Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
'• CO MMUNITY DEVELOPMENT Permit #: FPS2012 -00001
a 131 25 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2012
TIGA D Parcel 2S112 D600200
Jurisdiction: Tigard
Site address: 15255 SW 72ND AVE
Project: Pittman & Brooks Subdivision: FANNO CREEK ACRE TRACTS Lot: 45
Project Description: Fire sprinkler modification at 1st floor and addition.
Contractor: WYATT FIRE PROTECTION INC. Owner: BROOKS & PITTMAN RENTALS
9095 SW BURNHAM 15255 SW 72ND AVE TIGARD, OR 97223 PORTLAND, OR 97224
PHONE: 503 - 684 -2928 PHONE:
FAX: 503 - 684 -9657
FEES
Description Date Amount
Specifics: Permit Fee - COM 01/03/2012 $75.30
12% State Surcharge - Building 01/03/2012 $9.04
Type of Use: COM Plan Review - Fire Life Safety - COM 01/03/2012 $30.12
Class of Work: ALT Type of Const: VB Info Process /Archiving - Lg $2.00 (over 01/03/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 01/03/2012 $5.00
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
Standpipe Required: Hazard: LT
Density: 0 Design Area: 0
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 $121.46
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,328.00
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 obtai a c• .y of th- rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l
Issued By: - ermittee Signature:
- -'�i /_Giles` L
Call 5b 7:00 a.m. for the next available insp tion date.
This permit card shall be kept in a conspicuous place on the job site u til completion of the project.
Approved plans are required on the job site at the time of each inspection. -
;. • Bpilding Permit Application .
Fire Protection System RECEIVED FOR OFFICE USE ONLY City of Tigard DateB y / , PermitN -dQ�a 'J /
'� 13126 SW Hal] Blvd., Tigard, OR 97223
71
Phone: 503.639.4171 Fax: 503.598.196 0 3 Z012 PlanR ew ` � ��
Date/By: Other Permit:
TIGA Inspection Line: 503.639.4175 Date Ready/By: J See Page 2 for
Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method:��� Supplemental Information
T\ PE OF WORK a �; % .-- REQUIRED D ATA 1 AND 2 ",T'AIVIILY -DVI ELLING `t> I
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
'Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
>° O).1` P
work indicated on this application.
CA OF PEGORY° =CgNSTRUGTIO ' :- =x_ fi
❑ 1- and 2-family dwelling Commercial /industrial
Valuation: $
[11 Accessory building [11 Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOS `SITE INIZFOF> " D , 7°'� l number of floors:
, , gi p
A 1 AT1QN., AN LOCATlO]N,� °
Job site address: ) 5 -z.s-s ., Vim(- 7Z' -" / New dwelling area: square feet
City /State /ZIP: 1 % 0 / riz___ q7 -2. a 4 Garage /carport area: square feet
Suite/bldg. /apt. no.: 4- I FL, Project name: 7 it o e E Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
P I2EQti)I I21 b`FDAT reiiii6iiRf IAT =L S Ew 1i' G' KI�ISTy
° I• • a , , ,.a ,,4; .a;;>; 44 4 < 44,a.; :. 4 :- 04`Ve;M
S ubdivision: • I 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
'aH!F . ' e f�,C= 4.4444,444 ,. 44*,, ,W,,,, M ,i ;>e4V +, , 44,'4444"4P,, ,k• , :,, A — .;: ,,,
wt >, ° , .1 -- DESGRII'TI HDF" W0�2' ' p .140 x<, �it00 w ork indicated on this c;�eu , •� '- '",'_� :s.r, ;���%.,� OIY , t .- �rz,;;� >- : �:.,`.°"::= ..�e. x�,3 application.
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.-- (61 / l /" 6,p1V eMet./ r /67—
1 5 Valuation: $ /326,
G 769Dt.. 1 D . Existing building area: square feet
New building area: square feet
® - A V 44 OP,EI2TY -O\\ NER 4 ,1 T, a; °' ". 4 �a Number of stones:
,k= :'�r' > � °� "° T�1VAN ] �x��„ . ' -��- ,' N ries:
Name: Type of construction:
Address: Occupancy groups: .
City/State /ZIP:
Existing:
Phone: ( ) Fax: ( )
New:
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Business name: j G,)/(..*.1 /_' [. )/z— 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:
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e:
/ _ ') ,.7^ ;., „ , , k , ' Please r ta' ee schedule °r y
Business name: �✓,4- � '� � - 17 o & ) �� refer f � ; , -. 4,
Address: 90 S l'
( 6. Permit fee:
City/State /ZIP: 4.74140 02 9 •'7 Z State surcharge (12% of permit fee):
f FLS plan review (40% of permit fee):
Phone: (903) b4— —Z '.? y �. Fax: (03) 6 0 1- —9657 (Due upon application.)
CCB lie.: 7 Total permit fees:
Amount received - r'ry f b / /i��
Authorized signature: " [
+� — This permit application expires if a permit is not obtained
Print name: G --�� Date: C).t —63 -1z_ within 180 days after it has been accepted as complete.
1 c — * Fee methodology set by Tri- County Building Industry
• Service Board.
I. \Building\Permits \FPS- PemtitApp.doc 03/23/06 440 -46 i3T(I I /02 /COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
1.) ❑ New 2.) Modification to sprinkler heads only:
❑� Addition ❑ 1 -10 heads: No plan review required.
Alteration 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: '
Additional description of work:
:. :;:.:.. ':;:.. • •,
:T. e:o£ -S, stem:, Cain Iet e-A
, ? : " "
,
❑ Wet ❑
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
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Hood Project Valuation:
Y A "st i :' l . 9 " .i.S :ate. a:' :ii;' » >`' �? ',°:�'. , aY,
9 .
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�F,
r�u
C;3 'fret Al �..2,
.'o�w y ` 3 '�„`>- Y _
Submittal shall Battery Calculations ❑ Yes
include: Individual Component El Yes
Cut Sheets
Fire Alarm Project Valuation: $
iti ' "t" r ".,ei`' ^, .,,R . ✓' .Ss', '. , %. ^, Zk `"'- -t z 4.
,. te � "� vY:a. w,�:'. " `'�,'",5x.'�' - ° =_°
r Ems �` 3: € �; , rt .� -.,'
�T D. : Resclentia`l�S ` - < iri'kl e•r� .S:ta xidmAl > n � � ° � � f
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Square Footage: Permit Fee: , ' �j eist,::x" ,, : ., f „., ,
0 to 2,000 $187.50 . w. - 15
2,001 to 3,600 $232.50
107 - °' r > '. : ..".r.,
3,601 to 7,200 $292.50 ,fr ;”; tan;. :';. ~xti" =I ''s'
7,201 and $381.50 ";;, u i
; :.. "` :::v '
greater ,
Sprinkler Project Square Footage: sq. ft.
3 ' lA 3 -. ,..+ ,,, ._ ,,. -e -, x . < "..i , ...,� ..,. s .. -:.r. z., r n ,�� �� �f.;t ` �i1z
,._.,... , .- ...,.:. <... _ , ...- ..... - �,.�.� -... , .. >.. ,ire:;P >,. >.,rotectxotit.P rmiti�:F 94
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 /depart ments /cd /docs /TPS- PermitApp.doc 2