Permit v
CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 00022
T I GARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2010
Parcel: 2S112AA00500
Jurisdiction: Tigard
Site address: 14344 SW 72ND AVE
Subdivision: NELSON BUSINESS CENTER Lot: 0
Project: Leifs Auto Repair
Project Description: Add and relocate sprinklers for TI.
Owner: FEES
WALTON CWOR NELSON 13 LLC Description Date Amount
BY TTA/EPROPERTYTAX DEPT 735, PO BOX
Permit Fee - COM 03/11/2010 $102.20
4900 12% State Surcharge - Building 03/11/2010 $12.26
PHONE: Plan Review - Fire Life Safety - COM 03/11/2010 $40.88
Contractor:
JND FIRE SPRINKLER INC
12155 SW GRANT STED
TIGARD, OR 97223
PHONE: 503 - 968 -5200
FAX: 503 - 968 -5920
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard:
Density: 0 Design Area: 0
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 $155.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 2930
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /®1 0� �„ , ,, ` Permittee Signature:
� u(
PP
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. J�
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.
1
Building Permit Application
i
Fire Protection System 4 ' CEIVED '3 , ` n . _ .,4r.,
l ' 2 . e,. , 4 ' City of Tigard D /i Penn tNo.: 1� 40 ` , . `
13125 SW Hall Blvd, Tigard, OR 97223 MAR 1 '' G q Plan Review . ®
11114,: w ® 1 L U `� Other Permit
Phone: 503.639.4171 Fax 503.598.1960 DazeB
i 'i'"=' Inspection Line: 503.639.4175 Date Ready/By. . � hum 0 See Page 2 for
1 I6, • 1 -1• I CJ� -r1(� • N1,1( :1) Internet: www.tigard �`I' OF � �G��D Notified/Method Supplemental Information
BUTT DING DIVISION l__ry - t .-� �,r— �e
TYPE OF WORK REQUIRED DATA: 1- 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
X 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 XCommercial/industrial
❑ Accessory building Number of bedrooms:
❑ Multi - family
❑ Master builder ❑ Other Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: ' y 344 sw 7 2)4 A -vE New dwelling area: square feet
City/State/ZIP: Ti6tmez og 229 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: (Elf S 1 9,'g tEp 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.
PplY0 /14 g/) c .r414Mic is Folk Valuation: $2.19 3 CD
I � a w l $ t � L�G FFl C ' ' Existing building area: square feet
C Y " New building area: square feet
❑ PROPERTY OWNER TENANT Number of stories:
Name: LE 1, Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: J Etc D licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/ State/ZIP:
applicant is exempt from licensing, the following reasons
MAY:
Phone:( ) I Fax::( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: JjD F1 pc. '4L. (Hulse refer to fee schedule)
4,144,0" ^ Permit fee:
Address: 1 115 SW � SO 1 T- IJ
1 State surcharge (12% of permit fee):
City/State/ZIP: - t a R 9722.3 FLS plan review (40% of permit fee):
Phone: ((3 )C SZ Fax: 56 3) ca -s Z 0 (Due upon application)
CCB lic.: 1 9 G439,5- Total permit fees:
��''�� CC
Authorized signature: �—/� d��� Am ount received: l v�.J •3 4
�✓ This permit application expires if a permit is not obtained
Print name: ) 06.476/Q . Date: 3 ,j f f b within 180 days after it has been accepted as complete.
JEFF * Fee methodology set by Tri- County Building Industry
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
Alteration ;i4„ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: _
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density .10
Design Area l SaO
K. Factor S o
Sprinkler Project Valuation: $Z
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 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: 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: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or
NICET level "3" technicians.
C: \PERMIT APPLICATIONS \Tigard FPS- PetmitApp.doc