Permit -N
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I:' COMMUNITY DEVELOPMENT Permit#: FPS2022-00125
T IGAgj 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/20/2022
Parcel: 1 S136DC04600
Jurisdiction: Tigard
Site address: 7255 SW DARTMOUTH ST
Project: Planet Fitness Subdivision: 1995-013 PARTITION PLAT Lot: 3
Project Description: Fire sprinkler permit: (80)sprinkler heads for TI.
Contractor: SPRINKIT FIRE PROTECTION INC Owner: COMMERCIAL NET LEASE REALTY, INC
PO BOX 2227 450 S ORANGE AVE, STE 900
OREGON CITY, OR 97045 ORLANDO, FL 32801
PHONE: 503-272-6650 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee-COM 10/17/2022 $295.88
12%State Surcharge-Building 10/17/2022 $35.51
Type of Use: COM Plan Review-Fire Life Safety-COM 10/17/2022 $118.35
Class of Work: ALT Type of Const: VB Info Process/Archiving-Lg$2.00(over 10/17/2022 $6.00
Occupancy Grp: Height: 25 ft 11x17)
Stories: 1 Info Process/Archiving-Sm$0.50(up to 10/17/2022 $6.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Yes Hazard: LT
Density: 0.1 Design Area: 1500
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 $461.74
Valuations: Required Items and Reports(Conditions)
Sprinkler Valuation: $0.00
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 tain copy of the rules
Issued By: Permittee Signature:
Call 03.639.4175 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
Fire Protection System E':�+ FOROFFI( I SI:ONI.'i
p
City of Tigard ECEI V E r Ved
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 SEP 26 2022 Date/By h-)2? T �e�F'�0�.). -rwl ?L�
1 , , Inspection Line: 503.639.4175 Date Ready/By tuns See Page 2 for
Internet: www.ti aid-or. ov CiT\7 Notified/Method 3 Supplemental information
g g l 1 �1FT��,F�RC Pi,�f 7 y9"
1111 . et
TYPE OF WORK T` II AND 2 FAMILY TYWRELING
❑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.
Valuation:
❑ 1-and 2-family dwelling $
®Commercial/industrial
0 Accessory building El Multi-familyNumber of bedrooms:
❑Maotea builder ❑tither Number of bathrooms:
JOB SELL INFORMATION AND LOCATION Total number of floors:
Job site address:7255 SW Dartmouth St New dwelling area: square feet
City/State/ZIP:Tigard, OR 97223 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name:Planet Fitness - Dartmouth Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure arta: 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.
Valuation: $21,000
improve existing fire sprinkler system
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ' 1 '7- gi TENANT Number of stories:
Name:Bravo Fit Type of construction:
Address:15171 Bangy Rd Occupancy groups:
City/State/ZIP:Lake Oswego, OR 97035 Existing:
Phone:(714)269-7579 Fax:( ) New:
® APPLICANT ® CONTACT PERSON
NOTICE.
Business name:Sprinklt Fire Protection Inc All contractors and subcontractors are required to be
Contact name:Nena Stringham licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address:PO BOX 2227 jurisdiction in which work is being performed.If the
applicant is exempt from licensing,the following reasons
City/State/2W:Oregon City, OR 97045 apply:
Phone:(971)313-3826 Fax: :( )
E-mail:office@sprinkitfire.corn
CONTRACTOR BIT TIM ;PERMIT FEES*
Business name:Sprinklt Fire Protection Inc (Please refer to fee schedule)
Permit fee:
Address:PO Box 2227
City/State/ZIP:Oregon City, OR 97045 State surcharge(12%of permit fee):
FLS plan review(40%of permit fee):
Phone:(503) 272-6650 Fax:( ) (Due upon application submittal)
CCB lie 211320 Total permit fees:
Authorized signature: Amount received:
This permit application expires if a permit is not obtained
Print name:Ne a tringham Date:9/21/2022 within 180 days after it has been accepted as complete.
- * Fee methodology set by Tri-County Building Industry
Service Board.
1.Ouildingu'ermifsTPS.Permit.App_031016.doc 440-46f3T(11/02iCOMMBB)
r.
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:
El New system Number of sprinkler heads: 80 Number of alarm devices: n/a
® Addition or ❑ 1-10 heads Affidavit required and fl 1-5 devices: Affidavit required and
Alteration (3)copies of sketch showing area (3) copies of sketch showing area
to existing of w rk 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 ® Wet ❑ Dry
Additional Standpipes
Information: Sprinkler Supply Line El Yes ® No
Hazard Group
Density .10
Design Area 1500 sqft
K.Factor 5.6
Sprinkler Project Valuation: $21,000
B.) Type I - Hood Fire Suppression System n/a
Hood Project Valuation: $
C.) Fire Alarm n/a l :^
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 . eater $404.39
Sprinkler Project Square Footage: sq.ft.
FiProtection 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\Permits\FPS_PemvtApp_031016.doc 2