Permit IIIII CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit#: FPS2021-00105
Date Issued: 9/9/2021
-Fr c;A R.f-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AB00701
Jurisdiction: Tigard
Site address: 16145 SW UPPER BOONES FERRY RD
Project: Kiddie Academy Subdivision: CIRCUIT PARTITION Lot: 2
Project Description: Fire supply line to building.
Contractor: ROBERTSON& OLSON CONSTRUCTION Owner: KALVI LLC
16821 SE MCGILLVRAY BLVD#210 BY MURUGAPPAN, PRABAKAR
VANCOUVER,WA 98683-3404 8821 NW SAVOY LN
PORTLAND, OR 97229
PHONE: 360-699-4724 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/08/2021 $209.80
12%State Surcharge-Building 09/08/2021 $25.18
Type of Use: COM Plan Review-Fire Life Safety-COM 09/08/2021 $83.92
Class of Work: ALT Type of Const: VB Info Process/Archiving-Sm$0.50(up to 09/08/2021 $0.50
Occupancy Grp: E Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Yes 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 $319.40
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $12,702.00
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 obtaina copy of the rules
Issued By:
Holly Va,v1/Ve w PermitteeSignature: OvvAppltcatton
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.
s $uilding Permit Application j _`
Fire Protection System FOR OFFICE USE ONLY
RECEIVE II ,�;��
City of Tigard Davy: q 7/11 Permit No.: �1,_cm ivS—
• Phone:13125 SW Hall Blvd.,Tigard,OR 97223 M n q Plan Rev ew � l 0`� ��
S .ghr 7 22G1 -c-.� Other Permit: �,1' �
503.718.2439 Fax: 503.598.1960 Date/By:
T I G A R D Inspection Line: 503.639.4175 Date ReadyBy: kris, See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method:q g/a �, Supplemental Information
BUILDING DIVlSIO! 41013f ou-et ,f I ^e(
TYPE OF WORK REQUIRED DATA:1-AND 2-FAMILY DWELLING
®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.
ID1-and 2-family dwelling 171 Commercial/industrial Valuation: $
ElAccessory building ❑Multi-family Number of bedrooms:
❑Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 16145 SW Upper Boones Ferry Rd. New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Kiddie Academy Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Fanno Creek P1 & Upper Boones Ferry Otherstructurearea: 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.
4412—
Double Check valve assembly and 6" Fire Supply Valuation: $ to(t 72.
to Building Existing building area: square feet
New building area: square feet
I] PROPERTY OWNER ❑ TENANT Number of stories:
Name: Kalvi LLC Type of construction:
Address: 8821 NW Savoy Lane Occupancy c groups:
gm P
City/State/ZIP: Portland, OR 97222 Existing:
g
Phone:(503) 577-3822 Fax:( ) New: 146 LF @ $87 = $12, 702. 00
12 APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Robertson & Olson Construction, Inc . All contractors and subcontractors are required to be
Contact name: Mitchell Bergman licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 4857 NW Lake Rd. , Suite 320 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
city/Smte/zIP: Camas, WA 98607 apply:
Phone:( 369 844-0802 Fax: :( )
E-mail: mitchell .bergman@roconstruction . com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer Wee schedule)
Businessname: Robertson & Olson Construction, Inc .
Permit fee:
Address: 4857 NW Lake Rd. , Suite 320
State surcharge(12%of permit fee):
eityisrsterzlP: Camas, WA 98607
FLS plan review(40%of permit fee):
Phone:(3 6 0) 8 4 4-0 8 0 2 Fax:( ) (Due upon application submittal.)
CCB lie.: 108300 Total permit fees:
Authorized signature: Amount received: ]/�,��
Print flat/VA
This permit application expires if a per 1s not obtained
Date: 0 9-0 2-21 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry
Service Board.
1:1Buildeg\Penni s\FPS-PermilApp_031016.doc 440-4613T(1 I/02/COM/WEB)
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 ❑ 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 El 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: $
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): $
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: $ / n•/61
I:\Building\Permits\FPS_Pem itApp_031016.doc 2
Branden Taggart
From: Branden Taggart
Sent: Wednesday, September 8, 2021 3:28 PM
To: mitchell.bergman@roconstruction.com
Subject: Kiddie Academy fire Supply Line Permit: FPS2021-00105 - 16145 SW Upper Boones
Ferry Rd.
Attachments: Invoice.pdf
Hello Mitchell,
The Fire Supply Line permit for Kiddie Academy is ready to issue now. The balance due is$319.40, and I have attached
an invoice above for you to reference. These fees can be paid online now at https://aca-
prod.accela.com/TIGARD/Welcome.aspx by searching for the permit record number FPS2021-00105 under the Building
tab. There is a 3%service fee for credit cards, but e-checks do not have a service fee.
Once paid, please email the Permit Technicians at TigardBuildingPermits@tigard-or.gov so that we may issue this
permit and email the approved site copy set of plans for inspections.
Thank you,
Branden Taggart
si City of Tigard
m .'* Senior Permit Technician
nammi Community Development
13125 SW Kali Blvd
Tigard,OR 97223
(503)718-2449
bra n dent@tigard-or.g ov
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