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Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT COMMUNITY DEVELOPMENT Permit #: FPS2011 -00145 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/13/2011 Parcel: 2S101AB00100 Jurisdiction: TIGARD Site address: 12025 SW 70TH AVE Project: Dr. Sunil Thanik Subdivision: 1996 -024 PARTITION PLAT Lot: 2 Project Description: Fire sprinkler modification Contractor: FIRESTOP CO Owner: SUNIL THANIK 3203 NE 65TH ST. #2 470 SW 6TH ST. VANCOUVER, WA 98663 LAKE OSWEGO, OR 97034 PHONE: 360- 718 -8604 PHONE: 503 - 699 -6628 FAX: 360 -718 -8603 FEES Description Date Amount Specifics: Permit Fee - COM 11/29/2011 $112.96 12% State Surcharge - Building 11/29/2011 $13.56 Type of Use: COM Plan Review - Fire Life Safety - COM 11/29/2011 $45.18 Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg $2.00 (over 11/29/2011 $2.00 Occupancy Grp: B Height: ft 11x17) Stories: 1 Info Process /Archiving - Sm $0.50 (up to 11/30/2011 $1.50 11x17) Commercial Sprinkler System: Sprinkler Required: Yes Sprinkler Type: Wet Standpipe Required: Hazard: LT Density: .2 Design Area: 1500 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 $175.20 Valuations: Required Items and Reports (Conditions) Sprinkler Valuation: $3,850.00 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 ques s o NC by calling 503.232.1987 or 1.800.332.2344. Issued By: // 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 Internet: www.tigard- or.gov Application Fire are-4 r T, ,. 4' s a• t e i. ' 1k it..4 4 ^o —"x € a'4 Y ire Protection System C� * " � yv � FI £ i .r -� ,({. t��4�jµ i f ^,�,.�..� �*� -FOR 06FICE-�USE O>\Ll � � � � t � . --sr_ � 1f Ca � i1� R - ... + 't .M. x ,r:'h ' u:n.. «�..L'. rs: ' ?r_ :; �c s a'' et "' City of Tigard Received �� s �' �V T g an Permit No.: ° 13125 SW Hall Blvd: Tigard, 00 R° 97223 Date /By v �� i x a U Plan Revteiv �� Phone: 503.718.2439 Fax' >03.598.1960 9 20 1 Date /By: I mi Other Permit 4u�,,� ,, e ii Inspection Line: 503.639.4175 t H See Page 2 for TIGAERD� Ins p `�'i�� Date Ready /6y: luri g .- =`._ ;e=¢% t Q� 1 ux IM plY y Notified/Method: �{ Y 71 Supplemental Information r - — V I I • A yrJ<, TYPE OF WORK 1DIv.° REQUIRED DATA: 1 -AND 2- FAMILI' 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 I1 Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ❑ I- and 2- family dwelling 4 Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: / A 's JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: I.?„ -+ S l": •7 0 ih ,p V New dwelling area: square feet Cit /State /ZIP: �� y I I fT jt� 1 0 9 L Garage /carport area: square feet Idg. /apt. no.: t 0 0 Project name: fl c k. C-t) - D RtsJ ilk Covered porch area: square feet Cross street/directions to job site: L IS (-0 6, /A OE to o 1 A Deck area square feet 5,(41 . 7 o n` A vE . 4 S, w. b.A/2,.„ j NI o V T7( Other structure area: square feet e S'T d 'Si W , 2 r d Ave 6 H W'1 ZI "7 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 (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. AD F‘ S efLi lU KL -er- -S i'cS Na..ESSAlt -9 F p- Valuation: $ 3 1 9l`© 7 E NA- N IAA 9 iloV CAA C.) I " Existing building area: 31 Jam. - 0-0 square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: b e V 6— i.--At S Fr_-'( Type of construction: y (l Address: ' �3 0 1 1 5 of NG Wt N I h fLb Occupancy groups: Cit /State /ZIP: V'\ ,SCN,uf I I,LE 1 0 I = , q70-7 Existing: Phone: ( ) Fax: ( ) New: M APPLICANT ❑ CONTACT PERSON NOTICE Business name: r 12_6 .51b P L , L-{...- C- All contractors and subcontractors are required to be Contact name: lBo R C EK licensed with the Oregon Construction Contractors Board �` _ _ under ORS 701 and may be required to be licensed in the Address: 3 2. 3 1� ,:e • t0 s l_. � 5 1 J F ^ �c. E 2. jurisdiction in which work is being performed. If the City /State /ZIP: �II AA n r � ` 3 applicant is exempt from licensing, the following reasons VA Go U v E i wA _ F b ' apply Phone: (3(�0) ) 1 8 ` 9 G CI'{- Fax:: ( 36o )1 18 —8 G n 3 E-mail: kj ` b. 9 .v-c h Cr - 1 , - -- -e s - imp cit.. Co bn CONTRACTOR BUILDING PERMIT FEES* f (Please refer to fee schedule) Business name: a Wl G Ci S c'L 6 O ✓ f% Address: Permit fee: City /State /ZIP: State surcharge (12 %ofpermit fee): FLS plan review (40% of permit fee): Phone: ( ) I Fax: ( ) (Due upon application.) CCB lie.: 1 0 3 -4_1 ,0+ Total permit fees: . C 7 Authorized signature: /I%C ry" " "' � q '`' x — A ji-kuk_ Amount received: fff�� This permit application expires if a permit is not obtained Print name: ray ra E T IS . 6- fl_ 1`s) / Date: t, .2 1 I within 180 days after it has been accepted as complete. ' ( * Fce methodology set by Tri- County Building Industry City of Tigard: Fire Protection Permit Checklist Page 2 - Supplemental Information Describe work to be done: 1.) ❑ New 2.) Modification to sprinkler heads only: S Addition ❑ 1 -10 heads: No plan review required. ❑ Alteration ix 11+ heads: Plan review required. ❑ Repair Number of sprinkler heads: 4- ( Additional description of work: Type of System (Complete A, B, C or D as applicable): A.) Commercial Sprinkler . VI Wet ❑ Dry Additional Standpipes 0 Information: Hazard Group L- ( {-t T Density • O Design Area 15 o 0 K. Factor 5, 6 Sprinkler Project Valuation: $ et 50 �= • B.) Type I - Hood Fire Suppression System IIood 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 $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 2 sets of plans at submittal. Plan review fees are required at submittal. http : / /www.tigard- or.gov /city_hall/ departments- /cd /docs /LA'S- PermitApp.doc 02/01/P1