Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
ffi • COMMUNITY DEVELOPMENT Permit #: FPS2010 00168
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2010
Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 102
Project: Plaza Home Mortgage Subdivision: Lot: 0
Project Description: Modification of (8) sprinkler heads for TI
Contractor: FIRESTOP CO Owner: HILLTOP BUSINESS CENTER LLC &
3203 NE 65TH ST. #2 HUNZIKER LLC
VANCOUVER, WA 98663 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 360 - 718 -8604 PHONE:
FAX: 360 - 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/28/2010 $83.37
12% State Surcharge - Building 12/28/2010 $10.00
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 $93.37
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,700.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, S• =te o OR. - pecialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will ex ■ ire if ork • not started within 180 days of
issuan -, . • • is suspended for more the 180 days. ATTENTION: Oregon law requires y•• to f. llow e rules adopted by the Oregon
Utif Notification Cente . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -00 -0090. Y. may obtain a copy of the rules
o' direct questions to OUNC • in. 513.232.1987 or 1.800.332.2344.
I sued By: a / Permittee Signature:
_ +� ..1
Call 503.639.4175 by 7:00 a.m. for the next available inspection
This permit card shall be kept in a conspicuous place on the job site until comp of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Fire Protection System r�'1. FoR OFFICE usf: ONLY
`d
City of Tigard RECEIVED Received - Permit N g DateB : �� erm No.: i C�(� , i
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.199E C 2 8 Date/B : Other Permit:
1 . 1 I , D Inspection Line: 503.639.4175 Date Ready/By: Jwig: ® See Page 2 for
c; A Internet: www.tigard-or.gov BU C � rr OF � T ` lT \I11GARD Notified/Method: Supplemental Information
P WVKK
TYPE O 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
ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the,
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ I- and 2- family dwelling ommercial/industrial
Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder CI Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: -73,2, S (A .) H. v , .r`2-7._: V 41 New dwelling area: square feet
City /State /ZIP: \ ►1 [ N._ 3 17,-2 Garage /carport area: square feet
i
Suite/bldg. /apt. no.: in Project nam e:
L a OA i e A o
Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure a: square feet
REQUIRE ATA: COMMERCIAL -USE CHECKLIST
Subdivision: I 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.
J ,/1n I Valuation: $ 1 f
C p• liITCJI � N � lO Gto : � F ` ✓`L F r/27'�'e.! � � 'cwt.) t� i? 00 -
Existing building area: square feet
New building area: square feet
)) , ROPERTY OWNER I ❑ TENA Number of stories:
Name: p 6 Gn p f _1,.., r �) Type of construction:
Address: 24 &o /// ���//rt(' � � ,-' Occupancy groups:
City/State /ZIP: 'ICS b d O 0 Existing:
Phonel03) B _- $s- I Fax: j) (pqs •-c3S 7 New:
/APPLICANT ❑ CONTACT PERSON NOTICE
Business name: `` 1'- r , �� r (� l� L c , All contractors and subcontractors are required to be
Contact name: 4 r licensed with the Oregon Construction Contractors Board
/'T ( � -� � 6/ under ORS 701 and may be required to be licensed 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: A t e-t �JI�C P.' rz5'4 bp t- 7 . co ''v` ' .
CONTRACTOR BUILDING PERMIT FEES*
Business name: co (Please refer to fee schedule)
Ft r b — Permit fee: g 3.3 7
Address: 39,0 3 . t.., & L ----- , 00
City/State /ZIP: ULee L4.24r. q “ . " _ State surcharge (12 % of permit fee): �
is i FLS plan review (40% of permit fee): —,
Phone: (3 , r 1 - ,� & Fax:' 0 -7 653.---86,0 (Due upon application.)
CCB lic.: ' 99) .1 . Total permit fees: 0 95. 37
Amount received:
Authorized signature:
(1 --- . L------
This permit application expires if a permit is not obtained
Print name: A L , e , ic � -� Date: /-2_-28— to within 180 days after it has been accepted as complete.
t Fee methodology set by Tri -County Building Industry
Service Board.
1:\BuildingTennits '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.) El New 2.) Modification to sprinkler heads only:
,8 1 L - 10 heads: No plan review required.
}Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
Type of System Corn I lete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor 1 ,
Sprinkler Project Valuation: ' � -7
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): $
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.
I: \Building \Permits \FPS - PermitApp.doc 10/01/09 2