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Permit �' CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT II COMMUNITY DEVELOPMENT Permit #: FPS2011 -00021 Date Issued: 02/18/2011 TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112DC00500 • Jurisdiction: TIGARD Site address: 15887 SW 72ND AVE Project: Knouf Investments Subdivision: OREGON BUSINESS PARK III Lot: 40 Project Description: Relocating (10) sprinkler heads. Contractor: DELTA FIRE INC Owner: PACIFIC REALTY ASSOCIATES 14795 SW 72ND AVE 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 PORTLAND, OR 97224 PHONE: 503 - 620 -4020 PHONE: 503 - 624 -6300 FAX: 503 - 620 -1058 FEES • Description Date Amount Specifics: Permit Fee - COM 02/18/2011 $86.06 12% State Surcharge - Building 02/18/2011 $10.33 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Height: ft Stories: Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: .10 Design Area: 1500 K Factor: 5.62 Commercial Fire Alarm System: Fire Alarm Required: Alarm Type: Pull Station Required: Smoke Detectors Req: Battery Calcs Provided: Cut Sheets Required: Total $96.39 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $1,800.00 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 he rules or direct questions to OU by calling 503.232.1 • = • . c... - - . • 4. Issued By: itteeSignature: / / / Call 5 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 USE ONLY J ` CI ' O1 og Tigard Received ,( �, , Permit No.: I-- ']c\ ' v • 13125 Date /B v: l 1 C�� SW Hall Blvd., Tigard,OR 97223 Plan Review � Phone: 503.639.4171 Fax 503.598.l!G11�1 - ��j DaieBv: Other Permit: : j — I , 71a Inspection Line: 503.639.4175 Date Ready/By: Juris. TIGARD See Page 2 for Internet: wuw.tigard or.gov 8 p VI Notified/Method: 4' Supplemental Information r f 1 iy • TYPE OF WORK C ( *I,. N 'A .REQUIRED DATA: 1- .,ND 2 -FA II WELL LY DING El New construction ❑ � Cj �'v�� I G Permit fees* are based on the value of the work performed. Indicate the value (rotnded to the nearest dollar) of all ,Addition/alteration /replacement ❑ ther: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. E] I- and 2- family dwelling %Commercial/industrial Valuation: S El A ccessory building Number of bedrooms: Accessory Multi - family ❑ Master builder ❑ Other: Number of bathrooms: JOB_ SITE INFORMATION AND. LOCATION Total number of floors: Job site address:,. 5$$' NA) /a ,mil Ave,. New dwelling area: square feet City /State /ZIP: T l ry �.,, r a } OR q , "19 9 Garage /carport area: square feet Suite/bldg. /apt. no.: `�'� Project name: 015911X– t,L r,� Covered porch area square feet Cross street/directions to job site: Deck area: square feet • Other structure area: square feet ;REQUIRED .DAT CIAL-US CHEC Subdivision: • Lot no.: Permit fees* are based on the value of the' work performed. Tax map /parcel no.: r Indicate the value (rotnded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the i DESCRIPTION 'OF WORK work indicated on this application. \\ JAP.IOC��{L 10 op-in n �l Nods -C-or l �.t�-� r Valuation: S 1 I SQQ . ©C T . r Existing building area square feet New building area: square feet ❑ PROPERTY' OWNER ❑ TENANT Number of stories: • Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: o list APPLICANT ❑ CONTACT PERSON .. .. ,> • . NOTICE.• - Business name: l i_� c rp ) Inc . All contractors and subcontractors are required to be Contact name: I �-� I licensed with the Oregon Construction Contractors Board r 1 � ' under ORS 701 and may be required to be lensed in the Address: 9( I tit 1 � - larva. Ave. jurisdiction in which work is being performed. If the q " 1J;,' applicant is exempt from licensing, the following reasons City/State /ZIP: � l� r^ r ,0j - d rr�� �� apply: Phone: (503 C(, /`0 u0 Fax:: X5031 a,91) ' to E-mail: he;, t/1 t s` � e,s,Irp cult CONTRACTOR � BUILDING:PERMIT FEES* - j. �� . (Please reler'to(ee schedule Business name: ` , re ac. � � . o^ Address: ! 131C c 19 me _ Permit fee: C/II Pock-ACM OP\ n . State surcharge (12% 0 % of permit fee): c CitylState /ZIP: `-'' 1 FLS plan review (40% of permit fee): Phone: _. Fax: �ao -- . (Due upon application.) CCB lic.: (p(� 17 14 Total permit fees: Authorized signature: I Amount received: «/ _ Ai JA' . This permit application expires if a permit is not obtained Print name: 1.1c1�'1 � �, r n 0 1,t � Di/ a Its 11 f within 180 days after it has been accepted as complete. '�J * Fee methodology set by Tri County Building Industry Service Board. I 'Bmldine , FPS- PermuApp.dec 03 /23/06 440- 4613T(I 1:02 /CO1,1/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: ❑ A a�:t.__ ,uuiu 1-10 . - , 0 heads: No plan review required. _'alteration ❑ 11+ heads: Plan review required. ❑ Repair T Number of sprinkler heads: 1 V Additional description of work: • Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler Wet ❑ Dry Additional Standpipes JI Information: Hazard Group 1.:tchlr Density Design Area I b0 Q K. Factor t, a Sprinkler Project Valuation: j $ l , ( ) B.) Type - Hood Fire Suppression System Hood Project Valuation: I $ AJf,4' • C.) Fire Alarm . Submittal shall Battery Calculations ❑ Yes include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ AVA • D.) Residential Sprinkler (Stand Alone System) , Square Footage: Permit Fee: • 0 to 2,000 $187.50 • 2,001 to 3,600 $232.50 • 3,601 to 7,200 $292.50 7,201 and greater $381.50 Sprinkler Project Square Footage: )J JA. sq. ft. Fire Protection Permit Fees Project valuation subtotal (see A, B & C above): $ I zoo .06 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: I $ Co, 3 Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. I \ Building \Perrurs \FPS- PerrniL'pp.doc 2