Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
III s COMMUNITY DEVELOPMENT Permit#: FPS2021-00106
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/23/2021
Parcel: 25101 BD00300
Jurisdiction: Tigard
Site address: 8015 SW HUNZIKER RD
Project: Fred Shearer&Sons Subdivision: None Lot: None
Project Description: Provide antifreeze fire sprinkler coverage to two new canopies at office exterior.
Contractor: WESTERN STATES FIRE PROTECTION Owner: 8015 HUNZIKER LLC
17500 SW 65TH AVE 8015 SW HUNZIKER RD
LAKE OSWEGO, OR 97035 TIGARD,OR 97223
PHONE: 503-657-5155 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 09/22/2021 $295.88
12%State Surcharge-Building 09/22/2021 $35.51
Type of Use: COM Plan Review-Fire Life Safety-COM 09/22/2021 $118.35
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 09/22/2021 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 09/22/2021 $12.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
Density: 0.1 Design Area: 1500
K Factor: 05.6
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $464.24
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $20,047.00
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
Issued By: Permittee Signature:
Ho{dM Vaw De-Wege C)w A -ILe.rt>/-Lcry
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.
Bpildine Permit Application e,^ 7/2-
Fire Protection System RECEIVED FOR OFFICE I SIB ()NI.A
City of Tigard (� �/ Received
Date/By: -`/iZ4 X e 6 Permit No.FPs Z9ZI-60I0
:11111 , S50 Hall Blvd.,Tigard,OR 97223 S E P 0 7 2021 Plan Rev ew
Phone: 503.718.2439 Fax: 503.598.19¢(i DateBy: A Other Permit:
Y
Inspection Line: 503.639.4175 lL OF TIGARD Date Ready/By: ri ® See Page 2 for
Internet www.tigard-or BUILDING DIVISION! NgN}ffd/MetIod /
lu "TI Supplemental Information
TYPE OF WORK r'=REQUIRE))DATA:1-AND 2-FAMILUDALING
❑New construction ❑Demolition Permit fees*arc based on the value of the work performed.
.�f Indicate the value(rounded to the nearest dollar)of all
�y,Addition%alteration replacement ❑Other:
equipment,materials,labor,overhead,and the profit for the
CATEGORY OF c t `" UCTION work indicated on this application.
0 1-and 2-family dwelling jCommercial/industrial Valuation: $
ElAccessory building 0 Multi-family Number of bedrooms:
❑Master builder 0 Other: Number of bathrooms:
F, _ ,. ,_ u.�.x vgxtwx-x. �xo..,.. .'..., ,. , _.__..
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: gO( St,J .f.+Ik.vie r s-• New dwelling area: square feet
City/State/ZIP: 1lJ h , 1 619 9 2-Z 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Fred aizai,ram- .}ee�.��'oe 4sMo. Covered porch area: square feet
Cross street/directions to job site: re_r_4( S(��-rarer cy,11 S tr}t,li• Deck area: square feet
in)1..--Stw1 {� .A r ker Sri . -C Si,/ q 2r•d A-ve , Other structure area: square feet
a.a.si- .Firaw1 SW 1{ 131v-d4. REQUIRED DATA:C®li"„
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.
pt'D VIA.f. ari-4r�F ri'r�k-tom.- +d -t-wo Valuation: $ �, el it.?
Yt tn,J (µft,0i 25 Grt p F{,u �l p Existing building area: sµm:_ square feet
1 New building area: 'a.6. '4 square feet k(kLek.
0 PROPERTIC OWNER TENANT Number of stories:
Name: ' 51,....e.4,re.-i- S.- S N:S is
Type of construction: Y..
Address: gOI S ) 14+-tnst
,,! �i Occupancy groups: F.
City/State/ZIP: 'ri w d - R 1 Lz3
J' J Existing: 13,
Phone:(5: 3)552_o-`iel l t Fax (503 ) 6,2,6 -9 g9 I
New.
El APPLICANT ❑ CONTACT PERSON
� NOTICE
Business name: 14,LS s' Yi c- a-ft C I 'rY Pri 1J-PAe All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board
Contact name: �t t/ivy Q I$Qy`
under ORS 701 and may be required to be licensed in the
Address: (l500 SW 4c-ik-
rAtY-G jurisdiction in which work is being performed.If the
City/State/ZIP: t 0 � 9 3 S applicant is exempt fs inn licensing,the following reasons
Phone:(603)330 _0(6 Z cc tA(() Fax: :( ) apply
E-mail: �Pi✓hi3OtS�0. WS-CP_ S
CONTRACTOR BUILDING PERMIT FEES*
111
Business name: �e..c.+6rys, s{�-t�t 'VT:moo P�i.e ki� (Pleaserefer to fee schedule
Address: (- tso rj'W 6;-rL A� 1 Permit fee.
City/State/ZIP: I,4 051 j - `l�-035 State surcharge(12%of permit fee):
O FLS plan review(40%of permit fee):
Phone:(. o3) 6S7- ->I 6a5 cpe{,0,) Fax:(507 ) ,�4 -=j($'2- (Due upon application submittal.)
CC/3 lic.: t 045 40 Total permit fees:
Authorized signature: ` / _ Amount received:
V_ ' l S�'�� This permit application expires if a permit is not obtained
Print name:k.e. 1K 015 aye_ Date: el 73/i wI within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
1:\aui]ding1Permhe\FPS-PermiiApp_031016.doc 440-4613T(1 I/021COM'WEn)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
1.) Type of Work: 2.) Addition/alteration only to sprinkler heads: 3.) Addition/alteration only to alarm devices:
Q New system Number of sprinkler heads: 4 Number of alarm devices:
g. Addition or ❑ 1-10 heads: Affidavit requited 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
AhbF,w-at-F., Ae• - 11+heads: Plan review required and ❑ 6+ devices: Plan review required and
tnG r4 0e1- (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 6- Wet ❑ Dry
Additional Standpipes N/A
Information: Sprinkler Supply Line ❑ Yes ►. No (p,t,c-r-t')
Hazard Group L-i1
Density 0. 10
Design Area 1500 4+2- CE`n+,rye
K. Factor 5.C.
Sprinkler Project Valuation: $ 22)/I`l
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: I $
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 n:•',
Sprinkler Project Square Footage: I 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: $
I:\Building\Peanits\FPS_PemvtApp_031016.doc 2