Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
IICOMMUNITY DEVELOPMENT Permit#: FPS2021-00061
Date Issued: 11/23/2021
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111 BA00802
Jurisdiction: Tigard
Site address: 14170 SW 100TH AVE
Project: Wamala Subdivision: TIGARDVILLE HEIGHTS Lot: 24
Project Description: Fire Sprinkler permit:New NFPA 130 residential fire sprinkler system
Contractor: EXPRESS FIRE SYSTEMS INC Owner: WAMALA, RONALD&ELIZABETH
670 S 28TH ST 14170 SW 100TH AVE
WASHOUGAL, WA 98671 TIGARD, OR 97224
PHONE: 360-356-8105 PHONE:
FAX: 360-953-8394
FEES
Description Date Amount
Specifics: Permit Fee-COM 11/18/2021 $242.08
12%State Surcharge-Building 11/18/2021 $29.05
Type of Use: MF Plan Review-Fire Life Safety-COM 11/18/2021 $96.83
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 11/18/2021 $2.00
Occupancy Grp: R-3 Height: ft 11x17)
Stories: 2 Info Process/Archiving-Sm$0.50(up to 11/18/2021 $7.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.05 Design Area: 144
K Factor: 4.9
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $376.96
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $15,682.00
Residential Square Footage: 3357
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: 7,77 c
ri
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 fl
Fire Protection System RECEIVES FOR OFFICE USE ONLY
Received
City of Tigard Da eBy: leoSF 202 I e' / Permit No.fS2021-00 o/
• 13125 SW Hall Blvd.,Tigard,OR 97223 N 1 V 04 2021 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date,By. ,1- 1 G—D,4 Other Permit.
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyBy. / / Jur ® See Page 2 for
Internet: www.tigard-or.gov Nttfied:Meth !/ / 14 Supplemental Information
BUILDING DIVISION �
TYPE OF WORK h�>'/ I DATA:I-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.
LiI-and 2-family dwelling ❑✓ Commercial/industrial Valuation: $
0 Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 14170 SW 100th Ave New dwelling area: square feet
City/State/ZIP: Tigard, OR 97224 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: Wamala Assisted Living Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: 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.
Install new fire sprinkler system Valuation: $ 15,682
Existing building area: square feet
New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Ronald Wamala Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:(503)583-8624 Fax:( ) New:
❑ APPLICANT 0 CONTACT PERSON NOTICE
Business name: Express Fire Systems All contractors and subcontractors are required to be
Contact name: Tiffany Bell 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)583-8624 Fax: :( )
E-mail: Design@expressfiresystems.com
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule
Business name: Express Fire Systems
Permit fee:
Address:670 S 28th St.
City/State/ZIP:Washougal WA 98671 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(360 953-8432 Fax:( ) _ (Due upon application submittal.)
CCB lie.: 193272 Total permit fees:
Amount received:
Authorized signature: 9P3D51-4 )Clgi.e-- This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Tiffany Bell Date: 11/1/21
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits\FPS-PermitApp_031016.doe 440-4613T(I 1/02/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:
0 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
El 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 ❑✓ Wet ❑ Dry
Additional Standpipes _
Information: Sprinkler Supply Line ❑ Yes 0 No
Hazard Group Light _
Density 0.05
Design Area 265
K. Factor 4.9
Sprinkler Project Valuation: $ 15,682
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: 3357 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: $
1:A Building\Permits\FPS_PermitApp_031016.doc 2
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