Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
: . 11 COMM DEVELOPMENT Permit #: FPS2011 -00116
Date Issued: 10/04/2011
T[ GA R.D 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1 S1266C01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 450
Project: River City Travel Subdivision: Lot:
Project Description: Remove (11) heads and move (16) heads.
Contractor: AFP SYSTEMS INC_ Owner: WISCO REAL ESTATE EQUITY FUND I
19435 SW 129TH 1501 SW TAYLOR ST STE 100
TUALATIN, OR 97062 PORTLAND, OR 97205
PHONE 503 - 692 -9284 PHONE:
FAX. 503 - 692 -1186
FEES
Description Date Amount
•
Specifics: Permit Fee - COM 09/27/2011 $67.23
12% State Surcharge - Building 09/27/2011 $8.07
Type of Use: COM Plan Review - Fire Life Safety - COM 09/27/2011 $26 89
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Sm Sheet (up to 09/27/2011 $9 00
Occupancy Grp: B Height: ft 11x17)
Stories: 5
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type' Wet
Standpipe Required Hazard' LT
Density: 0 Design Area: 0
K Factor: 5 6
Commercial Fire Alarm System:
Fire Alarm Required Alarm Type:
Pull Station Required: Smoke Detectors Req
Battery Calcs Provided Cut Sheets Required
Total $111 19
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,100.00
Residential Square Footage: 0
Fire Alarm Valuation: $0 00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, 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 -00 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.800.332 2344. -
Issued By: _ - Per mittee Signature: 0n I /1 ,
�- AUW t k /I
Call 50 •39. , v', 0r . for the next available inspection date.
This permit card shall be 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 ApplicationRECIEIVED
Fire Protection System ['OR.OFFICr USE ONLY .
City of Tigard SEP 2 7 20 Date/13 F a7KL PernntNo 1 ,5 ,ll 00 :::,
0 13125 SW Hall Blvd., Tigard, OR 9 Plan Review s Other Peunit:
N- Phone: 503.639A171 Par: 503.k.' .41 OF TIGARD 'Dates : •ry �u/'aoll cello
TRlARD Inspection Line: 503.639.4175 o ILDING DIVISION Date Ready : l . , ludo to See Page 2 for
Internet: www.tigard- or.gov No "-d/Method: Supplemental Information
i `, Le_,
- - = TYPE OF,:WORK + - ,} IRECDDATA: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
VIAddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
'CATEGORY' OF CONSTRUCTION - = - "- work indicated tin this application.
❑ 1- and 2- family dwelling 0 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: 9 Q 10 5� W P, k I N e� ON S Q °J A K 3. 6, New dwelling area: square feet
City /State /ZIP: —1--1 %a,c.r p (2, (1- d 2, - Garage /carport area: square feet
Suite/bldg. /apt. no.: ti 5 a Project name: ?..,`, uQ, c C t y j C CxJ e. 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: I 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
DESCRIPT =OF, WORK _ - _= - work indicated on this application.
QM 1 �V I\ ..c.\ � t 1` IO `os/� �Q'
1ko .cK\ S Valuation: $ I 0
Existing building area: 1% square feet
New building area: 31 S( square feet
❑ -PROPERTY OWNER - , ' - _ -' 0 TENANT , - - ' Number of stories: s
Name: Type of construction: C al L r Cu ,\
Address: Occupancy groups:
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
APPLICANT., ` ,CACERO
T-- PSN.-
' � A .:...- ` �.'-- :- '. - - " -- .. ❑ O - -- -
- . _ NOTICE:.:_,,' = '_ = �..
Business name: k T' "7 . S STC.r^S 1"c_ , All - contractors and subcontractors are required to be
Contact name: \,....41..., O n �� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 6y 7 S S v4 \'Ze1 'IL Av t✓ jurisdiction in which work is being performed. If the
City /State /ZIP: r�Q`�� r Q,t ct — I.. V 2._ applicant is exempt from licensing, the following reasons
apply:
Phone: ('u3) U92. — 92.kLI - Fax:: (Col) IR -8 3 4
E -mail: 0 co- 41 OS e S S - Co rc•
," , - - .•CONTRe1�.CrOR -,..- _ -_; -' -°' ` _ _- - - - - -' BU ILDING PERMIT FEES" - - , -_
r - (Pleirse refer to (ee sahedule) -
Business name: A , c e vv Cy rh-s I eC .
Permit fee:
C I
Address: 1 l - S 5 S1.-- 17- R /a v a-
," c A A j' � N , Q R. O Z. State surcharge (12% of permit fee):
City /State /ZIP:
TLS plan review (40% of permit fee):
Phone: (5' U — 9 '7 % `k Fax: (Spy is e Z- 1,S( u (Due upon application)
CCB lie.: 01 5 Total permit fees:
Authorized signature: Amount received: #11/ / 9
This permit application expires if a permit is not obtained
Print name: W gt,S S 4 h g, c, Date: q (2'Z /II within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
f :'BuitdingwermitstFPS•PermitApp doe 03/23/06 440- 4613T(111O2ICOMJWEB)
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.
IN Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
t - 1\ We.ue%, «ovv. 1- Q.a6
Type of System (Complete A, B, C or 'D as applicable):
A.) Commercial Sprinkler - ,
❑
Wet ❑ Dry
Additional Standpipes
Information: I1azard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
B.) Type I - .Hood Fire Suppression System - -
Flood 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 $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: 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 2 sets of plans at submittal. Plan review fees are required at submittal.
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