Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
111 � COMMUNITY DEVELOPMENT Permit #: FPS2010 -00167
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TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 1 2/29/2010
Parcel: 2S112ACO2800
Jurisdiction: Tigard
Site address: 14865 SW 74TH AVE 260
Project: Classic Interiors Subdivision: METRO PART /MLP2002 -00007 Lot: 1
Project Description: Adding and altering (2) sprinkler heads total.
Contractor: OWNER Owner: FANNO CREEK ACRES LLC
14865 SW 74TH STE 300
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Description Date Amount
Specifics: Permit Fee - COM 12/29/2010 $51.09
12% State Surcharge - Building 12/29/2010 $6.13
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes 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 $57.22
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $500.00
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 Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �j �' Permittee Signature: V7/7/-
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 FOR OFFICE I'tiF ()NA
of Tigard Received
`'f g DateB : I • t
to Ili Permit No.: 10 U l A
. • 13125 SW Hall Blvd., Tigard, OR 972 ` , .Q Plan Review
Phone: 503.639.4171 Fax: 503.59*:, i \:‘ DateB : Other Permit:
11(; n u 1) Inspection Line: 503.639 \ �� Date Ready/By: ®S Page 2 for
Internet: www.tigard or.gov v `, \..., otified/Method: Supplemental Information
V r \( ,
TYPE OF WORT �`��' ` . ■ REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ De 1pil Permit fees* are based on the value of the work performed.
A� 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 CONS r' CTION work indicated on this application.
❑ 1- and 2- family dwelling III 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: / i/64, New 5 Gt.: 7 4 1:d 15 lJtt New dwelling area: square feet
City/State /ZIP: .7'7 G #g IS 0 n g /7 -2._ 4 Garage /carport area: square feet
l
Suite/bldg. /apt. no.: O Project name: L 1045 •�; d is 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.
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.
At RD 3 56r3e/AiGcc. S / �I c , 26 Valuation: $ 3 — p
G- ���c'GE4 liB�i) /N 2.60 Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER J ❑ TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State /ZIP: Existing:
Phone: ( ) Fax: ( )
New:
❑ APPLICANT ❑ CONTACT PERSON
NOTICE
Business name: G444.)N,D G.R.cL k . ,, 4 ` � 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 licensed in the
Address: / V 03, 5141 ,j01 A S �� 3 c , c' jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
l /"G.�R t) , p pc, ' 4 apply:
Phone: (SU 3) 9 9.J9 5- /7 5 Fax: : ( )
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: 50 �c,( (Please refer roj� schedule)
J Permit fee:
•
Address:
City/State /ZIP:
State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( )
(Due upon application.)
CCB lic.: Ay r, 0-41, /C /Z Total permit fees: 5-7 ?�
// Amount received: `
Authorized signature:
This permit application expires if a permit is not obtained
Print name: G �[ NAG 5� Date: _ / within 180 days after it has been accepted as complete.
/U j a 74,4 D * Fee methodology set by Tri -County Building Industry
Service Board.
I:\ Building \PermitsWPS- PermitApp.doc 1 0/01/09 440- 4613T(11 /02/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
De scribe w ork to be done:
1.) ❑ New 2.) Modification to sprinkler heads only:
JI Addition 12r 1 -10 heads: No plan review required.
❑ Alteration ❑ ii+ heads: Plan review required.
14 Repair
Number of sprinkler heads: A
Additional description of work:
Type of Sy_stem(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: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: $
C.) Fire Mann
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.
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