Permit (2) CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11 COMMUNITY DEVELOPMENT Permit#: FPS2022-00083
Date Issued: 6/16/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102DB09600
Jurisdiction: Tigard
Site address: 8815 SW OMARA ST
Project: Tigard Senior Housing Subdivision: TIGARD SENIOR HOUSING Lot: 1
Project Description: Installing NFPA3 Wet system and manual standpipe.
Contractor: PATRIOT FIRE PROTECTION INC Owner: TIGARD, CITY OF
4708 NE MINNEHAHA ST 13125 SW HALL BLVD
VANCOUVER,WA 98661 TIGARD, OR 97223
PHONE: 360-699-4403 PHONE:
FAX: 360-699-4485
FEES
Description Date Amount
Specifics: 12%State Surcharge-Building 06/16/2022 $132.15
Permit Fee-MF 06/16/2022 $1,101.27
Type of Use: COM Plan Review-Fire Life Safety-MF 06/16/2022 $440.51
Class of Work: NEW Type of Const: VB Info Process/Archiving-Lg$2.00(over 06/16/2022 $12.00
Occupancy Grp: R-2 Height: 55 ft 11x17)
Stories: 4 Info Process/Archiving-Sm$0.50(up to 06/16/2022 $112.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.1 Design Area: 1000
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 $1,798.43
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $164,020.00
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 Ilow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. Y y/obtain a c y of the rules
Issued By: }--pQrnrittea Sig°ature:
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.
f •
1 Building Permit Application
Fire Protection System RECEIVED
City of Tigard FOR OFFICE USE ONLY
.1111 • 13125 SW Hall Blvd.,Tigard, I Received .
Phone: 503.718.2439 Pax::03.5981�p 202� Date/B / '�a
Plan Review
TIGARD Inspection Line: 503.639.41756 -�"�;
Internet: www.tigard-or.gov CITY OF 1 IGARD DateB : _ ,'�
t� /� C 1. Date Ready/By: •t (,UI!-DINC DIVISION' ioti0ed/Method:' l�lL ��/� 0 Sea Paget for
`�` „c�I Supplemental Information
TYPE OF WORK L..a_
P.: ' REQUIRED DATA:1-AND 2-FAMILY D
0 Demolition WELLING
❑Addition/alteration/replacementPermit fees*are based on the value of the work performed.
0 Other: Indicate the value(rounded to the nearest dollar)of all
' equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION
work indicated on this application.
❑ 1-and 2-family dwelling
❑Commercial/industrial
❑Accessory building
CI Multi-familyNumber of bedrooms:
❑Master builder
117 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION
Job site address Jl• Total number of floors:
City/State/'LIP: 5 #4 k
. O• • 22.
e/c
Suitc/bldg./apt.no.: Garagarport area: square feet
Project name:
Cross street/directions to job site: ^ ,• 0
0 Covered porch area:
�� � square feet
Deck area:
square feet
Other structure area:
s9varc feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Tax Subdivision:mapon no.: Lot no.: Permit fees*arc based on the value of the work performed.
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.
I Pt ` . K.. SNe Valuation:
0 M r44uAt. W 'T 7 ►P(pE g area: $ Llo4,o�A
r Existing building square feet
PROPERTY OWNER New building area:+1 r47p
0 TENANT 1 square feet
Name: NO, H r. r�r/ Number of stories: 4"
1..,,,,t e5 Type of construction:
..,�L l
City/State/ZIP: - 1.) „ r� Occu anc
L(�^ Gj 7?Z Z P y groups:
Phone:(r0. , (054, -
�00 Existing:
IIIIIII ._ fPERSON 0.CONTACT New: MI)(o 11_E
Business name: • V�
!_ a'^ fa& e/ `�� ) NOTICE
Contact name: i All contractors and subcontractors arc required to be
licensed with the Oregon Construction Contractors Board
Address: 70e N�
-(16,j(� ST, under ORS 701 and may be required to be licensed in the
City/State/ZIP: d, 4DITI ca.. WA jurisdiction in which work is
■ 11 being performed.If the
Phone:(`3(Q� i applicant is exempt from licensing,the following reasons
fD 1i9. '4 017 Fax::(1j 90 _- _ •
aPPIY:
E-mail: ..IJa,llSCir
•�Alf- Ire .COIVN`
CONTRACTOR
Business name: ALL BUILDING PERMIT FEES*
' Please re er to ce ackedale
Phone ( ) State surcharge(12%offpennit fee): 1111111111111
FLS plan review(40°/a o permit fee):
Call
CCB lie.: p :0 ZZ Due a on ap plication submittal.
Authorized signature: ir
L. \ Total permit fees: M.
Amount received:
Print name: ._ti� This permit application expires if a permit is not obtained
1/ w Date: (• I ® within 180 days after it has been accepted as complete.
I:UiuildingNcrmitaUPS•PcrmitApp 03le1 fi.dac ' Foe methodology set by Tri-County Building Industry
440-4613T(I 1/02/COM/Wg11) Service Board.
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: Number of alarm devices:
❑ Addition or ❑ 1-10 heads: Affidavit required and
Alteration ❑ 1-5 devices: Affidavit required and
(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 le Wet ❑ Dry
Additional Standpipes MktJUPEL W -r
Information: Sprinkler Supply Line 4. Yes ❑ No 0-10(nEP¢,
Hazard Group L►k2HT
Density , 10
Design Area
4 ' sq.. rr
K. Factor
5,b , 4 tq
Sprinkler Project Valuation: I $ ((o4 102D
B.) Type I- Hood Fire Suppression System
Hood Project Valuation: $ Na
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes _
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ 64 a
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: 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')/0 of permit fee): $
TOTAL: $
I:\Building\PermitAI PS_PermitApp_031016.doc 2