Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
��'! l' COMMUNITY DEVELOPMENT Permit #: FPS2011 -00028
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2011
Parcel: 2S112DB00300
Jurisdiction: Tigard
Site address: 7233 SW KABLE LN 900
Project: Nuance Systems Subdivision: Lot: 0
Project Description: Alteration of (6) fire sprinkler heads.
Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES
3203 NE 65TH ST. #2 15350 SW SEQUOIA PKWY #300
VANCOUVER, WA 98663 PORTLAND, OR 97224
PHONE: 360 -718 -8604 PHONE: 503 - 624 -6300
FAX: 360 - 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 03/09/2011 $102.20
12% State Surcharge - Building 03/09/2011 $12.26
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 $114.46
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $2,100.00
Residential Square Footage: 0
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stat- of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expir woj is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you . oll• the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -4 $ • •u may obtain a copy of the rules
or direct qu- = •• s o . • • by calling 503.232.1987 or 1.800.332.2344.
Issued B : • / • / ,O 4 , � L Permittee Signature: X
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 FOR OFFICE USE ONI.I
City of Tigard
Date/B ed Permit No.:', D Q�� iy
M
'. 13125 SW Hall Blvd., Tigard,OR 9722314 R 9 2 11 i' Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
Inspection Line: 503.639.4175 C ITY OF TIGARD Date Ready/By: lurk ® See Page 2 for
TIGARD
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
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
';Q( 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: 7 Z3z, 5(A) . btie, `ho,,r,,ty - 9Q0 New dwelling area: square feet
City /State /ZIP: Po yujl b le ni - 7 Z2 `f Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: v 1 u�, G ,� Covered porch area square feet
Cross street/directions to job site: r 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 ( rowded to the nearest dollar) of all
equipment, materials, labor, ov rhead, and the profit for the
DESCRIPTION OF WORK work indicated on this appli on.
Valuation: ------
Existing building area square feet
New building area: square feet
OWNER ❑ TENANT Number of stories:
Name:
XPROPERTY
PO. L (, w S 4 Type of construction:
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
, APPLICANT ❑ CONTACT PERSON NOTICE
Business name: f d - p L . All contractors and subcontractors are required to be
Contact name: /J �e��� licensed with the Oregon Construction Contractors Board
ff under ORS 701 and may be required to be lcensed in the
Address: -szo 3 n . 4 -b� jurisdiction in which work is being performed. If the
City /State /ZIP: 0G,M)c ` � U e,� W P 9 8 Ca Co3 applicant is exempt from licensing, the following reasons
/ 2� (� ^ apply:
Phone: ?el ..— l t, $ — 8 a 4 fax:: G 7,,s — D ,, V 3
E-mail: ,I� i.r' ` 1-0 P O e . % „ 1 • cO Y2
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: VI; ff!--
ST (1..r ' 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.: 1S Z Total permit fees:
L, ,,,,_
Amount received: 1/9 /
Authorized signature:
Y' 4
This permit application expires if a permit is not obtained
Print name: �� �/ Date: within 180 days after it has been accepted as complete.
«' �' - * Fee methodology set by Tri -County Building Industry
Service Board.
1' \Building\Permits\FPS- PermitApp.doc 02/01/2011 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.) Mo fication to sprinkler heads only:
Addition 1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work: � n � � � �N L �
14
W 1' Q,� ov+�1 ` s ,
Type of System (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 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 three (3) sets of plans at submittal.
Plan review fees are required at submittal.
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