Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00001
Date Issued: 2/2/2021
T f C;A R T-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD, STE#501
Project: Lithia Driveway Subdivision: None Lot: None
Project Description: Fire sprinkler permit:Adding and relocating(13)sprinkler heads for TI.
Contractor: SPRINKIT FIRE PROTECTION INC Owner: LITHIA REAL ESTATE INC
PO BOX 2227 ATTN DEBOER, MARK
OREGON CITY, OR 97045 150 N BARTLETT ST
MEDFORD, OR 97501
PHONE: 503-272-6650 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 01/29/2021 $102.20
12%State Surcharge-Building 01/29/2021 $12.26
Type of Use: COM Info Process/Archiving-Lg$2.00(over 01/29/2021 $2.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: B Height: ft Info Process/Archiving-Sm$0.50(up to 01/29/2021 $6.00
Stories: 11x17)
Plan Review-Fire Life Safety-COM 01/29/2021 $40.88
Commercial Sprinkler System:
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 Calcs Provided: Cut Sheets Required:
Total $163.34
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $2,500.00
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: 01.6.\ 1 r Permittee Signature: cin c \ c t C—
v�l l l A ` j� X t
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 4.113i ` _-
Fire Protection System RECEIVED ft>R urii t: i st:0,1,1
City of Tigard Received
DateBy: S Permit No..
III
• 13125 SW Hall Blvd.,Tigard,OR 97223 DEC 31 20Y0 / �� /�°r�a���Jlk��
Plan Review
N.
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: ode pest' j{f�Q Inspection Line: 503.639.4175 CITY OF TIGA1 1 a See lcg Z f -�� `�
l I t d E U p Date Ready/By: i + i/ f Juts: See a e or
Internet www.tigard-or.gov Notified/Method , / II '716,. Supplemental Information
',&DING DIVISION
„/TiL
TYPE 01 WORK'" . ., .r fi'ws`vz . :'rl., t. , REQUIREDDA,.'A.I-.AND2-FAMIL'S11WELLING
0 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
CATEGORY OF CONSTRLCTION work indicated on this application.
0 1-and 2-famil Y dwellin Valuation: $
g ®Commercial/industrial
❑Accessory building 0 Multi-family Number of bedrooms:
❑Master builder ❑Other Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address:9020 SW Washington Square Rd. New dwelling area: square feet
City/State/ZIP: Garage/carport area: square feet
Suite/bldg./apt.no.:501 Project name:Lithia TI Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERCIAL-LSE CHIC
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.
Add and relocate fire sprinklers for TI. Valuation: $2,500
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: — Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax. ( )
New:
0 APPLICANT Q.CONTACT PERSON "" .. NOTICE
Business name:Same as below All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed.If the
City/State/ZIP: applicant is exempt from licensing,the following reasons
apply:
Phone:( ) Fax: :( )
E-mail. 5-FE't�/�! �.,.Z�- 0)0, "hit , Cc"-,
'TOR BUILDING PERMIT FEES"
Business name.Sprinklt Fire Protection Inc. (rrcascr rrw(ee rJredrrrel
Address:PO Box 2227 Oregon City, OR 97045 Permit fee:
City/State/ZIP: State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(5j03272-6650 Fax:( ) (Due upon application submittal.)
CCB lie.:211320 Total permit fees:
Authorized signature: /Z ,y D✓L Amount received:
This permit application expires if a permit is not obtained
Print name:Travis Schweitzer Date:12-30-20 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1.1Budding 1 PermitslFPS-PermrtApp_031016.doc 440-4613T(11/02/COM"WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
Describe wor1cii: 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: 13 Number of alarm devices: NA
® 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
,emu,
Sprinkler Type 11 Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line 0 Yes ❑ No
Hazard Group
Density .1/1500 min
Design Area NA
K. Factor 5.6k
Sprinkler Project Valuation: $2,500
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
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: $
C:\Users\SprinkIt Fire\Downloads\FPS_Per nitApp.doc 2