Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 00075
TI G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/23/2012
Parcel: 2S115BA02600
Jurisdiction: Tigard
Site address: 16230 SW PACIFIC HWY 140
Project: Spec Subdivision: 2004 -015 PARTITION PLAT Lot: 2
Project Description: Modification of (19) fire sprinkler heads.
Contractor: AFP SYSTEMS INC Owner: SN PROPERTIES PARTNERSHIP
19435 SW 129TH AVE 1121 SW SALMON ST
TUALATIN, OR 97062 PORTLAND, OR 97205
PHONE: 503 - 692 -9284 PHONE:
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - COM 05/11/2012 $67.23
12% State Surcharge - Building 05/11/2012 $8.07
Type of Use: COM Plan Review - Fire Life Safety - COM 05/11/2012 $26.89
Class of Work: ALT Type of Const: VB Info Process /Archiving - Sm $0.50 (up to 05/11/2012 $9.00
Occupancy Grp: B Height: ft 11x17)
Stories: 1
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type:
Standpipe Required: Hazard: ORD2
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 $111.19
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,085.00
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 - ' enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or ; rect questions to O ' C b -Iling 503.232.1987 or 1.800.332.2344.
I sued By: /AO / • 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.
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Building Permit APPIication�11�� ECEIVEl
Fire Protection System Foie owlet.: tisi °NI
City of Tigard MAY 1 1 2012 Dae;�ea 5msree9 PennitNo.: 'j . 4 ,, „ A , 607
q l 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1E2
ti Phone: 503.639.4171 Fax: 503.5 i4. r 3 ' Dac/B . �r�1� Other Permit:
Inspection Line: 503.639.4175 � OF ± TIGARD Data Ready/II. a 4 to See Pa e 2 for
i 1lir�ilI)
Inte net: www.tigard or.gov BUILDING DIVISION Naified/Merhod :. / /Z :'�1 SupplententalInfornration
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❑ New construction ❑ Dem olition Permit fees• are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
® Addition /alteration/replacement 0 Other: equipment, materials, labor, overhead, and the profit for the
;: :- :: G .• wor In Icated on this cation
:",.� < ..... :; ; ',_ :> •• : ° CATEORY ;OF -,�;; ..
,:.�,:.;;'; :
: ' :;'; ::� app
0 i- and 2- family dwelling ® CommerciaUndustrial Valuation: S
❑ Accessory building 0 Multi - family Number of bedrooms:
❑ Master builder 0 Other: Number of bathrooms:
- - - "�'' : ?`� - - Total number of floors:
.,: JOB >AT
0 I L' `OCA `=r'
Job site address: 423 . Sal '�:�.,� rt , e— tV New dwelling area: square feet
City /State/ZIP: ' 1 19per Q cj..• 9122`\ . Garagefcarport area: square feet
Suite/bidgJapt. no.: i i{ O I Project name: tt..\1a.; -v«az— Covered porch area: square feet
Cross street/directions to job site: I l __ 1 1_ ONI_ y" Deck area: square feet
Other structure area: square feet
` 1REQU IRED DATA COM111ERCL L USE :gimcKUST
Subdivision: 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
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:�: E$CRIPTION OF:WO12K.` p
Aa,s, 1 upr1 -C c„, Cov hi%e - v -rZT Valuation: S %Q
.b.c Qk's" CovimS Q4, �..174v. k•tc\ cca.0.•
Existing building area: square feet
New building area: 2c) 3 p square feet
P P �p !9'=:'fE� Number of stories•
RQ R TY, R . ;x� =: 1VAIV'fs'' -:� - ;;:�'.
Name: Type of construction: tub,. 4 - ,, V., Z- �� , Q - R
Address: Occupancy groups: (3 \ 2
City /State/ZIP: Existing:
Phone: ( ) Fax: ( ) New:
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Business name: A F p S io.... , `•,, a_ . All contractors and subcontractors are required to be
Contact mmne: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: ‘ q 4 4 1,5 SN.S 129 ?l. /i►v a jurisdiction In which work is being performed. If the
1 at hZ; applicant is exempt from licensing, the following reasons
City /StatePLIP:
n O0. C n tlko1 apply:
Phone: (Sa3)\ocl2. -SZ$`1 I Fax:: (50'3) \Dem \\$b
E -mail:
n:: :: u ::: a _ - , =may; ': sz
..CONTRACT R 'S` =�? - � - 1N FEES` _= := '; -
Business name: • A F 9 S c,1g.tv.S 1 r• C..
Y Penlil fee:
Address: 1 TVS 5 S W 12.9 IA, AV L
n 0 9, q 7 O b 2 State surcharge ((12% of permit fee):
City/State/2W: -r, d\ cl:c .,
FLS plan review(40 %ofpermit fee):
Phone: (S 03) 1a q 2. - c1 2 g y I Fax: (sfl3) b 92 – 11$ b (Due Upon application.)
CCB lie.: 1 5 3 4 Total permit fees: 9
Authorized signature: )--0 ZJ Amount received: "l, r
Tllis permit application expires Ira permit is not obtained
Print name: W o S , o n Q. I Date: 5 f 1 i I ( 2 I within 180 days after It has been accepted as complete. • Fee methodology set by Tri- County Building Industry
Service Board.
rABuitdirtePerroi0IPPS •Permiapp.doc 03/23/06 4404613T(11/07/CO\I/WBB)
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City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information
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PeS,CribdAvOkk to besdonc:
1.) 0 New 2.) Modification to sprinkler heads only:
21 Addition 0 1-10 heads: No plan review required.
o Alteration Lg 11+ heads: Plan review required.
Ej Repair
Number of sprinkler heads:
Additional description of work:
Type of Sys teni(COroPlete::A; :13; C: or D . ;.as
A.) Commercial Sprinkler
1:81 Wet El Dry
Additional Standpipes
Information: Hazard Group 01.-% 2.
Density .Z 0
Design Area
K. Factor t. 0
Sprinkler Project Valuation: $ j o %s-
Type
Hood Project Valuation: I $
Submittal shall Battery Calculations 0 Yes
include: Individual Component 0 Yes
_ Cut Sheets
Fire Alarm Project Valuation: $
D.) Residential Sprinkler • . ,• •:,
(S tand Al ite'System)
Square Footage: Permit Fee:
0 to 2,000 $187.50
2,001 to 3,600 $232.50
3,601 to 7,200 $292.50
7,201 and greater $381.50
Sprinkler Project Square Footage: 20 30 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 ti'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.
\Building\Perrnits \FPS-PcsmitApp.doc 06/25/08 2