Permit S r i (T6 S • I e. Coq - Addres C'orrec. -hoc,
q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
- COMMUNITY DEVELOPMENT Permit #: FPS2009-00031
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2009
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7352 SW DURHAM RD
Subdivision: Lot: 0
Project: Spec Space
Project Description: Alter (2), install (7) heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
Permit Fee - COM 05/14/2009 $62.50
#300 Tax - 12% State Surcharge 05/14/2009 $7.50
PHONE:
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503 -620 -1058
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:
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 $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1200
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 -0100. You may obtain a copy of the rules
•
Issued By: _ • . / 1 . - (1, Permittee Signature: � ,(1 V cct .ki Oy t
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
a CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2009 -00031
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/14/2009
Parcel: 2S113AB01400
Jurisdiction: TIGARD
Site address: 7358 SW DURHAM RD
Subdivision: Lot: 0
Project: Spec Space
Project Description: Alter (2), install (7) heads.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee - COM 05/14/2009 $62.50
#300 Tax - 12% State Surcharge 05/14/2009 $7.50
PHONE:
Contractor:
DELTA FIRE INC
14795 SW 72ND AVE
PORTLAND, OR 97224
PHONE: 503 - 620 -4020
FAX: 503 - 620 -1058
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:
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 $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1200
Residential Square Footage: 0
Fire Alarm Valuation: 0
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 -0100. You may obtain a co .y of the rules
c--
Issued By: Permittee Si / /
C3ZR / • . �ri�I -
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. ,
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 RECFI\f1 FOR OFFICE USE ONLY
City of Ti and .aeived
! g Permit er mit No.
y �/JS o2rrr�9 -ozro3 /
• II I 2 13125 SW Hall Blvd., Tigard, OR 97223 MAY 1 5 2O0 t. Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Date/By:
T 1 G A R U Inspection Line: 503.639 CITY OF I IGAf I) Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISI l� otified/ 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 (romded to the nearest dollar) of all
XAddition/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 38:CCommercialIindustrial 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: 735 r Yn 1-)1d. New dwelling area: square feet
City/State /ZIP: T i v m Q
, �- � u
Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name ?. a �� • t. I , , g � , Covered porch area square feet
Cross street/directions to job site: 'T. _. PO Deck area: square feet
Other structure area: square feet
REQUIRED DATA:,COMMERCIAL- USECHECKLLST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value rotnded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
� A w ria 7 heiAr (s le l hr +e A- 'Fire sp trwIl Valuation: $
(� n CI •S , 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:
Ej APPLICANT ❑ CONTACT PERSON
^ NOTICE
Business name: �' Je «ew ire , rnC- All contractors and subcontractors are required to be
Contact name: S bro Vc ik/ A A ^ e l C I O U . � licensed with the Oregon Construction Contractors Board
fir. t , V ` ` c�J under ORS 701 and may be required to be lcensed in the
Address: 1 cr 6 ao 7 t c,I A E. jurisdiction in which work is being performed. If the
City/State /ZIP: ?Q` +l f OK q' 1 al
(090-1409.0 ant is exempt fiom licensing, the following reasons
"� ��l�
apply:
Phone: (503 Fax::: ( ,9�� p
) ( _ I05 O
E-mail: he. d't, 6ectonP re . corn
•
� CONTRACTOR BUILDING PERMIT FEES*
t, t t , t c t (Ple6se refer ioJee schedule )
Business name om TCit r e.
V
c `\ ^ f a Permit fee:
Address: 11'17%5 W `land JA�P.
State surcharge (12% of permit fee):
City /State /ZIP: Imo. ('irklre 0 R c47,9 `t�` a (4
� v !�� FLS plan review (40 %ofpermit fee):
Phone: 605 a 90 .E u Fax: (! O &RD — 105 g (Due upon application.)
CCB lic.: 6LI 171 Total permit fees:
Authorized signature: ' „ 0 Amount received:
R11 / Qom( This permit application expires if a permit is not obtained
Print name: K�'IG('t Sca (- I nr0081A_ Date: 5/ l i )�� • within 180 days after it has been accepted as complete.
Fee methodology set by Tri -County Building Industry
Service Board
I Building \Permits \FPS- PermilApp,doc 03/23/06 440.4613T(11/02/CODIIWEB)
• I 1
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
Describe work to be don e:
1.) ❑ New 2.) codification to sprinkler heads only:
❑ Addition ` 1 -10 heads: No plan review required.
X Alteration ❑ 11+ heads: Plan review required.
❑ Repair Q
Number of sprinkler heads: 1 -
Additional description of work:
Type of System (Complete A, B, C or D as applicable):
A.) Commercial Sprinkler
❑ Wet ❑ Dry
Additional Standpipes A
Information: Hazard Grou ' NM
Density 10 •
Design Area 150C)
K. Factor 6. 4
Sprinkler Project Valuation: $ ACO oO
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 $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: JWA. sq. ft.
Fire Protection Permit Fees
Project valuation subtotal (see A, B & C above): $ 9 .00.00
Permit fee based on project valuation (see fee schedule): $ be'
�a-
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $ RQ
FLS Plan Review (40% of permit fee): $
TOTAL: $ 70 , OC)
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 \Permits \FPS- PecmitApp.doc p