Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11/111 COMMUNITY DEVELOPMENT Permit #: FPS2011 -00124
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 10/13/2011
Parcel: 2S112DC00500
Jurisdiction: Tigard
Site address: 15883 SW 72ND AVE
Project: Trane Oregon Subdivision: FANNO CREEK ACRE TRACTS Lot: 40
Project Description: Removing (7) sprinkler heads from existing fire suppression system.
Contractor: FIRESTOP CO Owner: PACIFIC REALTY ASSOCIATES
3203 NE 65TH ST #2 ATTN N PIVEN
VANCOUVER, WA 98663 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE" 360- 718 -8604 PHONE:
FAX: 360- 718 -8603
FEES
Description Date Amount
Specifics: Permit Fee - COM 10/13/2011 $59.16
12% State Surcharge - Building 10/13/2011 $7 10
Type of Use: COM Info Process /Archiving - Sm Sheet (up to 10/13/2011 $0 50
Class of Work: ALT Type of Const: 11x17)
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required Yes 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 $66.76
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $800.00
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 OUNC by calling 503 232 1987 or 1.800 332 2344.
Issued By: / • gnature_
Call 5 0 3 ` - .y 7:00 a.m. for the next available inspects • 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.
1
Building Permit Application
Fire Protection System CO FOR OFFICE USE ONLY � '
City of Tigard �� " DateB 10 t a El �j P ermit No �'5 ' 1
il h '" 13125 SW Hall Blvd., Tigard, OR 972 plan Review
Phone: 503.718 2439 Fax: 503 598.1960 1 � 411 DateBy Other Permit c�pc2C(I_0 1i
TI GA RD Inspection Line. 503.639.4175 IC� AQQ Date Ready/By. runs El See Page 2 for
Internet. www.tigard- or.gov C►r � Notified/Method %� Supplemental Information
O F D \ -C3 s � 1�
TYPE OF WOR REQUIRED DATA: 1- AND'2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rowded 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: $
❑ 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: 1 7 /j (.4.) t,J �N � �
( "s) New dwelling area: square feet
City/State/ZIP: Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: 7/4.- / � - • . 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 (rotnded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application. P�
� ^ 7e1(�i L � z7 1 NJ 16 u&--126 Valuation: $ S00
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: Existin
g:
Phone.( ) Fax:( ) New:
APPLICANT CONTACT PERSON NOTICE
Business na � �� A ll c ontractors and subcontractors are required to be
A � licensed with the Oregon Construction Contractors Board
Contact name:
2`? AAA. L.- under ORS 701 and may be required to be I in the
Address: ' v J 7 3 ) l � to ` ) 4 e jurisdiction in which work is being performed. If the •
City /State /ZIP: `l applicant is exempt from licensing, the following reasons
�/ , f � ) ∎) �� l�' r apply:
Phone: (1 (1,0 ). -`D 4 Fax:: (N)) s( .i i 3
E -mail:
CONTRACTOR BUILDING PERMIT FEES*
Business name: � j e — _r :? 6bri pA (Please refer [o fee schedule
� ` Permit fee:
Address: t.�b t\ L Ip �` - 4--)--r, City/State /ZIP: � �T � �l Z_ � � State surcharge (12 %of permit fee):
!�' i.'�� L FLS plan review (40% of permit fee):
Phone: ('z ) 46", t o O L ( ax: (Z _ b (Due upon application.)
'`
CCB lic.: t J L- 7 Total permit fees: 46( "7 (t
Authorized signature: i Amount received: , y1 - Z .,,,
This permit application expires if a permit is not obtained
Print name: 1L 1 I�r1.) 6 ?) LL ,�' Date: A --. .--1 — I within 180 days after it has been accepted as complete.
* Fee methodology set by Tri -County Building Industry
Service Board.
I \Buddmg\Permits\EPS- PermitApp doe 02/01/2011 440- 4613T(1 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 El 1 -10 heads: No plan review required.
❑ Alteration El 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads:
Additional description of work:
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 El Yes
include: Individual Component El 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.
I \Building \Permits \FPS- PermitApp doc 02/01/2011 2
RECEIVED
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CI ' OF TIGARD
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FirestopCompany.com
3203 NE 65th Street, Space 2
RYAN COLE Vancouver, WA 98663
Cell# (503) 708 -74 Office: (360) 718-8604
ryan.cole @firestopco.com Fax:' (360) 718-8603
AUTOMATIC FIRE PROTECTION