Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2010 -00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
Parcel: 2S101 CB00500
Jurisdiction: TIGARD
Site address: 12670 SW HALL BLVD, BLDG# 2
Project: Apex Industries Subdivision: Lot: 0
Project Description: Install (6) fire sprinklers to protect below ceiling in Clean Room.
Contractor: COSCO FIRE PROTECTION INC. Owner: TCTPI LLC
11800 NE 95TH ST., STE 240 25977 SW CANYON CREEK RD #J
VANCOUVER, WA 98682 WILSONVILLE, OR 97070
PHONE: 360- 883 -6383 PHONE:
FAX: 360- 883 -6390
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/14/2010 $75.30
12% State Surcharge - Building 12/14/2010 $9.04
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 $84.34
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,400.00
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
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 'cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. iou may obtain a copy of the rules
or d ect questions to OlJNp . ca ; ng . 13.232.1987 or 1.800.332.2344.
is
I sued By: ` h /a (I r 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 System RECEIVED eceived FOR OFFICE USE ONLY
Re 1111 ° ceived of Tigard Date /B : / �� ' Permit Nn „ _OV l •
13125 SW Hall Blvd., Tigard, OR 97223 y Plan Review `'YS
Phone: 503.639.4171 Fax: 503.598.1960 C 1 4 C a Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard -or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE 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 ® 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: 12670 SW Hall Blvd. New dwelling area: square feet
City/State /ZIP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite /bldg. /apt. no.: Project name: Apex Industries 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: 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.
Install six (6) fire sprinklers to protect below ceiling in Clean Room Valuation: 551,400.00
Existing building area: square feet
New building area: square feet
® PROPERTY OWNER ❑ TENANT Number of stories:
Name: Apex Industries Type of construction:
Address: 12670 SW Hall Blvd. Occupancy groups:
City /State /ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)235 -8324 Fax: (503)352 -3636 New:
® APPLICANT ❑ CONTACT PERSON 'NOTICE
Business name: Cosco Fire Protection All contractors and subcontractors are required to be
Contact name: Jeff Halstead licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 11800 NE 95 Street, Suite 240 jurisdiction in which work is being performed. If the
City /State /ZIP: Vancouver, Washington 98682 applicant is exempt from licensing, the following reasons
apply:
Phone: (360) 883 -6383 Fax:: (360) 883 -6390
E -mail: kfriesen @coscofire.com
CONTRACTOR BUILDING PERMIT FEES*
Business name: Cosco Fire Protection (Please refer (o fee schedule
Permit fee: 75.30
Address: 11800 NE 95th Street, Suite 240
State surcharge (12% of permit fee): 9.04 •
City /State /ZIP: Vancouver, Washington 98682 FLS plan review (40% of permit fee):
Phone: (360) 883 -6383 Fax: (360) 883 -6390 (Due upon application.) 30.12
CCB lic.: 67508 Total permit fees: 114.46
Amount received: 114.46
Authorized signature: Y `
(` ROOr 4 I .QS This permit application expires if a permit is not obtained
Print name: Kevin Friesen Date: 12/14/10 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
C \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 (ZI 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 6
Additional description of work
Type ofSystern (Complete A B, C or .D as applicable):
A.) .Commercial Sprinkler
® Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ 1400
B.) Type I Hood Fire Suppression
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): $ 1400
Permit fee based on project valuation (see fee schedule): $ 75.30
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ 9.04
FLS Plan Review (40% of permit fee): $ 30.12
TOTAL: $ 114.46
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
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