Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
COMMUNITY DEVELOPMENT Permit #: FPS2012 -00095
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 25101 DCO5000
Jurisdiction: Tigard
Site address: 13410 SW 76TH AVE
Project: Albertina Kerr Centers Subdivision: PACIFIC RIDGE Lot: 2
Project Description: Install new NFPA -13D system to existing house.
Contractor: AFP SYSTEMS INC Owner: ALBERTINA KERR CENTERS
19435 SW 129TH AVE ATTN: JERALD A HOFFERT
TUALATIN, OR 97062 424 NE 22ND
PORTLAND, OR 97232
PHONE: 503 - 692 -9284 PHONE: 503 - 239 -8101
FAX: 503 - 692 -1186
FEES
Description Date Amount
Specifics: Permit Fee - RES 07/16/2012 $198.75
12% State Surcharge - Building 07/16/2012 $23.85
Type of Use: SF Info Process /Archiving - Lg $2.00 (over 07/16/2012 $2.00
Class of Work: ALT Type of Const: VB 11x17)
Occupancy Grp: R -3 Height: ft Info Process /Archiving - Sm $0.50 (up to 07/16/2012 $28.50
Stories: 1 11x17)
Commercial Sprinkler System:
Sprinkler Required: 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 $253.10
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 1950
Fire Alarm Valuation: $0.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
410 .111111 1 .
ill
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application, r• fvF vi to
Fire Protection System ' - . - - 1 ;.,-..--.. E .
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City Of Tigard 2 1 2012' Received
minim Permit No.: ' ` a ..00O '
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan R0 ��
d Phone: 503. 639,4171 Far: 503,59$.19 Date/13 . � i��l ' IherPennit: ,M3r� /� 7
:
i 1 e; A it t7 Inspection Line; 503.639.4175 `s ' ,:i Data Ready/By: is / his: to See Page 2 for
Internet: www,tigard- or -gov 4. • + ,y. : \ Q i V ethod Supplementa
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TY E :O1;? WQt I ' '"•; SQUIRE I D A� :.1t . ,1 -' M 1L'Y,DWELL1N6, : .
_ ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
P i Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
a .,
TEGORY� F- �CONSA'RUGTiON'° - :
work indicated on this application.
I. and 2- family dwelling ❑ Commercial/industrial Valuation: S bf-gm®
ei
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder 0 Other: Number o ballrooms: a, A t pOk
"`' " ` '" Total umber of floors:
:.. , _,-- :::::.._ :... ..::,..... JOB? iTE3NF bN °% O OV :.,
Job site address: 13 tr.I /Q Si,./ 7ij" Ave. New dwelling area: / hoc, square feet
City/State/ZIP: rc ( of: ci 7 a. 2.3 Garage/carport area: 55 square feet
Suite/bldgJapt. no.: - I Project name: Al t t 9 roc. 6 Covered porch area: e-/5 square feet
Cross street/directions to job site: S ,) riiy S f Deck area: — square feet
Other structure area: / a3 D square feet
'<REQUIRED_DATAd'GQ,lIMER L V :XST :'
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
; .:.a.... -: P
equipment, materials, labor, overhead, and the profit for the
work indicated on this application.
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s - pP
CR1PT10N W K<- �4 =-
R
Acid Act/ NF PA-130 S Ss s - 1' o + a2rrt-4%MS Valuation: S
4,.....5 e. Existing building arca: square feet
New building area: , square feet
Number of stories:
-
=P E - - -
O R ;O R•a< =� ..a?; ,. ANTS' °;'';i'' "s,"s.`�� 't�' Numb
.- :......:;,:._ . 13 .E. '19C: : - _ - TEN.
Name: 4/4.-f. iC Type of construction: •
• Address: (./acf , 4' (z •"rI Ave_ Occupancy groups:
City /State/ZIP: (0Y+tar J i 0 R. _ 17 .X.3 X Existing:
none: 6 ).3 - - `3 tal Fax: (cc.; ),2 x73 - 8 . 10 6 •
New:
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Al' AiV Q t' IiS .- -- -
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Business name: A FP s All contractors and subcontractors are required to be
• Contact name: C f� a / yytd licensed with the Oregon Construction Contractors Board
1� `J under ORS 701 and may be required to be licensed in the
Address: / 17 y 35- /1"."--. ,4ve jurisdiction In which work is being performed. If the
City/State/ZIP: 1,--4,.., applicant Is•exempt from licensing, the following reasons
Phone: (S ) G �fe1 -9�F3N I Fax: : :(3 ) 69A- 1 184
Y
E -mail: J oN p ,„•P y5 +Col.,
u
:...:.. . , ..... .....CONY CT _ -, .� . - Rtl1 , RE � �:
f�. �� /� -,. -.. 1,..,.. , h` Oleaser ,6 feesehidul e j ` .._.._ ............ .. .:
Business name: 12,, ,1i t" s o• ► /1 1� yJIT'��
Permit fee:
Address: 9■b ti 1 , j Iii / r I. /P VC 14// 5t /Af
City/State/Z1P: 'r, R
D S 02 y �p� st State surcharge (12 °,s of permit fee ):
/� FLS plan review (40% of permit fee):
Phone: fa" '4 2,- q(}f$ 1 Fax: (603 ---11 n 49 (Due upon application.) _
CCB lie.: 1 `7 - 75 -76,11 3 Total permit fees: -
Authorized signature: - ---- • Amount received: . 0---a* This permit application expires if a permit Is not obtained
Print name: /n�� Date: G 180 days after It has been accepted as complete.
`���`'� , : 1004{-11.) e . * ,-. `'"'I'~�*� r4�//'� • Fee methodology set byTri- County Building Industry
Service Board.
r:\ BuildirtePermitswPS •PumitApp.doc 03/13/06 4404613T(11102/COM/WEB)
City of Tigard: Fire Protection Permit Checklist
Page 2- Supplemental Information '
Desertbe4Okk to be: o e. • :
1.) pg. New 2.) Modification to sprinkler heads only:
0 Addition 1-10 heads: No plan review required.
o Alteration 12 11+ heads: Plan review required.
0 Repair
Number of sprinkler heads:
Additional description of work:
A) Commercial Sprinkler
Wet ODry
Additional Standpipes •
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $ -
B) Type I - Hood Fire Suppression System
,
Hood Project Valuation:
C) Fire Aiann
Submittal shall Battery Calculations 0 Yes
include: Individual Component D Yes
Cut Sheets
Fire Alarm Project Valuation: $
AlO4e 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: a , 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): $ 7. 9
FLS Plan Review (40% of permit fee): $ 1 0
TOTAL:
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
I: \Building \Permits \FPS-PermitApp.doc 06/25/08 2
•
Commercial Fire Protection System Permit Fees
State F&LS - Total
Project Valuation Permit Fee Surcharge Review Fire Protection .
From: To: 12% 40% Fees
1 2,000 62.50 730 25.00 95.00
2,001 3,000 69.65 8.36 ' 27.86 105.87
3,001 4,000 76.80 9.22 30.72 116.74
4,001 5,000 83.95 10.07 33.58 ( 127.60)
5,001 6,000 91.10 10.93 36.44 138.47
6,001 7,000 98.25 •' - 11.79 39.30 149.34
7,001 8,000 105.40 12.65 42.16 .160.21
8,001 9,000 112.55 13.51 45.02 171.08
9,001 10,000 119.70 -14.36 47.88 181.94
10,001 11,000 126.85 15.22 50.74 192.81
11,001 . 12,000 134.00 16.08. 53.60 203.68
12,001 13,000 141.15 16.94 56.46 214.55
13,001 14,000 148.30 17.80 59.32 225.42
14,001 15,000 155.45 18.65 62.18 236.28
15,001 16,000 162.60 19.51 65.04 247.15
16,001 17,000 169.75 20.37 67.90 258.02
17,001 18,000 176.90 21.23 70.76 268.89
18,001 19,000 184.05 22.09 73.62 279.76
19,001 20,000 191.20 22.94 76.48 290.62
20,001 21,000 198.35 • 23.80 79.34 301.49
21,001 22,000 205.50 24.66 82.20 312.36
22,001 23,000 212.65 25.52 85.06 323.23
23,001 24,000 219:80 26.38 87.92 334.10
24,001 25,000 226.95 27.23 . 90.78 344.96 ,
25,001 26,000 232.54 • ' 27.90 93.02 353.46
26,001 27,000 238.13 28.58 95.25 361.96
•
27,001 28,000 243.72 29.25 • 97.49 370.46
28,001 29,000 249.31 29.92 99.72 378.95
29,001 30,000 254.90 30.59 101.96 387.45
30,001 31,000 260.49 31.26 104.20 395.95
31,001 32,000 266.08 31.93 106.43 404.44
32,001 33,000 271.67 32.60 108.67 412.94
33,001 34,000 277.26 .33.27 110.90 . 421.43
34,001 35,000 282.85 33.94 113.14 429.93
35,001 .36,000 288.44 34.61 115.38 438.43
36,001 37,000 294.03 35.28 117.61 446.92
37,001 38,000 299.62 35.95 119.85 455.42
- 38,001 39,000 305.21 36.63 122.08 463.92
39,001 40,000 310.80 37.30 124.32 472.42
40,001 41,000 . 316.39 37.97 126.56 480.92
41,001 42,000 321.98 38.64 128.79 489.41 .
42,001 43,000 . 327.57 39.31 131.03 497.91
43,001 44,000 333.16 39.98 133.26 506.40
44,001 45,000 338.75 40.65 - 135.50 .. ... '. - 514.90
45,001 46,000 344.34 41.32 137.74 523.40
46,001 47,000 349.93 41.99 - .. 139.97 531.89
47,001 48,000 355.52 42.66 142.21 540.39
48,001 49,000 361.11 - 43.33 144.44 548.88
49,001 50,000 366.70 - 44.00 • 146.68 ' 557.38
.....„..... ,
. 0
.I AFP SYSTEMS, INC. _ R EC" ,"
c'P :. . - AUTOMATIC FIRE PROTECTION
o� y � =�� s 19435 S.W. 129th Avenue
Tualatin. OR 97062 JUN 2 1 2012
• (503) 692 -92$4 /� OF
"'- ao� FAX (503) 692 -1186 CITY OF TIGAR�
i ID
. .. Fed. Tax 3.1011903 • BUILDING DIVISION
TRANSMfl TAL
To: City of Tigard Date: 06/21/12
13125 SW Hall Blvd Submittal #:
Tigard, Oregon 97223 Project: Albertina Kerr
Project #: 1213 1Zdgo
From: Wes Jones
ITEMS TRANSMITTED VIA
US Mail Fax •
X _Hand Delivered Overnight Service
Description:
2 sets of stamped Plans & Calcs, Product data, Application
•
REASONS TRANSMITTED Remarks:
Sign, Date
X For Your Approval -
For your Use
For your Information •
,As Requested
X Please Review & Approve
ADDITIONAL REMARKS
•
•
•
•