE rl U2Q Plan Review
s Phone: 503.718.2439 Fax: 503.598. 2020 DAB Oche Permit:
TIGARD Ins ection Line: 503.639.4175 Date Read Juris See Page2for
P CITY OF TIGARD Y AO
Internet: www.tigard-or.gov N *. ,1•a l t''�) Notified/Method:12/15/2 9 AO ci - �, Supplemental Information
L-11
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
IX 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
CATEGORY OF CONSTRUCTION work indicated on this application.
El1-and 2-family dwelling C4 Commercial/industrial
Valuation: $
ElAccessory building El Multi-family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
tIrlry 0
Job site address: q 4 SW 97TH AVE New dwelling area: square feet
City/State/ZIP:/ `
PORTLAND, OR 97214 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:TWAT ITY MI DDLF SCHOOL 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: 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
DESCRIPTION OF WORK work indicated on this application.
INSTALL ANSUL R-102 UL300 KITCHEN FIRE SYSTEM INTO Valuation: S 1200.00
TYPE 1 EXHAUST HOOD Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER 0 TENANT Number of stories:
Name: TIGARD SCHOOL DISTRICTR Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
EX APPLICANT rio CONTACT PERSON NOTICE
Business name: SANDERSON FIRE PROTECTION All contractors and subcontractors are required to be
Contact name: GEOFF SPAH R licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 1101 SE 3RD AVE jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/ZIP: PORTLAND, OR 97/14 apply:
Phone:(503) 889-3110 Fax::( )
E-mail: geofffisandersonfire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: SANDERSON FIRE PROTECTION (Praaasrafermfaeuhsdr<re,
Permit fee:
Address:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:( ) Fax:( ) (Due upon application submittal.)
CCB Be.:208652 Total permit fees:
FY ��� / Amount received:
Al.,Authorized signature: ; CtF% p� �
This permit application expires if a permit is not obtained
Print name: GEOFF 1 A Date: 12/7/2020 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board. /O R`.)
I:Soildmg\Permits`,FPS-PennitApp_031016.doc 440-4613Ttl 1102'COM'WEBj O 6
-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:
Dit 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
0 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 ❑ Yes ❑ No
Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $ 1200.00
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ 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): $
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: $
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