Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
o COMMUNITY DEVELOPMENT Permit #: FPS2010 -00111
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/12/2010
Parcel: 2S113AB00500
Jurisdiction: Tigard
Site address: 16083 SW UPPER BOONES FERRY RD 130
Project: State Farm Subdivision: Lot: 0
Project Description: Adding and altering 184 sprinkler heads.
Contractor: WESTERN STATES FIRE PROTECTION Owner: G &S FC LLC
13896 FIR ST STE B 516 SE MORRISON #100
OREGON CITY, OR 97045 PORTLAND, OR 97214
PHONE: 503 - 657 -5155 PHONE:
FAX: 503- 657 -5182
•
FEES
Description Date Amount
Specifics: Permit Fee - COM 09/24/2010 $209.80
Plan Review - Fire Life Safety - COM 09/24/2010 $83.92
Type of Use: COM 12% State Surcharge - Building 09/24/2010 $25.18
Class of Work: ALT Type of Const: IIB Permit Fee - COM 11/12/2010 $96.84
Occupancy Grp: B Height: ft
Stories: 3
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: No Hazard: LT
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 $415.74
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $22,000.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
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
issuan if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U ' Notification - -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
r direct questions to 0 b C • call' g 503.232.1987 or 1.800.332.2344.
I ued By: /,/ ,04 v ` Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 S y s t e m � � r <)lt <)rl lc t: u st: <)N ` I_,
City of Tigard '� ° Bed 1 Permit No.: ► _ •
° 13125 SW Hall Blvd., Tigard, OR 97223 9 EI 3 I - — — - t.
g ,Plan Review �� /,
C . Phone: 503.639.4171 Fax: 503.598.1960 C ) 231 Z � Date/B : "Ay/ 1 d der Permit:
Inspection Line: 503.639.4175 S C 'r• to Ready/By: p H See Page 2 for
T I G A E. D
Internet: www.tigard ■ •'R tified/Method: I 0 �i // Supplemental Information
0111 °r p N A S lO ` Wt li / /l!//
TYPE OF WORK B0‘0,- -- 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 ® Commercial/industrial 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: 16083 SW Upper Boones Ferry Rd. New dwelling area: square feet
City/State/ZIP: Tigard, Oregon Garage /carport area: square feet
Suite/bldg. /apt. no.: 130 �O V 1,I Project name: STATE FARM T.I. 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: I 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 ap r Iication. ' Z2 c
fire sprinkler tenant improvement Valuation: $169 0(`l (�
Existing ruilding area: square feet
New building area: square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANT C_ CONTACT PERSON NOTICE
Business name: Western States Fire Protection Co. All contractors and subcontractors are required to be
Contact name: Darrell Fluit licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 Fir Street, Suite B jurisdiction in which work is being performed. If the
City/State/ZIP: Oregon City, Oregon 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 I Fax: : (503) 657 -5182
E -mail: darrell.fluit @wsfp.us
CONTRAC BUILDING PERMIT FEES*
(Please fee
Business name: Western States Fire Protection Co. rsfe+ta schedule)
Permit fee:
Address: 13896 Fir Street, Suite B
State surcharge (12% of permit fee):
City/State/ZIP: Oregon City, Oregon 97045 %
FLS plan review (40% ofpermit fee):
Phone: (503) 657 -5155 I Fax: (503) 657 -5182 (Due upon application)
CCB lic.: 104570 Total permit fees:
Authorized signature: � ��" _7 Amount received:
This permit application expires if a permit is not obtained
Print name: Darre uit I Date: 09 -17 -10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permus \FPS- PermitApp.doc 10/01/09 4404613T(II /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 ❑ 110 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 184
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
(E1 Wet ❑ Dry
Additional Standpipes
Information: Hazard Group Light
Density 0.10
Design Area
K. Factor 5.6
Sprinkler Project Valuation: $ 13,000
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: 1 $
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): $ 13,000
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: $ 318.90
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
C: \My Data \Drawings \LS1722 - STATE FARM TI \City of Tigard permit application.de2 10/01/09
DESIGN WITH INTEGRITY PLANNING DESIGN INTERIORS ARCHITECTURE
720 NW Davis 503.221.11212
Suite 300 503.221.20770
RETURN OF SUBMITTAL Portland OR 97209 www.Irsarchitects.com
Project Name: State Farm TI Project Number: 210132
LRS Representative: Darcie McConnaha Submittal Number: Sprinkler Layout
Date: 09.21.10
To: Roman Michalchuk Distribution: Steve Sprawkins, Monique
Clouser, Kevin Bartel
This submittal has been reviewed only for conformance with the design concept and for compliance with information given in
the Contract Documents, and does not extend to means, methods, techniques, sequence of construction, dimensions, or
safety precautions thereto. Review does not relieve the Contractor from responsibility for deviations from Drawings or
Specifications unless the LRS Architect's attention has been called to such deviations in writing at the time of submission.
Corrections have been made on submittal material by LRS Architect's in accordance with Article 4.2.7 of the General
Conditions of the Contract for Construction, with additional comments as follows:
Action:
❑ No Exception Taken
❑ Revise & Resubmit
® Make Corrections Noted
❑ Record Only
Comments:
• See attached fire sprinkler layout for markups. There were a couple locations where the lights or HVAC were
interfering with the proposed sprinkler heads. Please adjust accordingly.
Attachments:
Fire Sprinkler Layout
L rs
ARCHITECTS