Permit i s CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2011 -00101
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/29/2011
Parcel: 2S112AA00300
Jurisdiction: Tigard
Site address: 14200 SW 72ND AVE
Project: Gerber Legendary Blades Subdivision: NELSON BUSINESS CENTER Lot: 0
Project Description: Relocating mains away from stairs.
Contractor: WYATT FIRE PROTECTION INC. Owner: GERBER LEGENDARY BLADES
9095 SW BURNHAM 14200 SW 72ND AVE
TIGARD, OR 97223 PORTLAND, OR 97223
PHONE: 503 - 684 -2928 • PHONE:
FAX: 503 - 684 -9657
•
FEES
•
Description Date Amount
Specifics: Permit Fee - COM 07/29/2011 $112.96
12% State Surcharge - Building 07/29/2011 $13.56
Type of Use: COM Plan Review - Fire Life Safety - COM 07/29/2011 $45.18
Class of Work: ALT Type of Const: Info Process /Archiving - Sm Sheet (up to 07/29/2011 $0.50
Occupancy Grp: Height: ft 11x17)
Stories:
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: ORD1
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 $172.20
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $3,110.00
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 O C by calling 503.232.1987 or 1.800.332.2344. -4
Issued By: 41, 111.11F -ermittee Signature: /
/ ��
Call 503.6 75 by 7:00 a.m. for the next available inspect; 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 .FOR OFFICE USE -ONLY -
o A Received
City of Tigard noS\ Date/By: ?LT PermitNo.: 9.011 -- ` .
_ Phone: 603.639.4171 Fax: 503.598.196Q \\ " 13126 SW Hall Blvd., Tigard, OR ° _ l• Plan Revew �l
h Date/By: / ' � �� I ( Other Permit I 1 0) IA y:
TIG ARD Ins Line: 603 , � $1° Date Ready/By: B See Page 2 for
Internet: www.tigard- or.gov 0 A �� Notified/Method: / I 11 Supplemental Information
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❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
�►^ Indicate the value (rounded to the nearest dollar) of all
1 �ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
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❑ 1- and 2- family dwelling lConunerciaUindustrial Valuation: $
❑ Accessory building ❑ Multi - family Number of bedrooms:
El Master builder El Other:
Number of bathrooms:
„�. , `� >e ,,F. A Total number of floors:
, el '; - J.OB.' - "SiTE INFOR11 a,19 ND--L'OGATl(JN :' °.:.. A i
Job site address: l � '�� -5k 72 , 11 - 119 Air& New dwelling area: square feet
City/State/ZIP: / / ( C ) Or_ 9- `7 _ Garage/carport area: square feet
Suite/bldg. /apt. no.: � Project name: c I p, 8 Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
• ItE "QUIRED D TA,,. COMMERCIALi6b LI -ECI JMST:'
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) ofall -
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/, C—! — 7& — . /ji/"c — K 5 ,T /A > A— ' ( r'�®M Valuation: $
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/�' /J Existing building area: square feet
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Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP:
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Phone: ( ) Fax: ( )
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Business name: S _..0A_/ � �-0 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: 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:
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Business name: Permit fee:
Address: 9D9 5 614../ 81)4Ai/-& - .
City/State /ZIP: / `(4 Aie.._D 04 , 3 7Z-�� State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (5503) 6 84 — 7_9 Fax: (5D3) 6g ¢— 76 S7 (Due upon application.)
CCB lie.: O < 7 Total permit fees: $/"Th' A ,
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Amount received: $17?
Authorized signature:
`� — This permit application expires if a permit is not obtained
Print name: - e.,1 � ` � �, Date: 7 - 2� — / I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
l.\ Building \Permits\FPS -PerrnitApp.doc 03/23/06 440- 4613T(11 /02 /COM/WEB)
•
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
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1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition "g--1 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 0
Additional description of work:
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❑ Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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__ __ _ - -.. Submittal.shall_ _______Battery_ Calculations -❑ Yes- - - - - -- - --
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
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Square Footage: Permit Fee: ;-ss
�� "�'����k. -�� ��,. <��'� ��_
0 to 2,000 $187.50 r �;��,,��. 1.�'��_::.
2,001 to 3,600 $232.50 ::: "'
3,601 to 7,200 $292.50 `
7,201 and greater tfAtV,;-1'fld,'
Sprinkler Project Square Footage: sq. ft.
iiiMe
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.
"New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression
engineer, or NICET level "3" technicians.
http: / /www.ci.tigard.or.us /city_ hall/depart menu /cd /dots /FPS- PermitApp.doc 2