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Permit q CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT '�7 . COMMUNITY DEVELOPMENT Permit #: FPS2011 -00137 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2011 Parcel: 2S112AA00300 Jurisdiction: Tigard Site address: 14200 SW 72ND AVE Project: GERBER LEGENDARY BLADES Subdivision: MILLMONT PARK Lot: 49 Project Description: Plugging (4) sprinkler heads and reinstalling (2) heads. Contractor: WYATT FIRE PROTECTION INC. Owner: GERBER LEGENDARY BLADES 9095 SW BURNHAM 14200 SW 72ND AVE TIGARD, OR 97223 PORTLAND, OR 97223 PHONE: 503 -684 -2928 PHONE: FAX: 503 -684 -9657 FEES Description Date Amount Specifics: Permit Fee - COM 11/16/2011 $64.54 12% State Surcharge - Building 11/16/2011 $7.74 Type of Use: COM Plan Review - Fire Life Safety - COM 11/16/2011 $25.82 Class of Work: ALT Type of Const: 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 $98.10 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $935.00 Residential Square Footage: 0 Fire Alarm Valuation: $0.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain - cop, of rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 44. Issued By: / _ Permittee Signature: • Call 503.6 . 1 by 7:00 a.m. for the next available inspecti +'n date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. . Buillling Permit Application Fire Protection System `. FOR OFFICE USE ONLY - City Of Tlb l "CI ° ` �� DateB / Permit No.: • J �� j 1 _60 ( 3 - : 9 13126 SW Hall Blvd., Tigard, OR 9 2 ' 29 +.,' '� Plan Review Phone: 503.639.4171 Fax: 603 9$�ic9'0-' Co 4.1 Date/By: Other Permit: TIGARD Inspection Line: 603.639 � \ �` Date Ready/By: Juris: RI See Page 2 for Internet: www.tigard- or.gov \ � °C - Notified/Method: r ' Supplemental Information .,.,.,:,t : =-,,k .G .: .... . - . .. .. >F.4=:,': ,. •.:!A'avx<;�t' ,, �,k..t ,:.3 w, ^, ', _, 2';BFv„^4eE 3'Y` iH e 'E v €.. 4Ft y .- .�- ..... .. ;�. ., .. x -�. .i„d. ; „�.. " ,... ,. .,,, > S, DES -'T ^i=`i Y ,. a �" 'T.0 g'� - ? - , .�TIfPE F VV.O 0 :;.' . -_ ^''` . ,..- : g :'RE<Po JllZEDDYITA;.I.A - . = F 0:`,.V Permit fees* are based on the value of the work performed. El New construction El Demolition P Indicate the value (rounded to the nearest dollar) of all ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the :. . - �' °r�S;:�,,: °= _'. - '-_., ".';; �a °= ate'- � * »E':� =' .��� "� r:.,_ work indicated on this application ;• �»1,4 CATE" 'OKY' OF =.CONSI'RU T•iib - °M.-•- PP ❑ 1- and 2- family dwelling ommercial/industrial Valuation: $ ['Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder El Other: Number of bathrooms: ; r�> �> 'Sr' ` ' ,;;;', �;,,� -, ,,„JOB. S TE: INFOR111ATION.,AND , .,...,'4..;.,;-,.0.-,,,„:,,,e. . Ati.�• _ =h,. -,a �f,3gi� Total number of floors: r = , Job site address: /4WD f/ 12 /1-1,- New dwelling area: square feet City /State /ZIP: 6412-0 i Q 2 97 2_2_4- Garage/carport area: square feet Suite/bldg. /apt. no.: Project name: 6, Z ,U1 j j Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet O AT O :.° A ` ; 'V. g 17iRE' V ? ,, C 1VIE'R MA USE GK ., .,,..x a, a=:":.;�. . -.,�Y' . •' , ..: � :r:Y±, :<. ...: '.- ',, ^.Ltl�:i, -.A .`gr.. 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 d11ar) of ill equipment, materials, labor, overhead, and the profit for the .ri.< ^>. �i'- ;i.%.ix"d.; ^:�- ^, "';,R. ^,?� .::'�',z'x...; •,; �xc��pw.�.;,, ,��.... ;a .,�w = ,�c. - x��y .±,� ��' «�E�- .r�.�i�`�`� �x � � - �` °.�� � ":z� -- .. �; - - -: -. work indicated on this application. . ,..f,„ ht-, � ,.,3 3 „'DESCRII'TI. -A. F .,- Vt?, ;..,.. -„ �s: V-r = PP _, " .,. kl � / A- f "::, a Fl SP/L� C C 7 f Valuation: $ , - /A, - -s -/- 2 J C't-0 - P- -e op 0 mic_ e9rc, - - - Existing building area: square feet New building area: square feet iivs. ' p. " rye ,._ . , 1, •- • ", , fir „`.: .,. ,,,.., .it:,,x E�:;; :1., bT>i ,,,, i'`C :PROE cza A A4,A4AA AAA ,,„ .»,.• •. a : ;T.FANA' 'N' : °' ;'m Number of stories: r =r 9 _� m �.. a� ° a. , � - .. - Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: ''31, > >0 �;- •m: - -�;,> » r�- m.;:.z�> ^;`tf', :fi =. :�:” ,,,�.� �a.s�.w,�a�R, ,�:•< .. Vii' ` V: =" ,,,. Y .' :� `f:,:. fit; „, P ®:° P . L.ICAiVT, »° �.. .CONTAGT''PERSOIV � �� , .»,. .,, ° ,,� ,,,�,»,.,,, . ., . �.», ..,..,. ,�a,�..:., , >�;;� >. te °�` °�"r;.,; �,,. <.. � >t,` a; �: �t�' 2�, s-' S' �` �.<. _,,.,:� _:'' Business name: • 2 7"-"C i ©fi_-- All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons • apply: Phone: ( ) • Fax:: ( ) E -mail: ' �,. <•<,. ..�, „CONTRACTOR _ `' \'" � � <' i :<_:: ,.'� r :�, . x.., x .• . � � ... ... ... . ... .r .. �_•.� ..,r t.- .. _ - , - ;'rr =` ` =yes �,. -:3': V , I `.D �P R IVIITaFEDS - -a »"t�s>.. , •r, , . .: <., ,. � •- atxar � x> w-- � . , ,.... , ... « „M...:.a a ^ .. ,>. ... anb��o':� ��r L ING� E _ 4442:0A-t:,,15,, > 7 _ a(P _ a .' ;' Business naive: V1 4 y 7i / L lz. ? i C � - - 77 - 0 `s .; - "d(Pease ere ,lo'fae'sc /iedule);ndr-;.�i :g :,` ;x . _ .,.f ! v 9S 5 73 u`e ,0� Permit fee: Address: City/State /ZIP: ��6 � ©,e_ 977_2-3 State surcharge (12 %of permit fee): FLS plan rev (40% of permit fee): Phone: (5-03) 4, �-- 2_ Ze Fax: (503) 6.;,E>4.- - 9 57 (Due upon application.) CCB lic.: 6)4-077 . Total permit fees: g J Authorized signature: ' /� Amount received: G�Q ` ( U �` This permit application expires if a permit s not obtained Print name: so �(. , — Date: 11 _' —/ ( within 180 days after it has been accepted as complete. * Fee methodology set by Tri- County Building Industry Service Board. i.\ Building \Permits -PemutApp.doc 03/23/06 440 -46 t3T(I1 /02 /COM/WEB) • City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information escr be.workt � n � �. ,.•;� .,.: ,.. >, .,., -,Q .: -�- ,.., . . .:....... .._ ..a..,., ,... - .. _ . ,'. x -,.,< ,- .,... � ors ;�: ztY ''�._ �'��. _ ;•_ 1.) ❑ New 2.) Modification to sprinkler heads only: ❑ Addition -10 heads: No plan review required. ❑ Alteration ❑ 11+ heads: Plan review required. ❑ Repair • Number of sprinkler heads: Additional description of work: r t ,Z W - �•'.'.. �:,. .::. ;. < a t "T `, , -' , ok�, �'' ,';;�i�w:t �� ,s exxx. �Com le'te,�A -'B w,.0 o �A � •- ,.:�::_<;::�� ,� �� °:�'� ��... :�.��,t,��: #�:.- s S^ �.:: ,'�,v,..a- <a.. >� "R`': �'," ."S.� `e�,•;. •' °:gib ":: "� >x:::.� ❑ Wet ❑ Dry Additional Standpipes Information: Hazard Group Density Design Area K. Factor Sprinkler Project Valuation: $ an t;•; -,_ s• *> ,,,,, �.ess'xori'S ..�.' ,.' Hood P±hject Valuation: - - -- $1151 „3 £- r�S�'- - �v�:, ":p;'� Y� 3:aY.�i;. 1 v, M , ::�5 .. ,��...,�,•'"- -,�';i:: �,v �, 5w�: ,. ?. e".r „>�. a:,,'i•'r �r*� �: ��ca�+,,.,,. '3 ' , a• E _ _ _ _ __ - . Submittal shall ___ __ _ ___ ._Battery_Calculations - - -- - ❑_ Yes---------- - - - - -- ^ - - -- - - -- include: Individual Component ❑ Yes Cut Sheets Fire Alarm Project Valuation: $ M N a. „-. :-t -' 3 `: ^Y',^, 5aagl; +'yffi' ems.., ^r:r'.::z: -: :•n`L2••:•rs,::- ?s �'r,;§,:� -., �,5 :,,,.�.�`- . -fir :-� ;�;• .�'� _.,r"„�a' "� <':' =,'�!r,a,:,:: " -wr •�� ,._<„ : � �' ,,.. ,. ^<; Y<: .<r i ^r ' ..d' ` ':,, -.¢v, 2 „N • ; . +,',:_ � aY r3 .., ','✓',e »„ x. • �.,. , . v . , • R.,, ss ,.Y. r.._c::r 'aLi'Si- ,�,.�'.:Y4.:'�,°, :` =. ,v':: u ..,:%5'vx' ,d,�,u.,:. ^.:fc.:rS :,r $ 's ^i�`� °^ t ,%x: _ <,'qxe >•.3 S� "; 'zy,., rrs"�.,- ;,,:;g • 3'S x'= .' =.r•`,a'5„„p:.;;� "��"' •,;�".�1'� <'.', fi.., ,,,�': ,ter "'`3 • "�.s�.f ^ a, .,��• ;:fin. # .�,...; c,. :.�.,x ,,,a.a ".,,; � ��_A<, "`'y� ' =::.a ' ,•q $`i ": . ;1 ,°1.. ,, £,'" ,� �•;.� ->.-.a ;?� ^S �, t�, `�",,:. ^ "d - �;'`' +i " "a� -. , � S� - .... , � .� „•t�i , ^ht='s' ,�- ��,, �<.: "-" D::.Resrdeiitxa'1 S rxnkler._ Stan = Al`. n u x,Y-: :_ ::;�'",';`., .�",.,.x...�, >. r, .. s..:,�a�":� ., h,�z>��', - . %*g.&� '�:.,: ^.�s' .i �1�`r = -,"r'� Square Footage: Permit Fee: `'=`'?' '' ,51: =" "`" `' '` -` 0 to 2,000 $187.50 > 2,001 to 3,600 $232.50 0''"° a a j ., `; : r' 6 �' 1e' 3 601 to 7 200 02,E . ; M; 0 �-::'_ .I; : - S A k, $292.50 � ��ex��� °,;� 7,201 and ;< > greater $381.50' v Sprinkler Project Square Footage: sq. ft. q ,.r yr s: i ,a.- „ e' i,.'. ._.-,- �,... ��,. �. ,�.= ��,,�,:, , r ...,s,,:,, t .'„ .:;� , r.'�:. �;�tFxrePirotectittPeritnF � : K��::, -,:�# px�:•'� _��..,., 3., �. _s � k .._ � .�,.__.. r„ .���:'.�.�,,, tit... _,. - � �..� _,_.:,�,,,,,;.,.,_ .. ,,„;•�..,,nr_ ,!��Si•,i�;,, ^, . ,�._. -'s,._ . � a�v�': -� -��� 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. "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. http: / /www.ci.tigard.or.us/ city_ hall/ departments /cd /dots /PPS- PermitApp.doc 2