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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT -? 8 • ; COMMUNITY DEVELOPMENT Permit #: FPS2010 -00080 T [ G A R.O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/10/2010 Parcel: 1S135BC01100 Jurisdiction: Tigard Site address: 11131 SW GREENBURG RD Subdivision: Lot: 0 Project: Jump Sky High Project Description: Fire sprinkler TI, approximately (29) heads. Owner: FEES ROBINSON FAMILY TRUST Description Date Amount BY E LEE & EVELYN L ROBINSON TRS, PO permit Fee - COM 08/10/2010 $145.24 BOX 91305 12% State Surcharge - Building 08/10/2010 $17.43 PHONE: Plan Review - Fire Life Safety - COM 07/29/2010 $58.10 Contractor: FIRESTOP CO 3203 NE 65TH ST. #2 VANCOUVER, WA 98663 PHONE: 360 - 718 -8604 FAX: 360 - 718 -8603 Type of Use: COM Class of Work: ALT Type of Const: IIIB Occupancy Grp: A -3 Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: No Hazard: ORD1 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 $220.77 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 7000 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 C UN es and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not s rted within 180 days of issuance • rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ules adopted by Oreg, Utili otification Cente, Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Yo f may obtain a copy o the rul or rect questions to OC (ling 03.246.6699 or 1.800.332.2344. \ /; (� Iss ed By: I� Permittee Signature: � —=._/ ` l� Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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 ''_ � '' t i • j ' �'� �1 Fire Protection System JUL 2 9 MO FOR OFFICE USE ONLY p� City of Tigard Received Date /By: / A ma y'/ a >� PermitNo.. OJat� O/O'ta0 , a e q 13125 SW Hall Blvd., Tigard, OR 97223 ', l / ,. .' i ' i n' P Review 1)i t0 Other Permit: `. C : Phone: 503.639.4171 Fax: 503.598.1960 ,, - . ' ; 1 , ": Da /B • : 11 u 19,0/40. ��d �/ ^ y TIGARD Inspection Line: 503.639.4175 Date Ready : y: Juris ® See Page 2 for I � '/ Supplemental Information Internet: www.tigard or.gov Notified/Method: / S t ttt. R44 . • TYPE OF WORK ` . REQUIRED DATA: ,4'..: AND 2= FAMILYDWELUNG .- ❑ 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: $ E y?'j` ❑ 1- and 2- family dwelling commercial /industrial ii�/'''�`"' `"'' Number of bedrooms: ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: Number of bathrooms: • •• • . JOB SITE INFORMATIO LOCATION Total number of floors: Job site address: 11 ( 3,- 1 Sc.' 6- E Al QV a G 2D . New dwelling area: square feet City /State /ZIP: GA R D 12 . C(7 22_ 3 Garage /carport area: square feet Suite/bldg. /apt. no.: ` Project name: 5v,, D sic r -11 & pH, Z I t :, Covered porch area: square feet Cross street/directions to job site: I 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. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the • DESCRIPTION OF WORK; work indicated on this application. Valuation: $ 7 / MI) - 4'�' A A b F1 12-G S P rSJ K L.E/LS A s N E c t Ss,} 12-'/ Fo /Z i, =, Existing building area: square feet New building area: square feet { PROPERTY-OWNER .. ' 0 TENANT ' Number of stories: Name: Ro E 1 0 sO N FAM 1 (_• 'T12_v5 T Type of construction: Address: Z( ? 6 0 N IA) A M Rcft cl© t b ia-' Occupancy groups: City /State /Z1P: '-ii ( �or2.p 0 IL, X17 12.4 Existing: Phone: (SCJ 61,45.7 ;) 61,45.7 g _ 531 Fax: ( 5 ) 3 ) G4-5-535 I �7 New: ❑ APPLICANT 0 CONTACT PERSON •. ' , N .O,TICE ' . • Business name: F I _E S To P Go 44 p f j iv y LL G All contractors and subcontractors are required to be p D licensed with the Oregon Construction Contractors Board r,� Contact name: o B 6Tl'E E N under ORS 701 and may be required to be licensed in the Address: 3 2 03 rJ, E , 6 5 Sr: S p/4 Z jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City /State /ZIP: VAN ov v -Ei vok , q (36,6 3 apply: Phone: (3bo // -- 7I e ' D604. Fax: :(360)7I P 360 E -mail: b O b.q re e N c ! t t re star 6-o Go i'1'1 CONTRACTO .. BUILDING PERMIT FEES *,, (Please ref • fee'schedute) . Business name: 54 41 A S , �- Q d V Permit fee: Address: State surcharge (12% of permit fee): City /State /ZIP: FLS plan review (40% of permit fee): Phone: ( ) Fax: ( ) (Due upon application.) I CCB Iic.: I S 3 Z 1 1 Total permit fees: Amount received: 58 , la Authorized signature: 744 • /S This permit application expires if a permit is not obtained v ,.--� Date: � Z 1 0 within 180 days after it has been accepted as complete. Print name: g..„ �?" ,D IWG / // * Fee methodology set by Tri- County Building Industry Service Board. Ll Building \PermitslEPS- PermitApp.doc 10/01/09 440- 4613T(I1/02 /COM/WEB) City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information 1.) ❑ New 2.) Modification to sprinkler heads only: X t Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration g 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 2 Additional description of work: Type of�System�(Complete'A, B, or'Il . applica A 3COminerClal �Sphtlkler d Y § F °. .. r . Wet ❑ Dry Additional Standpipes Information: Hazard Group 0 N Density ei PE Design Area K. Factor 5 i .(�, Sprinkler Project Valuation: $ 070 cry r Type Hood FtreSuppr`ession; Hood Project Valuation: $ tG1 T i P.wt s { -2 L t t Fi - r ` x t i C) "Fire Alarm °, ; . Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ yy �F141: � ' E t £D) .g:#14entiakV0 (,Stand Alo Sy ne ste �';$,rM ? a, - ._,, f'F_'� x l- f4wf : .. ,. -.g Square Footage: Permit Fee: , ¢ 0 to 2,000 $198.75 2,001 to 3,600 $246.45' s a taxi f 3,601 to 7,200 $310.05 7,201 and greater $404.39 4,Yr Sprinkler Project Square Footage: sq. ft. 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. I: \ Building \Permits \Permit Forms 10 -01 -09 \FPS - PermitApp.doc 10/01/09 2