Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
q
Is. _ COMMUNITY DEVELOPMENT Permit #: FPS2009 -00004
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/11/2009
Parcel: 2S113AB00300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 175
Subdivision: Lot: 0
Project: Key Realty
Project Description: Install (14) new sprinkler heads
Owner: FEES
OREGON STATE BAR, THE Description Date Amount
16037 SW UPPER BOONES FERRY RD
Permit Fee - COM 03/11/2009 $62.50
TIGARD, OR 97224
Tax - 12% State Surcharge 03/11/2009 $7.50
PHONE Plan Review - Fire Life Safety - COM 03/11/2009 $25 00
Contractor:
BLACKWATER FIRE SUPPRESSION
49630 SE HWY 26
SANDY, OR 97055
PHONE: 503 - 826 -1084
FAX: 503- 746 -5478
Type of Use: COM
Class of Work: FPS Type of Const: IIB
Occupancy Grp: B Height: ft
Stories: 3
Commercial Sprinkler System:
Sprinkler Required Yes Sprinkler Type: Wet
Standpipe Required Hazard: LT
Density: .20 Design Area 1500
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 $95.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 1716
Residential Square Footage: 0
Fire Alarm Valuation 0
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344
Issued By: Permittee Signature: /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
4 .�
BiiildiiPP Permit Application R E C EQVE Fire Protection System FOR OFFICE USE ONLY -.
City of Tigard MAR 0 3 2009 Date /131 • 3 • o q Permit No fi �„ ..
131 SW W Hall Blvd., Tigard, OR 97223 Plan Review �� �
_ Phone. 503.639.4171 Fax' 503 598 li Pl Re i iJdiei Pang TIGA RD Inspection Line 503 639.4175 CITY OF TIGARD Date Ready/By a See Page 2 for
Internet: www.ttgard- or.gov BUILDING DIVISION Notified/Method &TM Supplemental Information
, TYPE WORE: . - - REQUIRED DATA: 1- AND 2- FAMILY 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
® Addition /alteration /replacement ❑ Other equipment, materials, labor, overhead, and the profit for the
- CATEGORY OF OF CONSTRUCTION ' - .. - - work indicated on this application
Valuation $
❑ I- and 2 -family dwelling ® Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms'
❑ Master builder ❑ Other Number of bathrooms.
- . JOB SITE INFORMATION AND LOCATION . 'Iota' number of floors
Job site address. 16037 SW Upper Boones Ferry Rd t 75 New dwelling area. square feet
City /State /ZIP. Tigard. OR 97224 Garage /carport area square feet
Suite/bldg. /apt no. I Project name: Key Realty Covered porch area' square feet
Cross street/directions to job site. Deck area• square feet
SW Upper Boones Ferry FP SW 72"d Avenue 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.
Revise existing Fire protection system to Install 14 new pendent sprinklers Valuation. $1716.00
below new acoustic ceiling. Existing building area: square feet
New building area. square feet
❑'PROPERTY -OW1 ER . I ❑:TENANT -, - ' Number of stories:
Name Type of construction:
Address. Occupancy groups.
City /State /ZIP: Existing:
Phone: ( ) Fax: ( ) New:
® APPLICANTS` - .0 CONTACT; P - NOTICE
Business name Blackwater Fire Suppression, LLC All contractors and subcontractors are required to be
Contact name. Marc Walter licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address 4 %30 SE Highway 26 junsdiction in which work is being performed. If the
City /State /ZIP: Sandy, OR 97055 applicant is exempt from licensing, the following reasons
apply
Phone: (5113) 826 -1084 Fax. ' (513) 746 -5478
E -mail blackwatertire' yahoo.com
CONTRACTOR- - BUILDING PERMIT. FEES'
Business name Blackwater Fire Suppression, LLC (Plrnse refer ro fee nhedxle1
Permit tee ( 2 F
Address. 49630 SE Highway 26 �F
City/State/ZIP: Sandy. OR 97055 State surcharge (12% of permit fee): 7.50
FLS plan review (40% of permit fee)'
Phone' (503) 826 -1084 Fax (503) 746 -5478 (Due upon application.) 2 5 -o0
CCB he 1132606 ee a / 0 Total permit fees 95. 00
!(( Amount received:
Authorized signat
This permit application expires if a permit is not obtained
I Print name: Marc Walter I Date 03/02/2009 within 180days after It has been accepted as complete.
• Fee methodology set by In-County Building Industry
Service Board
I \Bmmhee'Pomiu'FPS- PermaApp dot. 03/23/06 440-4613T( 11/03/tOM/WEB) q-7 t g- C 3 O C 4-0
Q o a r rl
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 ❑ 1 -10 heads: No plan review required.
Z Alteration ® 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: 14.
Additional description of work:
' Type -of System (Coimple,te A B _C or D as - applicable):. - . - .. . .
A.) Commercial Sprinkler
Z Wet ❑ Dry
Additional Standpipes 0
Information: Hazard Group Light
Density .10
Design Area 1500
K. Factor 5.6
Sprinkler Project Valuation: $ 1716.00
- B.) Type °I - Hood - Fire Suppression System - _ - .
Flood Project Valuation: I $ 0
C.) Fire Alarm - - ' '
Submittal shall Battery Calculations ❑ Yes
include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: - $ 0
D.) Residential Sprinkler, (Staid'Alone'System)
Square Footage: Permit Fee:
0 to 2,000 $187.50 _
2,001 to 3,600 $232.50
3,601 to 7, $292.50 - _ •
_ 7,201 and greater - $381.50
Sprinkler Project Square Footage: sq. ft.
- - ,= ;,. - ue Protection-Permit: ees ....:::... .....
Project valuation subtotal (see A, B & C above): $ 1716
Permit fee based on project valuation (see fee schedule): $ 62.50
Permit fee based on square footage (see D above): $ 0
State Surcharge (12% of permit fee): $ 7.50
FLS Plan Review (40% of permit fee): $ 25.00
TOTAL: $ 95.00
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.
C fn ea cad \dwgl'•,Blackwatet' Folder ',09-018 Zip Realty\Zip Realty Pentut.doc7