Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
e COMMUNITY DEVELOPMENT Permit #: FPS2010 00090
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 1 S 127 DD01200
Jurisdiction: Tigard
Site address: 10031 SW CASCADE AVE
Subdivision: LEVITZ BLDG Lot: 0
Project: Ultimate Electronics
Project Description: Fire sprinkler, modification of approximately (31) heads.
Owner: FEES
ULTIMATE ELECTRONICS Description Date Amount
321 W. 84TH AVE., STE. A Permit Fee - COM 08/17/2010 $156.00
THORNTON, CO 80260 12% State Surcharge - Building • 08/17/2010 $18.72
PHONE: 303 - 412 -2500 Plan Review - Fire Life Safety - COM 08/17/2010 $62.40
Contractor:
HARVEY & ROSE INC
2015 NUGGET WAY
EUGENE, OR 97403
PHONE: 541- 746 -1621
FAX: 541 - 746 -7829
Type of Use: COM
Class of Work: ALT Type of Const: IIIB
Occupancy Grp: M Height: ft
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
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 $237.12
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 8000
Residential Square Footage: 0
Fire Alarm Valuation: 8000
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 OU ∎ . .y calling 503.246.6699 or 1.800.332.2344.
Issued By: • ••• : • Signature:
CaII 503.6 9.4175 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
Fire Protection System., _1 � � , 7 FOR oFFIL E usE ONI.l
City of Tigard 3 .'� Received ���� %/ ciO •/D Gee F/
�� - P ermit No.:
n 13125 SW Hall Blvd., Tigard, OR '7 3 11 1 20 1 0 Plan Review R
Phone: 503.639.4171 Fax: 503.." ��'bU 1 Date/B : lig 01 Ia Other Pertmt:
1 -1 G RD Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
A
Internet: www.tigard- or.gov .. -' „, Notified/Method: ��w t (( 10 EM Supplemental Information
TYPI; 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
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling ® Commerciallindustrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 10031 CASCADE AVE. New dwelling area: square feet
City /State /ZIP: TIGARD/ OR/ Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: ULTIMATE ELECTRONICS Covered porch area square feet
Cross street/directions to job site: SCHOLLS FERRY RD. & SW CASCADE AVE. Deck area: square feet
NEAR WASHINGTON SQUARE 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.
MODIFY EXISTING SPRINKLER SYSTEM TO SUITE NEW WALL & CEILING Valuation: $8000.00
LAYOUT. Existing building area 39317 square feet
New building area: 39317 square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories: 1
Name: Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing: 011
Phone: ( ) Fax: ( ) New: 011
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be Icensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) Fax:: ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: HARVEY & PRICE CO. (Please refer to fee schedule)
Permit fee: 156
Address: 2015 NUGGET WAY
State surcharge (12% of permit fee): 18.72
City /State /ZIP: EUGENE/ OR/ 97403 FLS plan review (40% of permit fee):
Phone: (541) 746 -1621 Fax: (541) 746 -7829 (Due upon application.) 62.40
CCB lic.: 77 /o /;l (a Total permit fees: 237.12
Amount received: 237.12
Authorized signature:
�J This permit application expires if a permit is not obtained
Print name: JUSTIN ROBERTS Date: 09- AUG -10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
I:\Building\Permits\FPS- PermitApp.doc 10/01 /09 440- 4613T(11 /02/COM/WEB)
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 ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 31
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 OH
Density
Design Area
K. Factor 5.6
Sprinkler Project Valuation: _ $ 8000
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 $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: sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $
Permit fee based on project valuation (see fee schedule): $ 156
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 18.72
FLS Plan Review (40% of permit fee): $ 62.40
TOTAL: $ 237.12
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
S: \ULTIMATE ELECTRONICS \FPS - PermitApp.doc 10/01/09 2
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HARVEY & PRICE LETTER OF TRANSMITTAL
...........:..:......:.:.:.:...
P.O. Box 1910 EC l vF0 09- Aug -1 o
2015 Nugget Way � ATTENTION
Eugene, Oregon 97444UG 1 1 2010 TFM
RE:
CITY OF T r RD ULTIMATE ELECTRONICS
TO: TIGARD FIRE MARSHALL -DING DIViSIOPJ
13125 SW HALL BLVD.
TIGARD, OR 97223
541 - 639 -4171
WE ARE SENDING YOU: ❑ Attached ❑ Under separate cover via the following items:
❑ Shop Drawings ❑ Prints ri Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order ❑
COPIES DATE NO. DESCRIPTION
5 09- Aug -10 SUBMITTAL OF FIRE SPRINKLER DRAWINGS
3 09- Aug -10 PRODUCT SUBMITTALS
1 09- Aug -10 BUILDING PERMIT APPLICATION FOR FIRE PROTECTION SYSTEM
1 09- Aug -10 PLAN REVIEW CHECK$237.12
THESE ARE TRANSMITTED as checked below:
For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Retumed for corrections - i Retum 3 corrected prints
51 For review and comment ❑
❑ FOR BIDS DUE: ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS:
INCLUDED ARE (5) SETS OF FIRE SPRINKLER DRAWINGS & (3) PRODUCT SUBMITTALS. PLEASE REVIEW
AND RETURN (3) SETS OF DRAWINGS & (1) PRODUCT SUBMITTALS WITH YOUR APPROVAL AND OR
COMMENTS AT YOUR EARLIEST CONVENIENCE.
THANK YOU
PAT LOOME
FIRE SPRINKLER DIV.
COPY TO FILE SIGNED:
If enclosures are not as noted, kindly notify us at once.
P.O. Box 1910 - 2015 Nugget Way Eugene, Oregon 97440 Ph 541 - 746 -1621 Fax 541- 746 -8729