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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit#: FPS2021-00059 Date Issued: 5/27/2021 TI GA Ft D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S102C600100 Jurisdiction: Tigard Site address: 12850 SW GRANT AVE Project: Broadway Rose Theater Subdivision: NORTH TIGARDVILLE ADDITION Lot: 43 Project Description: Fire sprinkler permit-install fire sprinklers in east&west building additions,connect to existing fire sprinkler system. Contractor: EXPRESS FIRE SYSTEMS INC Owner: TIGARD-TUALATIN SCHOOL DISTRICT 23J 1913 41ST STREET 6960 SW SANDBURG ST WASHOUGAL,WA 98671 TIGARD. OR 97223 PHONE: 360-953-8432 PHONE: FAX: 360-953-8394 FEES Description Date Amount Specifics: Permit Fee-COM 05/26/2021 $459.82 12%State Surcharge-Building 05/26/2021 $55.18 Type of Use: COM Plan Review-Fire Life Safety-COM 05/26/2021 $183.93 Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 05/26/2021 $8.00 Occupancy Grp: A-2 Height: 25 ft 11x17) Stories: 1 Info Process/Archiving-Sm$0.50(up to 05/26/2021 $12.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Yes Hazard: LT Density: .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 $719.43 Valuations: Required Items and Reports(Conditions) Sprinkler Valuation: $39,960.00 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: Vatv De.wee Permittee Signature: OVI/ADb1,1,Cai. -n 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 ii Fire Protection System RECEIVE I FOR OFFICE Lst,:ONLY City of Tigard 140 RECC1V� D,�j /3 2021 FFS2021-000S9 DateBv: Permit No.: III • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.598.1960 Date Bv: r. 7 / Other Permit: CITY OF TIGARU �� �S- _ I I.I,i A U Inspection Line: 503.639.4175 dy/ByfJ' l�!1y torts. I ® See Page 2 for Internet: www.tigard or.gov3UiLDING DIVISIONI ttfied/Moho l�S;jf� Supplemental Information , yam�'' /�qi� TYPE OF WORK q ORa d+ , REQUIRED DATA:1-AND 2-FAMILY DWELLING ❑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 CONSTRUCTION work indicated on this application. ❑ 1-and 2-family dwelling 0Commercial/industrial I Valuation: S ❑Accessory building ❑Multi-family Number of bedrooms: I 0 Master builder ❑Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 12850 SW Grant st., New dwelling area: square feet City/State/ZIP: Tigard,OR 97223 Garage/carport area: square feet Suite/bldg./apt.no.: I Project name: Broadway Rose Theater li Covered porch area: square feet Cross street/directions to job site: Deck area: square feet SW Walnut st Other structure area: square feet REQUIRED DATA:COMMERCIAL-USE CHECKLIST Subdivision: I Lot no.: Permit fees*are based on the value of the work performed. Tax map/parcel no.: 2S 102C 600100 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 Fire sprinklers in the east and west building additions connected Valuation: $39,960 to the existing lire sprinkler system Existing building area: 10,399 square feet New building area: 6,163 square feet ® PROPERTY OWNER I ❑.TENANT Number of stories: 1 Name: Broadway Rose Theater Type of construction: VB Address: 12850 SW Grant st., Occupancy groups: City/State/ZIP: Tigard,OR 97223 Existing: A&B Phone:( ) Fax:( ) New: A, B, F-1,S-1 INAPPLICANT ❑ CONTACT PERSON - . _.. NOTICE Business name: Express Fire systems All contractors and subcontractors are required to be Contact name: Mohamed Hussein licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 670 S 28th st. jurisdiction in which work is being performed.If the City/State/ZIP: Washougal,WA 98671 applicant is exempt from licensing,the following reasons apply: Phone:( 360 )953-8432 I Fax: :( ) I E-mail: mohamed@expressfiresystems.com CONTRACTOR BUILDING PERMIT FEES* (Please referto fee schedule Business name: Express Fire systems Address: 670 S 28th at. Permit fee: State surcharge(12%of permit fee): City/State/ZIP: Washougal,WA 98671 ELS plan review(40%of permit fee): Phone:( 360)953-8432 I Fax:( ) (Due upon application submittal.) CCB lic.: 193P72 Total permit fees: j- Authorized signature: /� Amount received: g��+/� This permit application expires if a permit is not obtained IPrint name: M oI- nota u SSP 3n I Date: ,cj` to/202.\ j within 180 days after it has been accepted as complete. * Fee methodology set by Tri-County Building Industry Service Board. I:\Bailding\Permits\FPs-Perm.tApp 03 io16.doc 440-4613T(11/02/COM/WEB) I r . 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: 0 New system Number of sprinkler heads: 65 Number of alarm devices: ❑ Addition or 0 1-10 heads: Affidavit required and 0 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 ❑x 11+heads: Plan review required and 0 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 0 Yes X❑ No Hazard Group Light &Ord. Gil Density .1 &.2 ppm/sq ft Design Area 1200 &1500 sq ft K. Factor 5.6&8.0 Sprinkler Project Valuation: $39,960 B. Type I - Hood Fire Suppression System Hood Project Valuation: $ C.) Fire Alarm Submittal shall Battery Calculations ❑ Yes include: Individual Component 0 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. � I 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_PennitApp_031016.doc 2