Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
III
13 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00088
T I GARS) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2012
Parcel: 1S136DA02300
Jurisdiction: Tigard
Site address: 6900 SW ATLANTA ST 100
Project: OME Subdivision: FRUITLAND ACRES Lot: 5
Project Description: Add (2) and relocate (2) fire sprinklers for TI.
Contractor: BASIC FIRE PROTECTION INC Owner: OREGON EDUCATION ASSN
8135 NE MARTIN LUTHER KING BLV 6900 SW ATLANTA ST
PORTLAND, OR 97211 TIGARD, OR 97223
PHONE: 503 - 285 -1855 PHONE: 503- 684 -3300
FAX: 503 - 285 -0713
' FEES
Description Date Amount
Specifics: Permit Fee - COM 06/06/2012 $77.99
12% State Surcharge - Building 06/06/2012 $9.36
Type of Use: COM Plan Review - Fire Life Safety - COM 06/06/2012 $31.20
Class of Work: FPS Type of Const: VB Info Process /Archiving - Lg $2.00 (over 06/06/2012 $2.00
Occupancy Grp: B Height: ft 11x17)
Stories: 2 Info Process /Archiving - Sm $0.50 (up to 06/06/2012 $0.50
11x17)
Commercial Sprinkler System:
Sprinkler Required: Yes Sprinkler Type: Wet
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 $121.05
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $1,428.00
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: I
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 Application
Fire Protection System FOR OFFICE USE ONLY
City of Tigard Received G � Permit No. �� -doe??
�' g Date /B : ��1,�
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit&(A0J - -efadi
I G n I: D Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for
T Internet: www.tigard - or.gov Notified/Method: IIM Supplemental information
TYPE OF WORK . '' REQUIRED DATA: 1 AND 2 FAMILY DWELLING
❑ New construction ❑ Demolition ' ermit fees* are based on the value of the work performed.
In.' ate the value (rounded to the nearest dollar) of all
gi Addition /alteration/replacement; , ; ' ! r . El Other: equip -nt, materials, labor, overhead, and the profit '.r the
CATEGORY OF CONSTRUCTION work in. • • red on this application.
❑ I- and 2- family dwelling , Commercial /industrial
Valuation: $
❑ Accessory building ❑ Multi- family Number of bedro. s:
❑ Master builder El Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: t 00 SI,J A D...A , rrf. T 'r New dwelling area: square feet
City/State /ZIP: F T'L.AC ,JD / C Z o4 / 9'122-71 Garage/carpo ea: sq.. e feet
Suite/bldg. /apt. no.: (7 g , Project name: (� I Covered .orch area: square . - t
Cross street/directions to job site: 6 Al g De• ' area: square feet
. Other structure area: square feet
REQUIRED DATA: COMMERCIAL - USE CHECKLIST
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
DESCRIPTION OF WORK work indicated on this application.
.�
� � i Valuation: $ 14 --
Aaa i f z) and r occ,te (2) -Cwt. SpriAtaQrs
ett -b rev t '� '' _ L S .�• ce g Existing building area: square feet
L a [� v uwe • New building area: nr square feet
PROPERTY OWNER El TENANT Number of stories: ..2
Name: C it e.,orJ Evuoa-rlt 7V AsSoGCArr(c4 Type of construction: V'/3
Address: 1,100 5W A J - - r r Occupancy groups: /i
Cit FberuA•.1D/ t)(L€ f )r. 9,-122 Existing:
Phone: (O OP)) ,. • 2,(40 Fax: (50,:gc 1(4 New:
/APPLICANT fi CONTACT PERSON NOTICE
Business name: laCtS L Fite. Qrotec toA, 1 n•G • 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: $ «5 we 1,,,,tue. J r . e` V a • jurisdiction in which work is being performed. If the
City/State /ZIP: ?or-4 -( r / � o n / o E ( applicant is exempt from licensing, the following reasons
�i Dec,, apply:
Phone: (50 /� �i� . uv rr Fax:' : (S6 2 e, z . Cl raj
E -mail: KetA,k•e(OGS Lc-fire. • GoM
CONTRACTOR BUILDING PERMIT FEES*
(Please refer to fee schedule)
Business name: dt 4.slL Flee fl!:- 0.1 [Ac,. Permit fee:
Address: a( me •L.LL- J(• glUd•
City/State /ZIP: 1 0 f' nd / O fe l 9']Z( State surcharge (12% of permit fee):
J FLS plan review (40% of permit fee):
Phone: ( ) Za5• I C Fax: (5 Le U t" (Due upon application)
CCB lic.: 44 i / /` Total permit fees:
Authorized signature: Amount received: la /, 0 5
This permit application expires if a permit is not obtained
Print name: 6•+,ekj Date: 4 4. „xQi' within 180 days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry
Service Board.
1:\Building \ Permits \FPS- PermitApp.doc Rev 01/05 /2012 440- 4613T(11/02 /COM/WEB)
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 Sr 1 -10 heads: No plan review required.
Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 4 (2ad6/2 r4o
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 Lich -k-
Density • LO
Design Area 16w
K. Factor 54,0
p
Sprinkler Project Valuation: $
B.) Type I - Hood Fire Suppression System
Hood Project Valuation: l $
C.) Fire Alarm
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $ alp, . .
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 • ' I - .1 • ; •
7,201 and greater $404.39
Sprinkler Project Square Footage: • $3/j 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.
http: / /www.tigard- or.gov /city_hall /departments /cd /docs /FPS - PermitApp.doc Re2 01/05/2012
4 BASIC LETTER OF TRANSMITTAL
•♦O FIRE
PROTECTION INC.
xe No.
8135 NE MLK JR. BLVD. - DATE 6-4-2012 12 -30637
PORTLAND, OREGON 97211
PHONE 285 -1855 FAX 285 -0713 ATTENTION Review
REGARDING:
Oregon Education Association
City of Tigard 6900 SW Atlanta Street
13125 SW Hall Blvd. Portland, Oregon 97223
Tigard, Oregon 97223 "First floor remodel "
WE ARE SENDING YOU
❑ Shop drawings ❑ Prints ❑ Plans ❑ Samples ❑ Specifications
Fl Copy of letter ❑ Change order ❑ Hydraulic calculations A Submittal Data
COPIES DATE NO. DESCRIPTION
1 06/04/12 1 of 1 Fire Sprinkler Permit Application w/o plans (1 -10 heads)
1 06/04/12 1 of 1 Fire Sprinkler Material Data
THESE ARE TRANSMITTED as checked below:
For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Return corrected submittal data
❑ As requested ❑ Returned for corrections ❑ Return corrected prints of each
❑ For review and comment ❑ For Architect's /Engineer's Approval
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS
Any questions feel free to give me a call.
COPY TO: FILE
Ken Kern
SIGNED: