Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 114
`• COMMUNITY DEVELOPMENT Permit #: FPS2011 -00010
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/17/2011
Parcel: 1 S134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 100
Project: TSE Subdivision: Lot: 0
Project Description: Adding and relocating a total of 76 sprinkler heads.
Contractor: AFP SYSTEMS INC Owner: ROBINSON, CONSTANCE A &
19435 SW 129TH ROBINSON, LYNN ET AL
TUALATIN, OR 97062 BY KG INVESTMENT MGMT
10240 SW NIMBUS AVE #L3
• PORTLAND, OR 97223
PHONE: 503 - 692 -9284 PHONE:
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 02/17/2011 $156.00
12% State Surcharge - Building 02/17/2011 $18.72
Type of Use: COM Plan Review - Fire Life Safety - COM 02/10/2011 $62.40
Class of Work: ALT Type of Const: IIIB Info Process /Archiving - Lg Sheet (over 02/17/2011 $2.00
Occupancy Grp: B . Height: ft 11x17)
Stories; 1 Info Process /Archiving - Sm Sheet (up to 02/17/2011 $8.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard:
Density: .30 Design Area: 2000
K Factor: 7.1
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
•
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $247.62
•
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $7,500.00
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 Notificati• -n - 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 que ons to OUNC • calli - '3. 2.1987 or 1.800.332.2344.
Issued By: /fir 1 Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspec n 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 "� D FOR OFFICE USE ONLY
City of Tigard I `<Q b Pla \ R eceived /'��
" 13125 SW Hall Blvd., Tigard, OR 97223 i
r �. a Date /B n Review i�, Pemtit No.: �-.
Other Permit: '
Phone: 503.718.2439 Fax: 503.598.198` r ��� Date/By: r � �� Lt � LI ®` 1 _Ard-
TIGARD Inspection Line: 503.639.4175 �ivl l ®� Date Ready :y: i See 'age 2 for
IN
Internet: Www.tig CCard -oCgov O S Notified Method: nrIr j Supplemental Information
y,, ��� 0 I/' (..0 r pr .1
: , ' :- :'
TYPE :_OF::-S , t % - sREQUIRED DATA :«1 AND ° 2 -FAIVIIL's DWEL
❑ New construction ❑ Demolition Permit fees* are based on the value of the work perfo , ed.
Indicate the value (rounded to the nearest dollar) o . 1
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the t •fit for the
- , A- -' - -. ' 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:
"JOB1,SITE INFORMATION'ANDA ,..: Total number of floor .
Job site address: i 0 (O c {^ 1
I il I � uc /� �6 New dwelling are.. square feet
City/State /ZIP: ¶i 6 ARP ' n / J� / Garage/carps area: square feet
Suite/bldg. /apt. no.: l ov Project name: -[S 1, I - Covere• •orch area: square feet
Cross street/directions tojob site: Dec area: square feet
` _1'1 - b u. S r tifi 1 Sp ( - £' N 5 ther structure area: square feet
NJ (m_ i) S A S T I3u?CI WL f,, =REQ TA::;CO,MMERC - U SE 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 ! I
WORK - ^I work indicated on this application. ,�-,l
V
ADD g< i ,
fd c 1 A tai cep KL, r � -s Valuation: $ ' y i Q�. (/ (/
oN t / & i Si - I n r� sl - rfr) Existing building area: / square feet
C/ I v 7 New building area: 7Y1 6 square feet
:;:113 PROPERTY OWNER - . T ❑ TENANT' , , E Number of stories: i
Name: ' 6 ' ( s�}2,tJC /. 6N CG 0 rl� L CON I �� •) Type of construction: 1400P
Address: –/ I q c) s W S A N t)g u R6i 5 Occupancy groups:
City /State /ZIP: )26f2TLd`N ()) a , 0'1.)-e) ? ) Existing: ,�,�/
�i1y y1L.
Phone: (.5:03) 624 c3.4,)G 6 Fax: ( ) 60 35 41 +3 New:
I 5, APELICAN I' I *i TACT RSN '
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`� -, °.' -� 'NOTICE- , -
� ...
Business name: S / ' N [ All contractors and subcontractors are required to be
Contact name: - (�i g�yi f licensed with the Oregon Construction Contractors Board
VV under ORS 701 and may be required to be licensed in the
Address: 1 94-3; so/ I d.9• Ave jurisdiction in which work is being performed. If the
City /State /ZIP: -ri)A. (., . -I- (� , 6� applicant is exempt from licensing, the following reasons
•
• apply:
Phone: ( - 7 )� y , � ` Fax: : ( `L) • 1 ! g�
E- mail: I I i' M t & 'P .S y S' , (-A
9 _ _
::::„--.7,77,-:;:_,..„ ^ • � - CO ° -. a." � , _ �- ; , , r = BUILDING PERiVITT: FEES *
Business name: - :. = •(Plevsereferrio>feeseliedute:- -
e _ . c Permit fee:
Address: •
City/State /ZIP: State surcharge (12% of permit fee):
• FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.) (Jf •�
CCB lie.: ( 34- Total permit fees:
Authorized signature: Amount received: r Ii O
This permit application expires if a permit is not obtained
Print name: Date: 0 2 —JO-- J I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board. '
I.\Budding\Permits\FPS- PermitApp doc 02/01/11 440- 46I3T(I1 /02 /COM/WEB)
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City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe Woik, . in be done: .
1.) ❑ New. 2.) Modification to sprinkler heads only:
❑ Addition ❑ 1 -10 heads: No plan review required.
❑
Alteration 1 heads: Plan review required.
❑ Repair
Number of sprinkler heads: -
Additional description of work:
A-DO � T � Nod -r - i
Type of'System (.C'omplete A, B, C or Dwas;apohcable) =
A) Commercial Sprinkler
Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
•
Design Area
K. Factor + 0
Sprinkler Project Valuation: $
B) `Type rI Hood Fire "Suppression` S ystem
Hood Project Valuation:
x- 1
H �
C ) _Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ I�j lYt
D.) Residential Sprinklo'(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: N 1A sq. ft.
,. Fire: Protection' Perm t 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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