Permit � CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
I'�l 1 n COMMUNITY DEVELOPMENT Permit# FPS2011 -00130
Date Issued 10/25/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 23113AB00300
Jurisdiction Tigard
Site address 16037 SW UPPER BOONES FERRY RD 165
Project Spec Space Subdivision FANNO CREEK ACRE TRACTS Lot 38
Project Description Add (9) new fire sprinkler heads for TI
Contractor FIRESTOP CO Owner OREGON STATE BAR, THE
3203 NE 65TH ST #2 16037 SW UPPER BOONES FERRY RD
VANCOUVER, WA 98663 TIGARD, OR 97224
PHONE 360- 718 -8604 PHONE
FAX 360 - 718 -8603
FEES
Description Date Amount
Specifics. Permit Fee - COM 10/25/2011 $64 54
12% State Surcharge - Building 10/25/2011 $7 74
Type of Use COM Plan Review - Fire Life Safety - COM 10/25/2011 $25 82
Class of Work ALT Type of Const
Occupancy Grp Height ft
Stories
Commercial Sprinkler 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 $98 10
Valuations Required Items and Reports (Conditions)
Sprinkler Valuation $1,000 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, _ work - 1 uspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility N ificatton Center hose r are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You 9 btain a copy of the rules
or dire questions to OUNC by .. g 503 ii 2 1,987 or 1 800 332 2344
/
Issue By G , .. Ce. „. %2 C `tks Permittee Signature
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 Applicatio4CEIVED
Fire Protection System FOR OFFICE USE ONLY
OCT 2 5 2011 �
City of Tigard Date)B Reeetyed
11111 a pr /� c // ail Permit No / Ay/A-0073 d o
ll
13125 SW l tall Blvd , 7 igard, OIL 9 ' ' OF TIGAR i 1NG DIVISION 41 Date /By Plan Renew
503 718 2439 Fax 503 ' l Other Permit
TIGARD Inspection Line 503 639 4175 Date Ready /By inns 10 see Page 2 for
inlet www tigard -or gov Noufied/Melhod Supplemental Information
TYPE OF WORK REQUIRED DATA:I - AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Penult fees* are based on the value of the work performed
Indicate the value (romded to the nearest dollar) of all
X Addnlnn /alteration /replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
f CATEGORY OF CONSTRUCTION
work indicated on this application
❑ I- and 2- faintly dwelling CommerclaUmdustrial 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 /6,6 -E;;... ki 0 'Q.- 72)esnfJ r ,- 4 7 i \ New dwelling area square feet
City/State /ZIP 77 6 Al \ oj 9t _ � -di Garage /carport area square feet
Surte/bldg /apt no Project name - 5u 1 I t - / 6 Covered porch area square feet
Cross streeUdirections 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
fax map /parcel no Indicate the value (romded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application
Valuation S , ICJ
Q_ I `7 <1 ,) ) ✓ G iLI -etc I - g -r , Existing building area square feet
New building area square feet
❑ PROPERTY OWNER I ❑ TENANT Number of stones
Name Type of construction
Address Occupancy groups
City/State/ZIP Existing
Phone ( ) Fax ( ) New
APPLICANT XCONTACT PERSON NOTICE
Business name rl ri �-��� �� , All contractors and subcontractors are required to be
Contact name \\ l licensed with the Oregon Construction Contractors Board
`I 1-4-r.r - A I V under ORS 701 and may be required to be Icensed in the
Address ? d- r r oe . ' 4 + jurisdiction in which work is being performed If the
City/State/ZIP .�. Ar applicant is exempt from licensing, the following reasons
y v� f_ I�`.DJ ✓� --'cd fib, apply
Phone ( ) ', f K n/a Fax ( ? _ ve0a5
E-mail
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name I1 r7 r ST Ln r
r Permit fee
Address - 2., 5 . MS (n fir ..6`
City/State/ZIP /� State surcharge (12% of permit fee)
) 'la -^ i A n. / f) co_ e I A ' ' FLS plan review (40 %ofpermit fee)
Phone ( U74?) )' V —ttp CO Fax (00) "9qC - V- tM55 (Due upon apphcaoon)
CCB he ff ? 7,7 rj Total permit fees i
Authorized signature/L /�/ Amount received 178./0
` (( This permit application expires if a permit is not obtained
Print name (` 0 L. ,r Date it l 7 (, 4 within ISO days after it has been accepted as complete.
(- - . * Pee methodology set by Tn -County Building Industry
Service Board
I \Building\Permits\FPS- PermaApp doe 02/01/2011 440 460T(11/02/COMP VFB)
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
Iteration 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 (-1 6, Prf
Density , 1 D
Design Area / S h-(
K Factor )111.—
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Ycs
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) $
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 V Budding VPermitsV1 PS- Permndpp chic 02/01/2011 2