Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
1 7 . COMMUNITY DEVELOPMENT Permit #: FPS2011 -00115
Date Issued: 09/27/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S101 BD00300
Jurisdiction: Tigard
Site address: 8015 SW HUNZIKER RD
Project: Performance Contracting Subdivision: Lot:
Project Description: Adding (7) fire sprinkler heads to clean room.
Contractor: WESTERN STATES FIRE PROTECTION Owner: PERFORMANCE CONTRACTING GROUP IN
13896 FIR ST STE B 16400 COLLEGE BLVD
OREGON CITY, OR 97045 LENEXA, KS 66219
PHONE 503 - 657 - 5155 PHONE:
FAX' 503 - 657 -5182
FEES
Description Date Amount
Specifics: Permit Fee - COM 09/27/2011 $134 48
12% State Surcharge - Building 09/27/2011 $16.14
Type of Use: COM Plan Review - Fire Life Safety - COM 09/27/2011 $53 79
Class of Work: ALT Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sorinkler 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 $204 41
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation $0 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 No ation Cen Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
or dire questions to OUN y all ng 503.232.1987 or 1 800.332 2344
Issue By: Per mittee Signature: - A I', g c
2,-,....i
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 F
Fire Protection System RECEIVED FOR OFFICE USE ONLY
City of Tigard � � � I Date /Bed o n 7 // /"
�i Permit No : 9�' �/� a�/
INI ° 13125 SW Hall Blvd., Tigard, OR 9 Plan Review
I I Phone. 503.718.2439 Fax. 503.598.1960_ F Date /B Other Permit
T I G n R D inspection Line 503 639 4175 CI TIGARD Date Ready /By Juris Ea See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified /Method Supplemental Information
, T YPE 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
® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling ® Commercial /industrial Valuation: $
El Accessory building 1=1 Multi-family Number of bedrooms:
❑ Master builder I=1 Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 8015 SW Hunziker Road New dwelling area: square feet
City/State /ZiP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: Performance Contracting 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, matenals, labor, overhead, and the profit for the
" DESCRIPTION OF WORK . work indicated on this application.
pipe to existing sprinklers in clean room mock - up and add misc. sprinklers Valuation: $55,247.00
Existing building area. square feet
New building area: square feet
® PROPERTY OWNER , ❑ TENANT Number of stories:
Name: Performance Contracting Type of construction:
Address: 8015 SW Hunziker Road Occupancy groups:
City /State /ZIP: Tigard, Oregon 97223 Existing:
Phone: (503)684 - 5533 Fax: ( ) New:
® APPLICANT ® CONTACT PERSON '
. NOTICE ,
Business name: Western States Fire Protection Co. All contractors and subcontractors are required to be
Contact name: Darrell Fluit licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 13896 Fir Street, Suite B jurisdiction in which work is being performed. if the
City /State /ZIP: Oregon City, Oregon 97045 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 657 -5155 Fax: : (503) 657-5182
E - mail: darrell.fluit @wsfp.us
CONTRACTOR BUILDING PERMIT FEES* "
• (Please refer to fee schedule)
Business name: Western States Fire Protection Co.
Permit fee:
Address: 13896 Fir Street, Suite B
City/State /ZIP: Oregon City, Oregon 97045 State surcharge (12% of permit fee):
FLS plan review (40% of permit fee):
Phone: (503) 657 - 5155 Fax: (503) 657 - 5182 (Due upon application.)
CCB lic.: 104570 31(q (/ Total permit fees:
Authorized signature: )(
/6 443
Amount received: 4 - %
This permit application expires if a permit is not obtained
Print name: Darrell Fluit Date: 9 -27 -11 within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board
1 \ Budding \ Permits \FPS -Pei m.App doc 02/01/11 440- 4613T(I I /02 /COM /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:
❑ Addition ❑ 1 -10 heads: No plan review required.
® Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of spruikler heads: 14
Additional description of work:
Type of System (Complete A, B, C or D as applicable) :.
A.) Commercial Sprinkler
® Wet El Dry
Additional Standpipes
Information: I- Iazard Group varies
Density varies
Design Area 1,500
K. Factor 5.6
Sprinkler Project Valuation: $ 5,247
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): $ 5,247
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.
C \ ibly Data \DraNxings \LS2107 - PCI Office - Warehouse lnap Rprs \I PermitApp doc2)2 /Ol /11