Permit I III CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
S COMMUNITY DEVELOPMENT Permit #: FPS2010 00131
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2010
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7352 SW DURHAM RD
Subdivision: Lot: 0
Project: Tax Services Inc
Project Description: Relocating (6) sprinkler heads and adding (3) heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee - COM 11/03/2010 $61.85
12% State Surcharge - Building 11/03/2010 $7.42
PHONE: 503 - 624 -6300
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503- 620 -1058
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 $69.27
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 900
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 rule
or direct questions to OUNC by calling 503.246.6699 0 :00.332.2344. / _ i
mil Issued By: Permittee Signature: /� / / /
. r..._..,00,,,I Z °. A
Call .639.4175 by 7:00 a.m. for an inspection that business day. f
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
City of Tigard Received
g \ � DaterBy: ('/ f v R , / W
r _ Permit No.: FPS-}_, 0 _ col i
:� • 13125 SW Hall Blvd., Tigard, OR 97223 J Plan Review `�
>a Phone: 503.639.4171 Fax: 503.598.1 `' O+ Date/By: Other Permit: /e �((� — O//yy/.,,� 7
T I G A x D Inspection Line: 503.639 *�QV Date Ready/13y: lures: S ( ee Page 2 for
Internet: www.tigard or.gov \� Oc �� k QQ Notified/Method: Ty'& Supplemental Information
ci. TYPE OF WORK - - � 1NS G 2-FAMILY - O REQUIRED DATA: 1- AND 2- FALY DWELLIlYG
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rotnded 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 OCommerciaUindustrial
Valuation: 5
Accessory building Number of bedrooms:
❑ g ❑ Multi- family
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: -7359. Nz' c Q New dwelling area: square feet
City /State /ZIP: Id r efl anf� l D 1, 017 9.9A v9A Garage /carport area: square feet
Suite /apt. no.: `� I Project name:C Z 5• /+,tx Covered porch area square feet
Cross street/directions to job site: Tx °„irv. tc eS , . -EnC _ 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 (rotnded 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. �+y�
'Pi Ovate- Co 5 the CLSA 3 PO[ never Valuation: 5 9W IJI J
T . T.• Existing building area square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups: •
City /State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
Z APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: , i.1 rep z i - _ All contractors and subcontractors are required to be
Contact name: He,-,0t., v �C� Y ICJrQ licensed with the Oregon Construction Contractors Board
^N under ORS 701 and may be required to be licensed in the
Address: 't,17 F NW o'N 1� A e. jurisdiction in which work is being performed. If the
'Pp rkleen , D % 017 9--9-1-1 apply:
60 3)co applicant is exempt from licensing, the following reasons
City, State, r ZIP:
Phone: 08.0 Fax : (5Cg < po'l0 pp
- : — 105 .
E-mail: heeOl i otpdet4v • ►rr. CQrY)
CONTRACTOR BUILDING PERMIT FEES*
Business name: ! f' re C (Please refer to fee schedule
Address: j y 7 - l5 _ ` 19r ?o1 AV e . Permit fee:
r cknot 0P �� 1 State surcharge (12% of permit fee):
City/State/ZIP: !�1,¢
1 FLS plan review (40% of permit fee):
Phone: �1 (O . 1,40a0 Fax: (503 ( , 10 5 (Due upon application. j
CCB lic.: 17'/ +� v Total permit fees:
Authorized signature:
Amount received:
This permit application expires if a permit is not obtained
Print name: �.'�' 5 ^ �lo f 6 1 ' Date: 1 ` f j I O within 180 days after it has been accepted as complete.
v..e� W v��� ,,,///V Fee methodoloey set by Tri- County Building industry
Service Board.
1 BuildingPermits ,FPS- PermitApp.doc 03 23106 0.40- 4613T(I I.C2/COM EB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information .
Describe work to be done:
1.) ❑ New 1 2.) Modification to sprinkler heads only: 1
Addition 1-10 heads: No M ari review required.
E' Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 9
.Additional description of work: - - - -
Type of System (Complete. A, B, or. D as applicable): .
A.) Commercial Sprinkler
, Wet ❑ Dry
Additional Standpipes .AJ
Information: Hazard Grou 1_,4144.-- • '
Density , 10
Design Area I boo •
K. Factor 5 ,
Sprinkler Project Valuation: $ qco , 0 0
B.) Type - I - Hood Fire Suppression System
Hood Project Valuation: I $
C.) Fire Alarm .
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler (Stand nd 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): , $
j 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.
.
[: \Braidin Pernits FPS- Permiulpp.doc 2