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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT e COMMUNITY DEVELOPMENT Permit #: FPS2010 -00109 T 1 CA R. O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/21/2010 Parcel: 1S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 510 Subdivision: Lot: 0 Project: Gress & Clark Project Description: Relocating (8) and adding (2) sprinkler heads. Owner: FEES WISCO REAL ESTATE EQUITY Description Date Amount FUND I LTD PARTNERSHIP, BY WYSE Permit Fee - COM 09/21/2010 $69.92 INVESTMENT SRVS CO, 1501 SW TAYLOR ST 12% State Surcharge - Building 09/21/2010 $8.39 PHONE: Contractor: AFP SYSTEMS INC 19435 SW 129TH TUALATIN, OR 97062 PHONE: 503 - 692 -9284 FAX: 503 - 692 -1186 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Sprinkler Type: Standpipe Required: Hazard: Density: 0 Design Area: 0 K Factor: 0 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $78.31 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: 0 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 • • • - ' • • ' -1010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to 0 NC by calling 503.24. • • _.`x0.332.2344. _ l Issued By: �. Permittee Signature: I'• I " /Iii �✓ Jim '' 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. , A • 1 Building Permit Application RECEIV '' Fire Protection System z Dreier; list: ONLY City of Tigard S EP 21 2 1 1�`e "`� 13125 SW HaII Blvd., Ti ard, OR 97223 atdB • g o 11 Permitxo. (!'f —� q 8 Plan Review 11111 0 Other Permit: 3� i r Phone: 503.639.4171 Fax: 503,598.1960 . �• . cIB : U w' , • Inspection Line: 503.639.4175 CITY OF TIG ` � r e . e adylBy: hots: to See Paget for " " " "" g ' Internet: WWW.h rd Or. OV BUILDING DIVI . , . l shod: Supplemental information TYPE OF :WORK BEQUIREB DATA( 1 -AND 2-FAhMILYDWEWNG ❑ New construction ❑ Demolition Penult fees* are based on the value of the work perfonned. Indicate the value (rounded to the nearest dollar) of all 0-Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ?.- work indicated on this application. CATEGORY OF CO NSRUCfION:* ❑ 1- and 2- family dwelling �:Commercinl/industrial Valuation: S ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: Total number of floors: : ; JO$ SITS BVFOIthIAT)'.ON AhTp LOCATI0111 Job site address: qp 20 S L) L0 tvt.. SR Rd New dwelling area: square feet City /State/ZIP: 1 0 Garage/carport area: square feet Suite/bldgJapt. no.: ( I Project name: G 0:1` S S i Civic K Covered porch area: square feet Cross street/directions to job site: 2 i 1 IQ ` L C c hC jl '. 5 do a Deck area: square feet Other structure area: square feet REQUJRED DATA COMhIERCIAL -USE CHECKLIST Subdivision: I Lot no.: Permit fees' are based on the value of the work perfonned. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all materials, labor, overhead, and the profit for the DCR ESIPTION OF WORK ' - equipment, rk indicated on this application. R, i c , SS e F ,., o Valuation: S I nti� ...p. t p l SS 0 L1 Existing building area: y(2 K square feet New building area: (Lz square feet PROPERTY OWNER . , [,' ;TENANT Number of stories: L, Name: ( f UL , QJ) C. l Type of construction: Address: 90 A 0 S (A.) w 0 _ J tj & , e.,1 4 :30 Occupancy groups: City /State /ZIP: "Tk f ,�„ t j © Existing: Phone: ( ) J Fax: ( ) New: ❑ APPLICANT ,; ,.0 CQNTA - :..-- !ERSON,_: ^ NOTI Business name: A F F S 9 S i S i &) C All contractors and subcontractors are required to be � licensed with the Oregon Construction Contractors Board Contact name: J (� IJ`') w ez under ORS 701 and may be required to be licensed in the Address: j dl t.(1_ S (J J 1 l� ` `b Jurisdiction In tvhich work is being perforated. If the City / State/ZIP: V tt'La L i -•-r ,) Or applicant is exempt from licensing, the following reasons apply: Phone: ( ) b 9 ?_ . 1 4s-i 1 Fax: : ( ) 61'2_ it FS b E -mail: :3 i km e_ 1''t PSy' 5• C tl d .. :. .:<.•.. _. ? . ,: ? . ,.. BUILDII Business : (Pleirierelerroleeserirdirfel: Permit fee: 0 q, C/1— Address: City/ State/ZIP: State surcharge (12% of permit fee): 4 �1 / FLS plan review (40% of permit fee): ^ Phone: ( ) Fax: ( ) (Due upon application.) CCB Iic.: 1.7 53N Total pemtit fees: 7t — 3l Authorized signature: B Amount received: J This permit application expires If a permit Is not obtained Print name: ,;,,M ,• :.✓G I Date: 1 — j' - 7,- j V I • within 180 days after it has been accepted as complete. Fee methodology set by Tri- County Building Industry Service Board. 1:1Buildin8PerminWPS•PermitApp.doe 03/23/06 440.4613T(I I /02/COMUWEa) 1 City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Deseribe.wotk to be :done: . 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition 1 -10 heads: No plan review required. ® Alteration ❑ 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 10 Additional description of work: A - Sr_ galcrcaz SS l� Type ofSystem (Complete A`B, Car D as applicable): A.) :Commercial Sprinkler —Wet ❑ Dry Additional _ Standpipes Luformation: Hazard Group Density : it) Design Area j K. Factor • �, Sprinkler Project Valuation: $ B.) Type 1 - Hood Fire Suppression System :.::::;,. Hood Project Valuation: I $ C.)- Fite Alarm .. . • Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Curt Sheets Fire Alarm Project Valuation: $ D. ; Residcntial: Sprinkler : Stand Alone:S tein : ;::: =: Square Footage: Permit Fee: • 0 to 2,000 $187.50 01 $232.50 - 2 0 to 3 600 0 , 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. T: \Building \Pemits \FPS- PeanitApp -doe 06 /25/08 2