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Permit Buildin¢Permit Application RECEIVED Fire Protection System AUG 2 ; 2021 1 OR Mill 1 I si.i1\1.1 City of Tigard TY OF TIGARL o ildll 12,25 - I !i i :,-Z(0 i—A!� 13125p :swHall iiaii Tigard'sOoi s97e21196ING V SION - 1 -2 4' -(i Sae"I,,i,i Inspection Line: 303.639.4I75 Ds i tinirbtattot G ,_ �,/ Wet Internet: www.tiprd-or.gov ®New coestnction 0 Demolition P.,inh fees•an bred on the value of the work pa foamed. Indicate the value(rounded to the nearest afore)etd ❑AddIdv miter tiodnphCMRr1 ❑OBta: equipment,materials,labor,overhead,and the profit Sr the work indicated on this application. Valuation: S ❑1-and 2-family dwelling ©CotnrereiaVindnvial Number of bedrooms: ❑Accessory building 0 Multi-family ❑Mauer builder ❑Other. Number of bathrooms: Tout number of floors: job are aurae: ipee loutweet78w Avenue New dwelling area: aquae feet City/State/ZIP: 71903,OR17224 Garage/carportas: square feet SuitoladgispL no.: Project name:General Pleb Otero Covered porch area: square far Cores M reet/rrections to job site:monism Wetness Pam t Deck area: square feC1 Other abvattne rem: equate feet Subdivider I Lot no.: Permit fees•are based on the value of the week performed Indicate the value(rounded to the nearest dollar)of all Tax rap/prcel no.: _ equipment,materials,labor,overhead,and the profit for the IIIIIICMIIIIIIIIMIWOKK work indicated on this application. tweed Anal 1102 Oveloppll pears sr Yarn Ilselsrau+l Fn sepWsseem Sy>a0^nor —peoppeiAtielWeisiesee Existing building area: square feet New building area: square feet Number of stories: Name:Owend►ens Grim Type of conmuetion: Address: MO SW 7bd Ave Occupancy groltpa: City/State/ZIP: Trott cot ai224 Eafstillg. nem(orbs ){244eo eta 4104 Far( ) New: Burmese use:wad pie Al eoerattots and subcontractors are required to be licensed with the Oregon Construction Contractors Board Carmel ruse: Ed Wallow licensed ORS 701 and may be required to be braised in the Arrow,est 1 RE ILUUr.1001. jurisdiction in which work is being performed.Ifthe applicam is exempt front licensing,the following reasons City/Sere/MP: Perewe.ORe72tt *Fly: p (tow ) room Fax::( ) E-mail: seelsrafrpksnn Bnmeae norm. Ia41M Me Permit fee: Address: Lets NE MLK.ar.Owl Sots surcharge(12%of permit fee): paaaa6 OR 17a1 t FLS plait review(40%of permit fee): Phone:(Pq ) 1494771 Fax:( ) (Dee eponmplication iubmrlrat) Total permit fees: CCB lie.:M2e0 Amount received: T Authorized si �-,d �I�'1�^ //l e prude appraise aspires Ira permit Is as error write 1N dye afar I has beef steeped as esesprte. Print tome: 9 L(�4 L Date: a't•-�xt ri • Fes methodology see by 76-County Building Wholly .. Service Board. t,91yOdirlryrJArrq•prwNApr_0110KIrt 610ffiUT11 L OI COWWER) 1 City of Tigard: Fire Protection Permit Checklist Page 2-Supplemental Information eescrie= K :..o. 1.) Type of Work 2.) Adchtion/altcration only to sprinkler heads: 3.) Addition/alteration only to alarm devices: O 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: •ble A.) Cottmierci. Sprinkler Type ❑ Wet ■ Dry Additional Standpipes Information: Sprinkler Supply Line 0 Yes ❑ No Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ -.., B.) Type I- Hood Fire Suppressiorisys em Hood Project Valuation: $ 1918(ID C.). Fire Alarm,. Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: I $ D.) #tesid_nttal,Sprtnkler(StandAlone S stem) 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. re rotection Per 't Fee: 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): $ FIS Plan Review(40%of permit fee): $ TOTAL: $ I:\Building\Permits\FPS_PermitApp_031016.doc 2